All dentists dread the phone call on a Monday morning, saying one of their patients has suffered dental trauma over the weekend. We, three Dental Core Trainees (DCTs) in Glasgow, have each encountered this situation in our Oral and Maxillofacial surgery, Paediatrics, Restorative and Oral Surgery departments.
As DCT dentists working within the secondary care system, we often see the impact of dental trauma on the quality of life and self-esteem of patients. On numerous occasions we have been required to break the bad news regarding loss of a poor prognosis front tooth following traumatic dental injury.
Delayed traumatic dental injury management often leads to more severe complications and potential tooth loss. This may lead to time and financial costs, for patients and the NHS and often results in increased complexity of treatment. This puts yet more pressure on sparse NHS resources, and often means referral to secondary care is necessary.
We know that high-risk sports are often the cause of traumatic dental injuries.
We wanted to find a solution to encourage prevention and we have worked to educate sports people to wear a customised mouth guard – with our advice called 'No mouthguard No play!'
The first four minutes following injury to teeth is critical to a patient's outcome – so the actions of the first responder is critical. So, the aim of our project was simple: provide education on the prevention and management of dental trauma for high-risks groups.
We decided to put together a training package to take out to the community, with the support of Beth Burns, Consultant in Restorative Dentistry and Scottish National Representative of Dental Trauma UK.
Our project is called it 'It's a Knock Out', and focused on Higher Physical Education and Sports Leadership pupils within Glasgow High Schools, local Sports Team Managers, Scouting and Guiding Leaders.
We started by contacting our key demographic. The response was overwhelmingly positive. We arranged 30-minute workshops where we targeted those who were deemed high risk, with our main focus being on the importance of prevention of dental trauma.
We provided a short presentation including videos from Dental Trauma UK demonstrating how to replace an avulsed tooth at time of injury for non-dental groups.
The presentation started with prevention - covering the importance of mouth guards for both training and matches. We discussed the different types of mouthguards and why customised mouth guards were superior.
The gory photos of trauma were the best received by the audience and helped the message resonate.
We then moved onto Dental Trauma UK's Pick It – Lick It – Stick It Campaign which provided handy posters and pitch side How-To Sheets for First Aid boxes.
During this training we also wanted to make sure participants knew how to provide immediate first aid should a tooth be avulsed.
We then ran a practical session, with audience participation: we tasked them with replanting an avulsed "tooth" on dental typodonts. We aimed to make these workshops fun and interactive with lots of opportunities to ask question and participants really seemed to enjoy getting hands-on
Collectively, our previous experiences, and pre-workshop questionnaires demonstrated a lack of emphasis on customised mouth guard use for prevention amongst high risks groups both during training and games. This cemented the idea that we needed to expand the project outside of Glasgow.
How can dentists get involved?
Going forward, we have made links in Aberdeen, Edinburgh and Ireland. We have recruited fellow DCTS in these areas, and we are always looking for more volunteers! Please get in touch if you'd like to take part or talk to us about this project.
We also want to encourage high-street dentists to engage with their patients and local communities on prevention and immediate management of an avulsion injury.
We ask our GDP colleagues to incorporate a question regarding high risk sport participation on patient's social history forms and ensure that appropriate advice regarding mouthguard use is given to these patients.
High-street dental practices can also join DTUK, support us, and make use of the excellent patient and professional education resources that are available, including patient leaflets on mouthguard usage and the 'Pick it - Lick it - Stick it' posters for display in waiting rooms.
Victoria Cave DCT
Beth Burns, Restorative Consultant
Emma O'Donnell DCT
Niamh McGrath DCT
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