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May 26, 2009 | DentalProductsReport.com Exclusive
STAFF

Can your office handle a traumatic injury?

Make sure your staff is ready for that phone call.

by Renee Knight

A frantic parent calls your office. Little Johnny fell off the monkey bars and managed to knock out one of his teeth. He’s crying and in pain, and mom doesn’t know what to do.

When that call comes in, whoever answers the phone needs to know how to handle it. And when the patient gets to your office, you need to be ready to fix the problem as quickly as possible. To make that happen, both you and your staff need to have a plan in place to handle traumatic dental injuries.

It’s usually children

30%of the population will have some form of injury to their teeth during their lifetime.

Why are traumatic dental injuries more common in children?

Children between the ages of 8 and 13 are learning many different things, from how to ride a bike to how to play football, Dr. Leif K. Bakland said. They play more than adults and have less fear, leading to more injuries.

You’ll see most of these injuries, from crown fractures to avulsed teeth, in children between 8 and 13 years old, said Dr. Leif K. Bakland, Ronald E. Buell Professor of Endodontics at Loma Linda University. Sure, every now and then an adult will chip a tooth after a fight or wrecking on a bike, but typically when you see a displaced or fractured tooth you’ll be looking at a child.

“This has advantages and disadvantages,” Dr. Bakland said. “The advantage is the teeth have pulps or nerves that have a better chance of recovering than an adult’s. The disadvantage is if we end up with death of a pulp, then that will stop the development of the tooth. So a person may end up with a tooth not fully developed and more prone to fracture.”

It starts with the front office

Common traumatic dental injuries:

Chipped or fractured teeth. Most chipped or fractured crowns can be repaired by reattaching the broken piece or by placing a tooth-colored filling. If the pulp is exposed or fractured, root canal treatment may be necessary, making it important to follow up with your patient.

Dislodged teeth. When an injury happens, a tooth may be pushed sideways out of or into its socket. If the tooth is permanent, root canal treatment is usually needed.

Avulsed teeth. If a tooth is knocked out, it’s important for your patients to know time is critical. The tooth should be handled gently, and patients should avoid touching the tooth surface itself. Make sure patients know they can rinse the tooth in water, but they shouldn’t use soap or any other cleaning agent, and they shouldn’t scrape or brush the tooth.

Root fracture. When a traumatic dental injury happens, it could also lead to a horizontal root fracture. If the fracture is close to the root tip, it’s much easier to treat successfully. But if it’s close to the gum line, chances for long-term success go down. This may require stabilization with a splint.

Source: American Association of Endodontics

Before you can do your part to help ease your patient’s pain and save the tooth long-term, your front office staff has to do their job, said Bakland, who is also the Executive Director of the International Association of Dental Traumatology. Anyone who answers the phone needs to know how to handle one of these calls. What happened, when and where are key pieces of information that will help you get a feel for how urgent the situation is.

“It’s almost like a 911 call,” Dr. Bakland said. “People who call in are parents or people taking care of children, and they will be frantic about what has happened. It’s important for front office personnel to ask the right questions and to be prepared to give advice to the person who is calling.”

And that isn’t as simple as saying get here as soon as possible, Bakland said. If you’re dealing with a broken tooth, tell the caller to look for the part that broke off, put it in water and bring it to the office. Your patients may not realize there’s a good chance you can bond it back to the tooth. If the tooth has been knocked out, encourage the patient to find the tooth, rinse it off with water and place it back into the socket. This could be a bit off putting to the patient, and if that’s the case, your staff member should suggest putting it in milk.

“That will give the tooth a better chance of taking after it gets put back into the socket,” Dr. Bakland said. “If you can get it put back into the socket in a few hours and it’s been kept in milk, there’s a good chance of it actually taking and returning to normal.”

Once they arrive

When the patient finally gets to the office, don’t leave him or her sitting in the waiting room, Dr. Bakland said. The patient will be in pain, maybe even bloody, and will probably feel uncomfortable sitting with your other patients. Take the patient to an operatory or a separate room.

Once there, ask the patient the same questions he or she was asked over the phone—when, where and how did this happen. Make sure this information is recorded in the patient’s chart, because it will likely be needed for insurance purposes. When all this is recorded, don’t waste any time getting to work on the patient.

Don’t worry about payment

Emergency appointments can’t be planned or scheduled, and when a patient comes to you in pain, there’s not much time to talk about fees, Dr. Bakland said. Save this discussion for after you’ve treated the problem.

“Many times it’s important to get going on a procedure as quickly as possible,” Dr. Bakland said. “It probably comes down to individual judgment, but the emergency part takes precedence. Then sit down and discuss what has been done, what needs to be done and what the cost is.”

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