Immediate Management of Dislodged Teeth in Intubated Trauma Patients

Imaging and Localization Strategy

• Obtain chest radiograph immediately if the patient displays any breathing difficulties or if teeth remain unaccounted for, to rule out aspiration into the tracheobronchial tree, as recommended by the American Academy of Pediatrics 1, 2
• Perform intraoral radiography if available to confirm tooth location or rule out intrusion into alveolar bone, according to the American Academy of Pediatrics 1, 3

Management of Remaining Dental Injuries

• Remove any severely mobile tooth fragments that cannot be stabilized, as these pose continued aspiration hazard in the intubated patient, as suggested by the American Academy of Pediatrics 1, 2

Ongoing Monitoring

• Arrange dental consultation once the patient is stabilized for definitive management of remaining dental injuries and assessment for permanent tooth damage, as recommended by the American Academy of Pediatrics 1, 4
• Consider antibiotic coverage if there is concern for contamination from oral flora, though this is not routinely indicated for uncomplicated dental trauma, according to the American Academy of Pediatrics 4