Trauma to the Permanent Maxillary Incisors in the Mixed Dentition and Orthodontics

Dentoalveolar trauma to the permanent maxillary incisors is a relatively common occurrence in young children. The extent of the injury can be variable but can have significant emotional, social and financial implications to both the child and their parents in both the short and long term. Management of traumatised permanent maxillary incisors in the mixed dentition requires long-term monitoring of both pulp vitality and root development. Although comprehensive orthodontic treatment may not be immediately required, early interceptive management of a malocclusion characterised by an increased overjet may be indicated to reduce the risk of trauma or further trauma to the permanent maxillary incisors beyond the mixed dentition stage of development. If orthodontic treatment is to be considered in these cases, then a team approach involving general dental practitioners, restorative, orthodontic specialists and paediatric dentists is advocated. To prevent trauma to the permanent maxillary incisors in young children, education of children and their parents is vital. The use of custom mouthguards in patients at risk of trauma to the permanent maxillary incisors is recommended.