Preface

This book focuses on dental trauma and oral conditions that significantly impact patients' well-being if not treated effectively and efficiently, including, for example, chronic periodontal disease and cysts. It is written by renowned global dental specialists with vast experience and high levels of expertise in their own areas. Concepts of dental trauma and other oral conditions are reviewed, with management techniques providing practical support for clinicians. Dental emergencies and accompanying dental trauma, with the issues associated with their management, are covered. The importance of teledentistry in the current climate of digital technologies is also highlighted.

The book opens with a chapter on dental emergencies and conditions that need prompt treatment. Dental emergencies such as injury to the hard tissue and soft tissues (teeth or gingiva) are potentially serious and should not be ignored. Ignoring a dental problem may increase the risk of permanent damage to the hard and soft tissue structures, as well as more extensive and expensive treatment to correct the problem at a later stage.

Chapter 2 covers the early management of dental trauma during COVID-19, noting how the lack of guidelines potentially promoted the spread of nosocomial COVID-19 through oral healthcare facilities, whilst simultaneously denying people in need of immediate treatment. Moreover, the cessation of dental care provision during this period actually increased the burden on hospital emergency departments that were already struggling with the pandemic. The chapter combines local guidelines and experience with a proposed algorithm for the early management of dental trauma during a pandemic.

Chapter 3 focuses on decision-making in dental traumatology when there are fractures involved, highlighting the need for detailed examinations in all such cases. A complete radiographic examination is essential in order to assess the state of the pulp, the degree of root development and the existence of any pathologies affecting the supporting tissues. This will serve to ensure that the patient receives comprehensive and holistic treatment and management.

Chapter 4 on teeth avulsion describes the significant amount of force that is required for the avulsion of a tooth. Replantation is the treatment of choice, and time management and appropriate storage of the avulsed tooth is crucial to a good prognosis. The chapter highlights the importance of a proper diagnosis and treatment strategy for a successful outcome.

In Chapter 5, there is a discussion of the splinting of traumatized teeth and other management techniques that favour the patient in terms of acceptance of the long procedures that accompany dental trauma and other chronic oral conditions. The full dental team is key in dental trauma situations, as they are often the first point of care. Dental hygienists are key members of the emergency treatment team, contributing to the success of subsequent endodontic or restorative procedures in cases of dental trauma.

Orbital trauma entailing diverse mechanisms of injury and subsequent fracture patterns which may result in both functional and aesthetic problems is covered in Chapter 6. The suggested surgical approaches to the orbit show that regardless of how complex the fracture is, the principles of anatomic reduction, atraumatic technique and stable fixation apply to all cases. The chapter discusses the use of titanium mesh as an appropriate reconstructive material and compares this method with conventional reconstruction techniques.

Chapter 7 describes trauma from occlusion and its management. Occlusal instability is a clinical finding often ignored by general dentists; however, establishing the cause is key, since treatment is often only directed towards the effects. Thorough evaluation and occlusal analysis will lead to a definitive diagnosis that will help better anticipate the damage.

 The impact of dental and orofacial trauma on oral health-related quality of life (OHRQoL) in children and adolescents is the subject of Chapter 8. OHRQoL is described in the literature as an essential part of a person's general health and overall well-being.

Chapter 9 examines new instruments that can be used to assess dental trauma impacts in young children. The psycho-social impacts of dental trauma cannot be underestimated and are an important aspect of patient management. The negative psychological effect of traumatic dental injuries is specific to an individual, and as such it is suggested that each patient should be treated holistically with all factors being taken into account.

Chapter 10 discusses injury to the periodontal tissues which includes microbial, physical, thermal, chemical, mechanical, occlusal and habitual injury which may impact the harmony of the periodontal attachment apparatus, altering the entire functioning of the dentition. When trauma is unintentional and iatrogenic, the type of tissue damage is described as acute and self-limiting. The chapter reviews the various forms of non-microbial trauma to the periodontal tissues, their clinical manifestations and appropriate management.

Antioxidants, increasingly needed as adjuncts to periodontal therapy to maintain the balance with reactive oxygen species, are discussed in detail in Chapter 11. The chapter presents new possibilities based on recent studies that have used different antioxidants as supplements to conventional periodontal therapy.

In Chapter 12, we discuss the management of periodontal emergencies during the COVID-19 pandemic. Most periodontal treatment is more dangerous work than other dental procedures due to bioaerosol generation. Transmission can occur through direct doctor-patient contact, as well as through contamination from instruments or surfaces in the dentist's surgery. This chapter offers advice for clinicians on how to approach such situations.

Salivary duct cysts, discussed in Chapter 13, are described as true cysts caused by obstruction of salivary ducts. They are rarely found in minor salivary glands. Intraoral salivary duct cysts and mucoceles represent clinically salivary gland neoplasms, making diagnosis difficult and subject to errors in treatment. It is further shown within this chapter why it is important for oral surgeons to include salivary duct cysts in the differential diagnosis of swelling affecting the buccal mucosa.

The pandemic has had a significant impact on dentistry and pushed us to the forefront of the digital era. An aspect of telehealth, teledentistry involves the exchange of clinical details and relevant imaging over remote distances for consultation and treatment planning. An innovative approach, it can reach more people who may lack access to care. Chapter 14, on teledentistry, highlights important points for both current and future consideration and research.

We hope this book will provide the reader with much useful knowledge.

**Aneesa Moolla** Lecturer, University of Witwatersrand, Johannesburg, South Africa

Principal Researcher, Health Economics and Epidemiology Research Office, Johannesburg, South Africa
