**1. Introduction**

Trauma to the hard and soft tissues occurs when a subject undergoes injuries due to motor vehicle accidents, physical fights; self-infested wounds, assaults, bicycle accidents or while playing sports. Other reasons of traumatic injury can be domestic abuse in adults and child abuse in children. Anterior teeth in both primary and permanent dentition are most commonly affected by dental trauma. Primary and permanent anterior teeth are not only important for esthetics but also essential for phonetics, mastication, integrity of supporting tissues, psychological and mental wellbeing [1]. Traumatic injuries are part of the growing up years and can have ever lasting wounds with scarring on the affected individuals. Dental trauma refers to injury to the oral and perioral structures i.e. teeth (enamel, dentin, pulp and cementum), gums, periodontal ligament, alveolar bone and also involves

nearby soft tissues around the teeth such as the lips, tongue, etc. Traumatic dental injuries (TDI's) are part of body injury and occur frequently in children and young adults accounting to 5% of all the bodily injuries [2]. School going children up to 25% experience dental trauma and 33% of adult's less than 19 years of age have permanent dentition trauma [3]. Incisor teeth both in maxilla and mandible are the most commonly affected teeth with highest incidence in maxillary central incisors. A prospective study in 2017 found that among patients with maxillofacial fractures, 41.8% of them had concomitant dental injuries of two or more teeth [4]. Immediate care, appropriate diagnosis and treatment with comprehensive follow-up are essential for a favorable prognosis of the affected teeth.

Dental treatment of TDI's is usually delayed and not given as much attention as general medical treatment. Immediate dental consultation and treatment could improve long-term prognosis of the injured teeth [5]. Timing of the dental care rendered to patient who have undergone trauma is critical in management and saving of the teeth. Dentist must have the essential knowledge regarding the management of patients with trauma especially during the emergency phase of treatment. Appropriate management of patients with dental trauma requires coordinated efforts of different specialties including general dentists, oral radiologist, pediatric dentist, periodontist, oral surgeon and endodontist. Team efforts involving these different specialists will help the patient to receive successful long term outcome.

When a subject undergoes a traumatic incident, he or she is mentally disturbed and may tend to get disoriented with time and space. The person with dental trauma will experience difficulty in maintaining daily oral hygiene and this leads to dental plaque accumulation. The neglect of oral hygiene during and after dental trauma will lead to gingivitis which if untreated may lead to periodontitis and tooth loss. Studies have also shown that Oral Health-Related Quality of Life (OHRQoL) is affected by TDI's and it negatively impacts on the OHRQoL of children and their families [6]. It is imperative that oral hygiene standards are maintained during and post dental trauma for the long term survival of teeth with dental trauma. Twice daily brushing with soft bristled manual brush or electric toothbrush with toothpaste, interdental cleaning with dental floss or interdental brush and use of mouth rinse every day is apt to keep the teeth and mouth clean. Dentist must educate about oral hygiene maintenance and special instructions to be followed during TDI's to patients.
