**9. Conclusion**

The research of published data suggests that there is a lack of proper knowledge on emergency dental first-aid among the parents, care givers, school authority and general public. In most of the countries worldwide, no attempt has been made by the government or other dental organizations to educate people on the management of dental trauma. TDI's are an important general and public health issue and public awareness of its importance should be bolstered to enable equitable access for injury care. Greater emphasis on prevention and the significance of emergency care for dental injuries will reduce the financial burden of the individual and improve the quality of life [6].

Research conducted to assess the treatment and management of TDI's have shown that the treatments provided at emergency care units are often inadequate and patients remain unsatisfied with care provided. The International Association of Dental Traumatology (IADT) has given a comprehensive guidelines management of TDI's, which can be accessed via Internet (www.iadt-dentaltrauma.org) [38]. The IADT recently developed a core outcome set (COS) for traumatic dental injuries (TDI) in children and adults, these guidelines should be followed and, even in extreme situations, replantation of teeth should always be considered [39]. Interactive website has been introduced for clinicians (Dental Trauma Guide, www. dentaltraumaguide.org) which can be used by dentist and health care workers either via computer or smart phone during a trauma situation [40]. Mobile phone based free App was introduced by IADT (IADT ToothSOS Mobile App) to help user to take care of a dental trauma at the scene of an accident.

Dental injuries cause both periodontal and pulpal complications. The delay in dental consultation for TDI's increases the amount of complications that develop later during the maintenance. Time lapse between the TDI's and the date of dental consultation is a decisive element in the therapeutic choice and influences the prognosis [5]. The parents and individuals should be educated to consult a dentist immediately after trauma and take prompt treatment for the TDI's to reduce the complications that develop at the later date.

There is need for refinement of dental curriculum for the management of TDI's in terms of design, content, teaching methodology and long term maintenance for better prognosis of the patients with dental trauma [41].

The prevalence of TDI's in Europe and many other continents is one in five school going children and if untreated they affect the quality of life of children. The environment of the school and action taken towards management of TDI's is very crucial. Schools with supportive social and physical environment have fewer occurrences of TDI's. Schools should adopt health and safety policies, improvements in the physical environment and closer supervision of children while playing will reduce the occurrence of TDI's [42]. School teachers and physical instructors should be educated about emergency management of TDI's and consult child specialist and dentist at the earliest to lessen post traumatic complications. Studies have pointed out that health promotion policies, safe environment at the schools, correction of predisposing risk factors of TDI's and use of protective intraoral and extra oral devices while physical activity will lessen the financial burden caused by TDI's [43]. Conducting health educational programs to improve the level of general knowledge about prevention and managing TDI's at the schools is necessary [44].

Parents, Education authorities, and children involved with sports and recreation activities should be educated about the risk factors involved and management of TDI's. Screening programs to identify children with high anatomic (incisal over jet and inadequate lip coverage) and behavioral risk for occurrence of traumatic injury and necessary corrective measures (preventive orthodontic treatment and use

*Short and Long Term Oral Hygiene Maintenance Protocols for Traumatic Dental Injuries DOI: http://dx.doi.org/10.5772/intechopen.96043*

of Mouth guards) will help reduce the occurrence of injury among children [45]. Mounting posters, leaflets at public places along with media campaigns using television, social networking sites and internet will educate people for managing avulsed permanent teeth [1]. The teachers and school management should be educated about TDIs and emergency care and referral to dentist as schools with good physical structures and promote health activities had lesser prevalence of TDIs [46, 47].

The dentist treating TDIs must involve other specialists including Oral Radiologist, Pediatrician, Paedodontist, Endodontist, Periodontist, Prosthodontist, Orthodontist and Oral maxillofacial Surgeon. Dentist must capture good quality photographs of the TDIs and lesions and can use them to discuss the treatment protocol with specialists. Studies have proved that photographic assessment method of dental trauma was valid and reliable as compared to the oral clinical examination [48].

Dentist must be aware of different types of TDIs and its immediate treatments [49]. Dentist should educate good oral hygiene maintenance techniques to the patients suffering from TDIs. During the healing and splinting of teeth, oral hygiene cleaning with interdental brushes will help the patients.

Complications even with the best of treatment guidelines followed occur occasionally and pulp necrosis is the most observed complication [12]. Dentist must refer the patient to other specialists whenever deemed necessary. Combined efforts of different specialists will improve the prognosis of the teeth and soft tissues.
