**3.1 Emergency phase**

When a patient with trauma arrives at the dental clinic, certain necessary actions have to be taken to start the treatment. Proper history of the etiology of the injury preferably in a structured checklist will be beneficial. The dentist can follow these steps for treating patients with dental trauma.


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


### **3.2 Immediate follow-up phase**

During the subsequent visits after three days, dentist should evaluate healing of the primary lesions and occlusion of teeth should be checked for any discrepancies. Sensitivity tests should be carried out on all teeth with trauma and the opposing teeth. Cold testing is recommended over electric pulp testing in young patients. The pulp test has to be carried out during the follow-up visits as the teeth with trauma are nonresponsive for several weeks. Dentist should help achieve complete healing of soft and hard tissue structures. Healing complications are more common in teeth with vertical fracture of teeth, trauma in supporting tissues and avulsion. Complications usually occur in the first three months and necrotic pulp was the most common complication [23].

#### **3.3 Restorative phase**

The Restorative phase should include restoration of fractured and decayed teeth. Fractured teeth have to be carefully examined, for type and extent of the fracture and the need for endodontic and periodontal treatments. A multidisciplinary approach will improve the prognosis of the teeth. Non-surgical periodontal therapy (NSPT) including scaling, root planing, patient education and local drug delivery should be carried out, to keep the tissues in healthy state. Dentist must observe the gums for any inflammation and periodontal examination for periodontitis and check for ulcers or irritation due to prosthetic appliances.

## **3.4 Rehabilitation phase**

Rehabilitation phase includes occlusal corrections with orthodontic tooth movement. Psychological counseling among children will help children to overcome and forget traumatic events of TDI's. Patient should be educated and motivated to maintain healthy teeth, gums and periodontium for long term rehabilitation.

#### **3.5 Maintenance phase**

Maintenance phase or oral hygiene phase should be carried out during all the phases of treatment of TDI's. Regular oral hygiene maintenance with either manual or powered toothbrush should be started in immediate follow-up phase and maintained throughout life. Brushing twice daily once early morning and once before going to bed is best advised. The interdental areas between the teeth should be kept clean with appropriate interdental cleaning aids. Mouthwashes should be routinely used to maintain the overall health of oral structures like teeth, gums, periodontium, oral mucosa and tongue.

Regular visit to the dentist for periodic checkup and examination should be followed by the patients who experienced TDI's. Dentists must keep the patients with TDI's on maintenance therapy for regular interaction and follow-ups.
