Physical Examination and Diagnosis

  • Rebecca L. Slayton
  • Elizabeth A. Palmer


Although there is a sense of urgency when a child presents to the dental office or emergency department with a traumatic dental injury, it is essential that thorough documentation is made of the event, treatment, and follow-up. It is recommended that a trauma assessment form be used to provide consistency and to minimize the risk of missing vital information. Often, the injury may result in litigation at a later date, so having detailed documentation of the accident, the clinical findings, and the treatment recommendations is critical. Whenever possible, clinical photographs and radiographs should be made to aid in the documentation of the injury. Early in the assessment, the dentist must determine if the injuries are serious enough to warrant referral to the emergency department. This is done by completing a neurologic evaluation of each of the cranial nerves. For young children or children with developmental disabilities, the child’s reaction may be difficult to assess.


Dental trauma Pediatric Special needs Neurologic evaluation Informed consent Trauma guidelines 


  1. 1.
    Andreasen FM, Andreasen JO. Diagnosis of luxation injuries: the importance of standardized clinical, radiographic and photographic techniques in clinical investigations. Endod Dent Traumatol. 1985;5:160–9.CrossRefGoogle Scholar
  2. 2.
    Bakland LK, Andreasen JO. Examination of the dentally traumatized patient. J Calif Dent Assoc. 1996;24:35–44.PubMedGoogle Scholar
  3. 3.
    Andreasen FM, Andreasen JO, Tsukiboshi M, Cohenca N. Examination and diagnosis of dental injuries. In: Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth. 5th ed. Hoboken: Wiley-Blackwell; 2019. p. 295–326.Google Scholar
  4. 4.
    Andreasen JO, editor. The dental trauma guide. San Diego: International Association of Dental Traumatology; 2012. Accessed 18 May 2019.Google Scholar
  5. 5.
    American Academy of Pediatric Dentistry. Assessment of acute traumatic injuries. In: Pediatric dentistry reference manual, Vol. 40, No. 6. 2018–2019. Accessed 18 May 2019.
  6. 6.
    Kopel HM, Johnson R. Examination and neurologic assessment of children with oro-facial trauma. Endod Dent Traumatol. 1985;1:155–9.CrossRefGoogle Scholar
  7. 7.
    Glasgow Coma Scale. Institute of Neurological Sciences NHS Greater Glasgow and Clyde. Accessed 18 May 2019.
  8. 8.
    Croll TP, Brooks EB, Schut L, Laurent JP. Rapid neurologic assessment and initial management for the patient with traumatic dental injuries. J Am Dent Assoc. 1980;100:530–4.CrossRefGoogle Scholar
  9. 9.
    Davis MJ. Orofacial trauma management. Patient assessment and documentation. N Y State Dent J. 1995;62:93–6.Google Scholar
  10. 10.
    Tubbs RS, Shoja MM, Loukas M, Oakes WJ, Cohen-Gadol A. William Henry Battle and Battle’s sign: mastoid ecchymosis as an indicator of basilar skull fracture. J Neurosurg. 2010;112:186–8.CrossRefGoogle Scholar
  11. 11.
    Herbella FA, Mudo M, Delmonti C, Braga FM, Del Grande JC. ‘Raccoon eyes’ (periorbital haematoma) as a sign of skull base fracture. Injury. 2001;32:745–7.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Rebecca L. Slayton
    • 1
  • Elizabeth A. Palmer
    • 2
  1. 1.Department of Pediatric DentistryUniversity of Washington School of DentistrySeattleUSA
  2. 2.Department of Pediatric DentistryOregon Health & Science University School of DentistryPortlandUSA

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