Dentoalveolar Trauma Assessment & Management Protocol
Classify and manage acute dentoalveolar trauma with evidence-based protocols
What You Can Do
You can systematically assess acute dentoalveolar injuries using structured frameworks that classify fracture types, luxation stages, and avulsion status. The skill guides you through rapid determination of urgency tiers, identifies associated injuries requiring coordination with other specialties, and establishes evidence-based treatment timelines—all while generating standardized documentation for medico-legal purposes.
Features
Ellis classification for crown fractures, luxation staging (subluxation, extrusion, intrusion, lateral), and avulsion status assessment
Determines priority interventions and stabilization requirements based on tissue viability and systemic involvement
Systematic evaluation for alveolar bone fractures, root fractures, soft tissue lacerations, and TMJ involvement
Evidence-based sequencing for splinting, repositioning, endodontic intervention, and follow-up assessment intervals
Standardized injury documentation, photographic guidelines, and consent templates for complex cases
Identifies referral needs and communication points with emergency medicine, general dentistry, orthodontics, and prosthodontics
Protocols for managing tooth viability assessment in cases presenting >72 hours post-injury
Structured algorithms for mandibular vs. maxillary trauma, pediatric vs. adult considerations, and primary vs. permanent dentition
Example Output
Example 1: Acute Avulsion
Presentation: 8-year-old with #8 (maxillary right central) avulsed 45 minutes prior; tooth found by parent, rinsed under tap water, stored in tissue
Urgency Tier: IMMEDIATE (T0)
Viability Window: 45 minutes elapsed, 45-120 minutes optimal for replantation
Immediate Steps:
✓ Handle tooth by crown only; minimal manipulation
✓ Transport to clinic in 0.9% saline or milk (reimburse parent for storage medium if necessary)
✓ Intraoral inspection: No alveolar fracture; socket integrity intact
✓ Replantation with repositioning splint (passive flexible type)
✓ Antibiotic prophylaxis + tetanus status verification
✓ Radiographs: PA, lateral, occlusal to confirm position
Follow-up: 2 weeks (splint removal), 4 weeks (clinical assessment), 6 weeks, 3 months, 6 months (endodontic evaluation)
Example 2: Complicated Crown-Root Fracture
Presentation: 35-year-old with #21 (maxillary left central) buccal oblique fracture extending subgingivally; trauma sustained 6 hours prior
Urgency Tier: URGENT (T1)
Viability Assessment: Pulp vitality testing (cold response present); bleeding from fracture line indicates vascular involvement
Classification: Ellis Class III equivalent; complicated crown-root fracture with gingival margin involvement
Immediate Management:
✓ Radiographs: PA, lateral, cone-beam CT if alveolar involvement suspected
✓ Gingivoplasty/modest bone recontouring if fracture margin >2mm subgingivally
✓ Provisional restoration (composite) to stabilize fragment and protect pulp
✓ Endodontic consultation for vital tooth management timeline
✓ Splinting assessment: Likely not required given crown stability
Follow-up: 1 week (clinical, vitality retest), 2-4 weeks (endodontic initiation if needed), 6 months, 1 year
What's Included
- SKILL.md: Complete protocol instruction file for Claude integration
- Trauma Classification Checklist: Ellis classification, World Health Organization luxation staging, and avulsion status assessment tool
- Urgency Triage Flowchart: Decision tree for T0 (immediate), T1 (urgent), and T2 (routine) categorization
- Treatment Planning Timeline Template: Phased intervention schedule with splinting duration, follow-up intervals, and specialist referral triggers
- Medico-Legal Documentation Worksheet: Standardized injury notation, photographic protocol checklist, consent documentation, and chain-of-custody templates
Who It's For
- Oral and Maxillofacial Surgeons — Primary users managing acute dentoalveolar trauma in hospital and private surgical settings
- Emergency Medicine Physicians — Hospital-based clinicians triaging acute dental injuries before specialist consultation
- General Dentists — Community practitioners providing initial stabilization and documentation pending specialist referral
- Pediatric Dentists — Specialists managing trauma in mixed and primary dentitions with age-specific protocols
- Trauma Coordinators/Nurses — Clinical staff documenting injuries and coordinating multidisciplinary care pathways
Best For
- Acute tooth fracture assessment — Rapid classification and treatment planning within first 72 hours post-injury
- Luxation and avulsion management — Immediate stabilization, repositioning, and splinting protocol selection
- Medico-legal documentation — Standardized injury recording for insurance claims, litigation holds, and patient records
- Multidisciplinary coordination — Identifying referral needs and communication pathways with endodontics, orthodontics, and prosthodontics
- Delayed trauma presentations — Viability assessment and treatment modifications for injuries presenting >1 week post-injury
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