Damage to supporting tissues


Apart from the periodontal ligament itself (he soft tissues frequently involved in oro-dental injury are those of the face, lips, gingivae, alveolar mucosa, (renal attachments, soft palate, and tongue. The most common site for soft tissue injury has been shown to be the lower lip.


An estimation of the number of soft tissue injuries is extremely difficult As has been pointed out previously, many oro-dental injuries heal leaving no sign and this ,s especially true of injuries to the soft tissue in young patients. Rapid healing of minor bruises, abrasions, and cuts, is the norm, so that the great majority of soft tissue injuries are never recorded in epidemiological studies. Also, when here is an associated hard tissue injury, soft tissue injury may go unrecorded or he accorded less attention unless severe. Another factor is that only those injuries considered by Lhe parents to be sufficiently serious to warrant attention resull in the child being brought to the dentist or hospital casualty department.


Injury of the facial and oral soft tissues can be divided into three types- contusion abrasion, and laceration, with penetrating wounds as a separate, fourth, category,

1. Contusion

Damage to the soft tissues results in swelling and bruising (Fig 8 1) The tissues commonly affected are the attached gingivae and alveolar mucosa labial to the upper central incisors (Fig. 8.2). The bruising and swelling is at a maximum al 48 hours after the accident. The presence of contusion may indicate indirect trauma elsewhere, for example, a bruise on the chin should prompt careful examination of the mandibular condyles.

2. Abrasion

The surface of the affected tissue is lost by being scraped across a rough or uneven surface (e.g. a playground or road) (Fig. 8.3). The surface most commonly affected in this type of injury is that of the face (Fig. 8.4),

3. Laceration

Damage is caused by a solid object cutting through the soft tissues (Fig 8 5) The cut can be caused by any hard, sharp, object including the patient's own teeth

Soft tissue injuries frequently present with features of all the above three categories and many lacerations are associated with swelling as the cut is rarely the

Fig. 8.1 Schematic representation of submucosal bleeding and oedema following Injury io the soil tissue overlying the labial surface of the teeth.
Fig. H.2 Contusion and abrasion of the soft tissues associated with the labial aspect of the upper deciduous incisors following a fall.


Hg. 8.3 Schematic representation of the effect of abrasion injury on the labial aspect of the soft tissue in the upper incisor region.

result of a clean 'incision' hut a combination of crushing and tearing of the tissue.

4. Penetrating wounds

These are usually produced by a sharp object. This might be the patient's own teeth, a stick or pencil held between the teeth or held by a third party, or a projectile.

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