Orofacial/Dental injuries

Qualtity assurance

From IOFOS with advice from:

Drs. Mörnstad ( Sweden ), Nagesh ( India ), Ouvehand (the Netherlands ), Richter ( Iceland ), Bergman ( Sweden ), Mesotten ( Belgium ), and Grusd ( Norway )

If you follow the procedures:

1.  Black indicates required steps

2. Blue indicates recommended steps (may be omitted or changed without further explanation)

General

1. The main purpose is to

a. describe the injuries

b. establish a cause/injury relationship

· what may have happened

· who may have caused it

2. For compensation claims: to assess the cost of repair

3. In criminal cases: to assess the injury as evidence in the case

Before examination

1. Determine if there is any legal obstruction to performance of the examination

2. Obtain informed consent

3. Inform the injured person that the examination is not an ordinary dentist/patient relationship

Information from the injured person

1. What is injured?

a. Injuries to teeth and oral tissues

b. Non- dental injuries

2. What happened?

3. How did this happen?

4. Who was responsible for the injury?

5. What was the condition of the teeth before the damage?

6. What was done after the injury?

7. Has a doctor ordentist examined or treated the injury?

Examination of an injured person

1. Note extra-oral injuries

2. Note intra-oral and dental injuries

3. Note which teeth are present, carious, restored, missing, replaced

4. Make notes of the periodontal condition, soft tissues, attrition, occlusion and tooth positions

5. Note any anatomical peculiarities

6. Take photographs of the injuries

7. Take radiographs, and from the films

a. note any injuries

b. note pathological conditions and treatments not described clinically

c. note anatomical anomalies

8. Take impressions

9. Collect dental records from dentists who have previously treated the patient

a. find out if the person’s consent is needed

In compensation cases

For future treatment and costs assess:

1. The dental condition before the injury

2. Necessary future treatment

3. Possible future developments/complications

4. Costs of immediate restoration of the injury

5. Possible future costs

In criminal cases

As evidence assess:

1. The nature of the object causing the injury

2. The force used

3. The direction of the force

4. If the information given by the injured is compatible with the injury

5. If there are feasible alternative hypotheses for how the injury was made

 

Edit: 12/02/2008