Dental Trauma Protocol Calculator
Guide treatment decisions for pediatric dental injuries based on IADT guidelines — from enamel fractures to avulsion replantation.
About this calculator
This calculator follows the International Association of Dental Traumatology (IADT) guidelines -- most recently revised in 2020, and freely published in the journal Dental Traumatology -- to translate a dental trauma classification into a treatment urgency level, treatment approach, splinting recommendation, follow-up schedule, prognosis estimate, and antibiotic consideration. The injury classification is the primary driver: eleven categories span the spectrum from enamel fractures and concussion (routine, days-scale follow-up) through luxation injuries (urgent, same-day repositioning and splinting) to avulsion (a true dental emergency). Dentition type -- primary tooth, permanent with an immature open apex, or permanent with a mature closed apex -- changes the recommendation independently, most sharply for luxation injuries: a displaced primary tooth is typically extracted to protect the developing permanent successor rather than repositioned, and an open apex generally carries a better prognosis than a closed one because of its greater healing and revascularization potential.
For avulsion specifically, extra-oral dry time and the storage medium the tooth was kept in become the dominant factors in both prognosis and estimated periodontal ligament (PDL) cell viability, since PDL cells begin dying within minutes outside the mouth and a proper storage medium (milk, saline, or the tooth kept in the socket) meaningfully slows that process. This tool supports, but does not replace, an in-person clinical evaluation and radiographic assessment -- it does not account for concurrent injuries, root development stage beyond the three broad categories offered, or medical history that could affect antibiotic selection.
Medical Disclaimer
This calculator is for informational and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider before making decisions about your health. Never disregard professional medical advice or delay seeking it because of results from this tool.
Inputs
Results
Urgency level
1
Figures current as of 2020. Source: International Association of Dental Traumatology. IADT Guidelines for the Management of Traumatic Dental Injuries (General Introduction; Fractures and Luxations; Avulsion of Permanent Teeth; Injuries in the Primary Dentition). Dent Traumatol. 2020.
How to Use This Calculator
- Select the Injury classification (1–11): fractures (1–5), luxation injuries (6–10), or avulsion (11) per IADT terminology.
- Select the Dentition type: 1 = primary tooth, 2 = permanent with open apex, 3 = permanent with closed apex.
- For avulsion cases (type 11), enter Extra-oral dry time in minutes and Storage medium (0 = dry, 1 = water/saliva, 2 = milk, 3 = HBSS/saline, 4 = still in socket) — these have no effect on any other injury classification.
- Review Urgency level (1 = routine, 2 = urgent <24h, 3 = emergency/immediate), Treatment code, Splinting recommendation, Follow-up timing, Prognosis, and whether Antibiotics are indicated.
What each input means
- Injury classification
- IADT injury classification.
- Dentition type
- Whether the affected tooth is primary or permanent, and its root maturity.
- Extra-oral dry time (min)
- Minutes tooth was out of socket (avulsion only — has no effect for any other injury classification).
- Storage medium
- Medium the avulsed tooth was stored in before presentation (avulsion only).
What each result means
- Urgency level
- 1=Routine (days), 2=Urgent (within 24h), 3=Emergency (immediate).
- Treatment code
- 1=Observe, 2=Pulp therapy/extract, 3=Pulp cap, 4=Reposition+splint, 5=Extract, 6=Space mgmt, 7=Await re-eruption, 8=Surgical extrusion, 9=Replant.
- Splinting recommendation
- 0=None, 1=Flexible 2 weeks, 2=Flexible 4 weeks, 3=Rigid 4 weeks.
- First follow-up (weeks)
- Weeks until first clinical/radiographic follow-up.
- Prognosis
- 1=Excellent, 2=Good, 3=Fair, 4=Poor, 5=Hopeless.
- Antibiotics recommended?
- 0=No, 1=Yes (systemic antibiotics per IADT protocol).
- PDL cell viability (%)
- Estimated periodontal ligament cell viability for avulsion cases.
How this is calculated
Worked example, using the default values
- Identify Input Parameters4 parametersInjury classification = 6, Dentition type = 2, Extra-oral dry time (min) = 0, Storage medium = 2 = 5 input(s) provided
- Calculate Urgency levelUrgency level = 1=routine(days)1 = 1
- Calculate Treatment code1 = 1
- Calculate Splinting recommendationSplinting recommendation = number = 0;0 = 0
Figures and sources
Engine last updated . Checked against 5 independently-derived tests — how we verify calculators. Built by Paul Gunder, a software engineer, not a licensed financial, medical, or legal professional.
Frequently Asked Questions
Why is a displaced primary tooth usually extracted instead of repositioned?
Attempting to reposition and splint a displaced (luxated) primary tooth risks pushing its root into contact with the developing permanent tooth bud underneath, which can damage the permanent successor. Extraction removes that risk entirely, which is why this calculator recommends extraction rather than repositioning for lateral or intrusive luxation of primary teeth.
How much does storage medium change the outcome for an avulsed tooth?
Substantially -- keeping an avulsed tooth in milk, saline, or its own socket preserves periodontal ligament cell viability far longer than dry storage or even water. This calculator estimates near-full PDL viability when a tooth is kept in the socket, dropping through moderate viability with milk or saline within the first 15 minutes, down to minimal viability after 30-60 minutes of dry storage.
Does an open apex always mean a better prognosis than a closed one?
Generally yes in this calculator's logic -- an immature, open-apex permanent tooth has a wider blood supply and greater revascularization potential than a mature, closed-apex tooth, so identical injuries (root fracture, pulp exposure, or avulsion) are scored with one prognosis grade better for open apex than closed apex, all else equal.
Which injury types trigger an emergency (same-visit) urgency level?
For permanent teeth, crown fracture with pulp exposure, crown-root fracture, root fracture, and every luxation injury from lateral luxation through avulsion are classified as emergency urgency in this calculator, since delayed treatment for these injury types risks pulp necrosis, worsened periodontal ligament damage, or reduced replantation success for an avulsed tooth. Primary (baby) teeth are treated more conservatively: only lateral and intrusive luxation trigger emergency urgency there, because primary teeth are generally not replanted and pulp exposure, root fracture, extrusive luxation, and avulsion of a primary tooth are instead classified as urgent (same-day-to-next-day) rather than emergency.
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