Paediatric Dentistry Interview Questions & Answers

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About this NHS interview question bank

To prepare for an NHS paediatric dentistry interview as a specialty doctor or consultant, expect questions on dental general anaesthetic planning, caries prevention, behaviour management and sedation for anxious children, consent with parents and Gillick competence, dental neglect and child protection, dental trauma, and children with additional needs or complex medical histories. Panels also test the GDC Standards for the Dental Team, the NHS values, teamwork with paediatricians, anaesthetists and health visitors, audit and teaching, so build short spoken answers around real cases from your own hospital or community practice.

This bank contains 40 original practice questions with first-person model answers for dentists applying to NHS paediatric dentistry posts in hospital and community dental services, pitched mainly at specialty doctor level with a selection aimed at those stepping up to consultant. It covers general anaesthetic lists, prevention and oral health inequalities, behaviour management, inhalation sedation, clinical holding, dental trauma, molar incisor hypomineralisation, children with bleeding disorders, heart conditions and autism, dental neglect and safeguarding, alongside the communication, teamwork, leadership, confidentiality and patient safety questions every panel asks. Each question explains what the panel is really assessing, the points you must hit, the mistakes to avoid and the guidance worth reading, so you can practise answers that sound like you rather than a textbook.

 

What this question bank covers

• Motivation for paediatric dentistry
• NHS values and oral health inequalities
• How children's dental services are commissioned
• Prevention and Delivering Better Oral Health
• Talking to parents about diet
• Dental general anaesthetic assessment and planning
• Preventing wrong tooth extraction
• Behaviour management and anxious children
• Inhalation sedation
• Clinical holding
• Dental trauma and avulsion
• Molar incisor hypomineralisation and first permanent molars
• Gillick competence and parental responsibility
• Dental neglect and child protection
• Children with autism and learning disabilities
• Bleeding disorders and cardiac conditions
• Acute dental infection and antibiotic stewardship
• Medical emergencies in the dental clinic
• Audit, teaching and service improvement
• GDC Standards, CPD and wellbeing

 

40 NHS interview questions with full model answers. The first 8 are free to read below. Unlock the remaining 32 for £2.99 (12 months' access).

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why do you want to work in paediatric dentistry, and why at specialty doctor level?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine reason for choosing children's dentistry that goes beyond enjoying working with children. They are listening for an understanding of what the specialty doctor role actually involves in a referral service, and some realism about the harder parts, such as general anaesthetic lists and safeguarding.

 

Model answer

I think it started in my first year after qualifying, in a busy general practice. A mum brought in her five-year-old who had been up at night with toothache, and he'd already decided he hated dentists. I didn't do any treatment that day. I counted his teeth with him, let him hold the mirror and sprayed the air on his hand. He let me put fluoride varnish on at the end and walked out grinning. The following visit we managed a small restoration. What struck me was how much that half hour mattered. If it had gone badly, I could easily have been the reason he grew into an adult who only comes in when he's in agony.

Since then I've done a dental core training post with a paediatric component and I've worked in the community dental service, and the work has kept pulling me back. I like that it is never just about the tooth. You're thinking about the child's development, their behaviour, the family's routines, sometimes their medical condition, and sometimes whether they are being properly cared for at home.

The specialty doctor role appeals because it sits right in the middle of that. I'd be seeing referred children who can't be managed in general practice, working on general anaesthetic and sedation lists, doing a lot of prevention, and acting as a link with general dental practitioners, health visitors and paediatricians. I want the depth that comes with a steady caseload of more complex children, and I want to be someone the wider team can rely on.

I'm also realistic. Some days are hard. Taking out several teeth from a toddler under general anaesthetic is not a happy outcome, even when it's the right one, and safeguarding concerns are part of the job. Those parts haven't put me off. They're actually why I think good paediatric dentistry, with prevention built in, matters so much.

 

Why this answer works

The answer opens with a specific memory rather than a cliche, which makes it believable. It shows the candidate understands what a specialty doctor in paediatric dentistry actually does, from GA lists to liaison work, and it is honest about the emotional side of the job without sounding put off by it.

 

Key points to include

• A real, specific moment that drew you to children's dentistry
• Understanding that the work includes behaviour, development, family and medical factors
• A clear picture of the specialty doctor role in a referral service
• Realism about GA extractions and safeguarding
• What kind of clinician you want to be for children and colleagues

 

Common mistakes to avoid

• Saying only that you love children or find them fun
• Treating the post as a stepping stone without showing commitment to it
• Ignoring prevention and focusing only on treatment
• Sounding unaware of the emotional and safeguarding side of the work

 

NHS values and standards

Compassion; Improving lives; Commitment to quality of care; GDC Standards: put patients' interests first

 

Further reading

• GDC Standards for the Dental Team
• NHS Constitution for England
• British Society of Paediatric Dentistry guidance and policy documents

 

 

Question 2: What do you see as the biggest challenges facing children's oral health in the NHS at the moment?

NHS Values question  ·  NHS Values and Current Priorities

 

What the interview panel is assessing

The panel is checking that you understand the wider picture beyond your own clinic: inequalities, access, prevention and the pressure on general anaesthetic services. They want a balanced, informed view and some sense of what a paediatric dentist can do about it, without invented statistics.

 

Model answer

For me the biggest challenge is that tooth decay in children is almost entirely preventable, yet it is still one of the most common reasons young children end up having a general anaesthetic in hospital. That tells you something has gone wrong much further upstream than our theatre list.

The second thing is inequality. Decay isn't spread evenly. Children from more deprived areas, looked-after children, some refugee and asylum-seeking families and children with additional needs carry far more of the burden. NHS England's Core20PLUS5 approach for children and young people specifically names tooth extractions for decay in young children as an area to tackle, which I think is the right signal, because it treats oral health as part of health inequalities rather than a separate dental issue.

Third, access. Many families still struggle to find a general dental practice that will see their child regularly, so we see children who've never had a check-up arriving in pain with extensive disease. That then feeds the waiting lists for general anaesthetic and specialist care, and children wait in pain or with infection risk.

There are positive developments too. Supervised toothbrushing in early years settings, fluoride varnish programmes and community water fluoridation all have a place, and the approach in Scotland with Childsmile and in Wales with Designed to Smile has shown how a national prevention programme can work. Arrangements differ across the four nations, so I'd always check what's in place locally.

As a specialty doctor I can't fix all of that, but I can make every contact count. That means proper prevention for every child we see, clear discharge letters so the general dental practitioner knows what to continue, talking with health visitors and school nurses, and using our own data, such as repeat general anaesthetic rates, to push for better pathways.

 

Why this answer works

The answer is structured around three clear themes and stays honest by avoiding made-up figures. It links national priorities like Core20PLUS5 and nation-specific programmes to what a specialty doctor can actually do day to day, which shows both awareness and practical ownership.

 

Key points to include

• Decay is largely preventable but still drives many children's general anaesthetics
• Strong social gradient and inequality, including looked-after children and those with additional needs
• Access problems in general dental practice feeding specialist waiting lists
• Prevention programmes and differences between the four nations
• What you personally do: prevention, liaison and using data

 

Common mistakes to avoid

• Quoting precise statistics you are not sure of
• Blaming parents rather than recognising wider social causes
• Talking only about treatment capacity, not prevention
• Giving an England-only answer when applying elsewhere in the UK

 

NHS values and standards

Everyone counts; Improving lives; Commitment to quality of care

 

Further reading

• Delivering Better Oral Health: an evidence-based toolkit for prevention
• NHS England Core20PLUS5 approach for children and young people
• Childsmile (Scotland) and Designed to Smile (Wales)
• NHS Constitution for England

 

 

Question 3: A three-year-old has extensive decay linked to sugary drinks in a bottle at night. How would you talk to the parent about diet?

Communication question  ·  Communication with Parents

 

What the interview panel is assessing

The panel wants to see that you can give clear preventive advice without blaming or shaming the parent. They are looking for active listening, practical and achievable changes, and an awareness that a pattern like this may sometimes need a wider conversation with the health visitor or, rarely, safeguarding.

 

Model answer

The first thing I'd remind myself is that most parents in this situation already feel guilty. If I start with a lecture, they'll switch off or stop bringing the child back. So I'd start by asking rather than telling. I'd ask about a normal day, what goes in the bottle, when it's given and what bedtime looks like. Often you hear a story that makes complete sense: a child who won't settle without the bottle, a parent working shifts, a grandparent helping out who does things differently.

I'd then show them what's happening, in plain language. With a three-year-old I'd often use a mirror or a photo and explain that it isn't so much how much sugar but how often and how long it sits on the teeth, and that a bottle at night means the teeth are bathed in it while the saliva that normally protects them has slowed right down.

Then I'd agree one or two changes with them rather than a list of ten. That might be moving to water only in the bottle at night, or diluting it gradually over a week if stopping suddenly feels impossible, and moving towards a free-flow cup. I'd talk about brushing twice a day with a family fluoride toothpaste of the right strength for their age, brushing last thing at night, spitting not rinsing, and an adult doing the brushing. I'd also explain why we'll put fluoride varnish on at each visit. I follow Delivering Better Oral Health for the details and check I'm up to date with the current version.

Finally I'd check understanding by asking them what they'll try first, and I'd write it down for them. If I sensed the family was struggling more widely, I'd ask whether they had a health visitor and, with their agreement, let them know, because they can support routines at home. If decay kept progressing despite support and appointments were missed, I'd think about dental neglect, but that wouldn't be my starting point.

 

Why this answer works

This answer leads with empathy and curiosity, which is what actually changes behaviour. It gives accurate, practical prevention advice anchored to Delivering Better Oral Health without quoting numbers, agrees small achievable goals, and shows awareness of when a dietary problem might become a safeguarding issue.

 

Key points to include

• Non-judgemental, open questions about the child's routine
• Explain frequency of sugar and night-time exposure simply
• Agree one or two realistic changes, not a long list
• Fluoride toothpaste, supervised brushing and fluoride varnish in line with Delivering Better Oral Health
• Check understanding, involve the health visitor where helpful, and keep neglect in mind if support isn't working

 

Common mistakes to avoid

• Lecturing or blaming the parent
• Giving a long list of rules that no family could follow
• Quoting fluoride concentrations you are unsure of
• Jumping straight to safeguarding without trying support first

 

NHS values and standards

Compassion; Respect and dignity; Improving lives; GDC Standards: communicate effectively with patients

 

Further reading

• Delivering Better Oral Health: an evidence-based toolkit for prevention
• GDC Standards for the Dental Team
• Making Every Contact Count

 

 

Question 4: A three-year-old is referred for extractions under general anaesthetic. Talk us through your assessment and treatment planning.

Clinical Scenario question  ·  General Anaesthetic Planning

 

What the interview panel is assessing

The panel wants to see a thorough, safe pre-GA assessment that covers medical, social, dental and safeguarding factors. They are looking for a comprehensive plan that aims to avoid a repeat general anaesthetic, clear consent, and a prevention and follow-up plan after the procedure.

 

Model answer

I'd start before the child even comes in by reading the referral carefully, because sometimes what's been asked for isn't quite what's needed. At the assessment appointment I'd take a full medical history, including any heart, breathing or bleeding problems, previous anaesthetics, allergies and medicines, and anything that might affect the anaesthetic, such as a recent cough or snoring. I'd also take a social history: who has parental responsibility, who lives at home, whether the child has a regular dentist, whether there's a social worker involved, and the attendance history.

Then I'd examine as fully as the child allows. With a three-year-old, a knee-to-knee exam on the parent's lap works well. I'd chart the teeth, note abscesses or swelling and look for anything that doesn't fit. I'd consider whether radiographs are possible now or are better taken under the anaesthetic, justified in line with radiation regulations.

The plan should aim for one general anaesthetic, not two. For a young child with high caries risk, that usually means removing teeth with a poor or uncertain prognosis rather than restoring them and hoping. I'd plan any restorations, fissure sealants and fluoride varnish to be done in the same session, and I'd discuss the plan with the anaesthetist if there were medical concerns.

Consent would be with someone with parental responsibility, in clear language, covering what we're planning, why, the alternatives, the risks of the anaesthetic and of extractions, and the possibility that we might find more decay on the day. I'd explain what happens on the day, fasting instructions from the anaesthetic team, and pain relief afterwards.

I'd also think about safeguarding. Extensive decay in a three-year-old isn't neglect in itself, but if there were missed appointments, untreated pain or other concerns, I'd discuss it with our safeguarding lead. And I'd plan the after-care: a prevention plan, a letter to the general dental practitioner, and often a note to the health visitor, because without that the next referral is only a matter of time.

 

Why this answer works

The answer follows the natural order of a real pre-GA clinic and covers medical, social and safeguarding history as well as the dental plan. It shows awareness of the key principle of avoiding a repeat GA, takes consent properly with someone with parental responsibility, and ends with prevention, which panels value highly.

 

Key points to include

• Full medical, anaesthetic, social and attendance history
• Examination adapted to a young child and justified radiographs
• Comprehensive plan aiming to avoid a repeat general anaesthetic
• Valid consent with someone with parental responsibility, covering risks and alternatives
• Safeguarding awareness and a clear prevention and follow-up plan

 

Common mistakes to avoid

• Planning only what the referral asked for without your own assessment
• Restoring teeth with poor prognosis in a high-risk child, leading to a second anaesthetic
• Forgetting to check who has parental responsibility
• Leaving out prevention and communication with the general dental practitioner

 

NHS values and standards

Commitment to quality of care; Working together for patients; Compassion; GDC Standards: obtain valid consent

 

Further reading

• Royal College of Surgeons of England and BSPD guidance on dental general anaesthesia for children
• Delivering Better Oral Health
• Ionising Radiation (Medical Exposure) Regulations 2017
• GDC Standards for the Dental Team

 

 

Question 5: A seven-year-old has been brought only once in the past year despite toothache and multiple abscesses. How would you approach possible dental neglect?

Safeguarding question  ·  Dental Neglect

 

What the interview panel is assessing

The panel wants to know that you understand dental neglect as a safeguarding issue and can respond in a proportionate, graded way. They are listening for a balance between supporting the family and acting when a child is suffering, plus clear communication with other agencies and good records.

 

Model answer

Dental neglect is a persistent failure to meet a child's basic oral health needs, and I'd take it seriously, especially here because there's a child in pain with abscesses. That's not a minor issue. Untreated dental infection affects sleep, eating, concentration at school and can make a child really unwell.

My first step would be to deal with the pain and infection that day, because that's the child's immediate need. Then I'd have an open, non-judgemental conversation with the parent. I'd ask about what's made it hard to attend. Sometimes there's a straightforward explanation, like a lost letter, a change of address, a parent with their own illness or real difficulty getting time off work. I'd be honest that I'm worried about the child having been in pain for a while.

I'd then follow a graded approach. If there are no other concerns, the first stage is preventive and supportive: a clear treatment plan, flexible appointments, reminders, and writing down exactly what the child needs. With the parent's knowledge I'd contact the GP, health visitor or school nurse, because they may already know the family and can help. Our trust would use a was not brought approach rather than did not attend, which reminds us that a child can't bring themselves.

If the support doesn't work, or if I had other worries, such as the child seeming withdrawn or underweight, other injuries, or a known social worker, I'd talk to our named safeguarding lead and make a referral to children's social care in line with local procedures. If I thought the child was at risk of significant harm, I wouldn't wait for a staged process. I'd refer straight away, and in an emergency I'd involve the police.

Throughout, I'd keep careful, factual records of what I saw, what was said, appointments offered and attended, and every discussion and referral. And I'd try to keep the family engaged, because the goal is a child who's free of pain and well cared for, not a family who disappears from services.

 

Why this answer works

The answer defines dental neglect accurately and puts the child's immediate pain first. It follows the recognised graded approach of support, liaison with other professionals and then referral, while being clear that significant harm overrides any staged process, which is the safe and expected position.

 

Key points to include

• Treat pain and infection first
• Non-judgemental conversation to understand barriers
• Graded response: support, multi-agency liaison, then referral if no improvement
• Escalate immediately if there is risk of significant harm
• Was not brought thinking and detailed factual records

 

Common mistakes to avoid

• Treating missed appointments as just an admin problem
• Going straight to accusation without exploring the family's circumstances
• Waiting for a staged process when the child is at risk of significant harm
• Failing to involve the safeguarding lead or record discussions

 

NHS values and standards

Everyone counts; Compassion; Working together for patients; GDC Standards: raise concerns if patients are at risk

 

Further reading

• BSPD policy document on dental neglect in children
• Child Protection and the Dental Team
• Working Together to Safeguard Children (England) and equivalents in Scotland, Wales and Northern Ireland
• Children Act 1989 and 2004

 

 

Question 6: How would you manage a very anxious seven-year-old who refuses to sit in the dental chair?

Clinical Scenario question  ·  Behaviour Management

 

What the interview panel is assessing

The panel wants to see a calm, child-centred approach to behaviour management that starts with non-pharmacological techniques. They are looking for awareness of the full range of options, including sedation and general anaesthetic, and an understanding of when to stop rather than push a frightened child.

 

Model answer

I'd start by not making the chair the goal. If a child is frightened, forcing the issue just teaches them their fear was right. So I'd let them sit on a parent's lap or a normal chair, crouch down to their level and chat about something that isn't teeth: their school, a toy they've brought, what they like on television. I'd ask the parent quietly beforehand what's happened in the past, because often there's a previous bad experience behind it.

Then I'd use the basic techniques that work for most children. Tell-show-do is the main one: explaining in simple words, showing on their finger or on a teddy, then doing it. I'd avoid scary words, so the suction is a little straw and the air is wind. I'd give the child some control, like a stop signal where they raise a hand and I genuinely stop. And I'd praise specific behaviour, saying I love how still you held your mouth open, rather than just being good.

I'd keep the first visit short and achievable. Sometimes success is getting them to sit in the chair and let me count their teeth with a mirror. That's fine. I'd plan acclimatisation over a few visits, starting with prevention like fluoride varnish, and only move on to treatment once they trust us.

If the child needs treatment fairly soon and isn't managing despite all that, I'd think about the options. For a child of this age who can cooperate with a nose piece, inhalation sedation with nitrous oxide and oxygen can be very effective. If they have extensive disease, or can't manage sedation, general anaesthetic may be the right choice. I'd discuss those options with the parent, and with the child in words they understand.

The one thing I wouldn't do is hold a frightened child down for routine treatment. If there's dental pain that needs managing now, I'd manage the pain with the safest approach possible and plan the definitive care properly. A child's long-term relationship with dentistry matters as much as getting today's job done.

 

Why this answer works

The answer shows genuine understanding of how children behave and builds up from simple communication to tell-show-do, acclimatisation and then pharmacological options. It is clear about not restraining a child for elective care, which is an important safety and ethical point panels listen for.

 

Key points to include

• Explore the cause of the anxiety with the parent first
• Non-pharmacological techniques: tell-show-do, positive reinforcement, distraction, stop signal
• Short, achievable visits and acclimatisation, starting with prevention
• Inhalation sedation or general anaesthetic where appropriate, with consent
• No forcing or restraint for routine treatment

 

Common mistakes to avoid

• Pushing ahead with treatment to finish the course
• Jumping straight to general anaesthetic without trying behaviour management
• Using frightening language or giving the child no control
• Forgetting to involve the parent in understanding the child's fear

 

NHS values and standards

Compassion; Respect and dignity; Commitment to quality of care; GDC Standards: put patients' interests first

 

Further reading

• BSPD guidance on non-pharmacological behaviour management
• Standards for Conscious Sedation in the Provision of Dental Care (Intercollegiate Advisory Committee for Sedation in Dentistry)
• SDCEP Conscious Sedation in Dentistry
• GDC Standards for the Dental Team

 

 

Question 7: Wrong tooth extraction is a Never Event. How would you make sure it doesn't happen on your general anaesthetic list?

Patient Safety question  ·  Safety on GA Lists

 

What the interview panel is assessing

The panel is testing whether you understand wrong site surgery in dentistry and the specific checks that prevent it, especially in children with mixed dentitions. They want practical, team-based safety habits and a willingness to stop the line if something doesn't add up.

 

Model answer

In children it's a real risk, because you've got primary and permanent teeth side by side, different notation systems between referrers, and teeth that look different under anaesthetic than they did in a crying child in clinic. So I'd build in checks from the start, not just in theatre.

At the assessment I'd do my own charting rather than relying on the referral letter, and I'd write the treatment plan clearly, naming each tooth in the notation our unit uses and saying whether it's primary or permanent. The consent form should match exactly. If there's any difference between the referral, my plan and the radiographs, I'd sort it out before the day, not in theatre.

On the day I'd follow our local safety standards for invasive procedures, based on the national standards. That means the team brief at the start of the list, where I'd talk through each child and their planned extractions with the anaesthetist and nurses. Before the child goes to sleep we do the sign in, checking identity, consent and the plan with the parent present where possible. Radiographs and the written plan are displayed where everyone can see them.

Before I start, there's a time out, and I'd count and confirm the teeth in the mouth against the chart aloud with the nurse. I personally like a pause before each extraction where I name the tooth and the nurse confirms it from the plan. At the end we do the sign out: counting the teeth removed against the plan, confirming the throat pack is out, and recording any changes and why.

The most important thing is the culture. Anyone in the room, including the newest dental nurse, should feel able to say stop. If they did, I'd thank them and recheck, even if I was sure. If a mistake did happen, I'd be honest with the family straight away under the duty of candour, report it through our incident system and support the learning review.

 

Why this answer works

This answer is specific to paediatric dentistry, naming the real risks of mixed dentition and notation confusion. It walks through checks from assessment to sign out in a logical order, includes throat pack checks, and shows a team culture of speaking up and openness when things go wrong.

 

Key points to include

• Recognise risks specific to children: mixed dentition and notation differences
• Do your own charting and reconcile referral, plan, radiographs and consent before the day
• Team brief, sign in, time out and sign out under local safety standards for invasive procedures
• Count teeth before and after and confirm throat pack removal
• Speak-up culture and duty of candour if an error occurs

 

Common mistakes to avoid

• Relying on the referral letter without your own examination
• Treating the checklist as a tick-box exercise
• Forgetting the throat pack check
• Not mentioning what you'd do if a mistake did happen

 

NHS values and standards

Commitment to quality of care; Working together for patients; GDC Standards: put patients' interests first

 

Further reading

• National Safety Standards for Invasive Procedures (NatSSIPs)
• NHS England Never Events policy and framework
• WHO Surgical Safety Checklist
• Patient Safety Incident Response Framework (PSIRF)

 

 

Question 8: A nine-year-old arrives an hour after knocking out an upper front tooth at football. The tooth is in a cup of milk. What do you do?

Clinical Scenario question  ·  Dental Trauma

 

What the interview panel is assessing

The panel wants a safe, structured approach to dental trauma based on current international guidelines. They are listening for a full assessment including head injury and safeguarding, correct handling of an avulsed permanent tooth, and a clear follow-up plan with good communication to the family.

 

Model answer

First I'd check this is a permanent tooth, because at nine the upper central incisors should be permanent. If it were a primary tooth, we wouldn't replant it. I'd also make sure the child is otherwise well. A blow hard enough to knock out a tooth can cause a head injury, so I'd ask about loss of consciousness, vomiting, headache or confusion, and if there were any concerns I'd send them to the emergency department first. I'd also check the history fits the injury, which is part of every trauma assessment in children.

Milk is a good storage medium, so the family have done well, and I'd tell them that. I'd handle the tooth by the crown only, not the root, and look at the root surface. If it's dirty I'd rinse it gently with saline. I'd examine the socket, give local anaesthetic, gently irrigate the socket with saline and replant the tooth with gentle pressure. I'd check the position clinically and with a radiograph, and look for any fracture of the socket wall or other injured teeth.

Then I'd place a flexible splint, which for an avulsion is usually kept on for about two weeks under current guidance. I'd check tetanus status and consider systemic antibiotics in line with the current guidelines, choosing an agent suitable for the child's age. I'd give clear aftercare advice: soft diet, careful brushing, chlorhexidine if appropriate, and avoiding contact sports for a while.

At nine, the root may still be developing with an open apex. That gives a chance the pulp could heal, so I'd monitor closely rather than start root canal treatment straight away, but I'd look for signs of infection or resorption at every review, because these can progress quickly in children. I'd set up the follow-up schedule recommended by the International Association of Dental Traumatology and write it down for the family.

Finally, I'd document everything carefully, including times and storage, and write to the child's general dentist. I'd also be honest that the long-term outcome isn't certain and that we might need to make further decisions as the child grows.

 

Why this answer works

The answer applies current trauma principles accurately: no replanting of primary teeth, checking for head injury and safeguarding, correct handling, flexible splinting and age-appropriate follow-up. It recognises the significance of an open apex in a nine-year-old and frames the long-term outlook honestly for the family.

 

Key points to include

• Confirm permanent tooth and rule out head injury
• Check the history is consistent with the injury
• Handle by the crown, clean gently, replant, confirm with a radiograph
• Flexible splint, tetanus check and consider antibiotics per current guidelines
• Open apex: monitor for healing or infection with a structured follow-up

 

Common mistakes to avoid

• Replanting a primary tooth
• Forgetting head injury and safeguarding
• Starting root canal treatment immediately on an immature tooth without considering the open apex
• Giving no written follow-up plan to the family

 

NHS values and standards

Commitment to quality of care; Compassion; GDC Standards: put patients' interests first

 

Further reading

• International Association of Dental Traumatology guidelines
• Dental Trauma Guide
• NICE guidance on head injury
• GDC Standards for the Dental Team

 

 

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