The Dental Trauma Guide: Copenhagen's chairside trauma tool built on the IADT guidelines, what it costs, and what the free tier actually opens

What it says#

The Dental Trauma Guide at dentaltraumaguide.org is a website, not a document, so what follows is what the site itself states about what it is and what it does. Its About page says the website offers easy accessible evidence based guidance for clinicians in order to perform optimal diagnosis, treatment and prognosis of traumatic dental injuries in the primary and permanent dentition, and that it is developed in cooperation with the University Hospital of Copenhagen and the International Association of Dental Traumatology. It describes itself as rooted in the University Hospital of Copenhagen, Rigshospitalet, and as a research-based non-profit organization, produced with the Resource Centre for Rare Oral Diseases and the Department of Oral and Maxillofacial Surgery there.

The relationship to the IADT guidelines is stated plainly on the professional objectives page: the purpose of the Dental Trauma Guide is, via a visualization of the IADT trauma guidelines, to promote the application of treatment procedures documented in clinical and experimental studies to enhance pulp and periodontal healing after trauma. The free sections for primary and permanent teeth open with a link to the IADT guidelines themselves, hosted on the IADT's own site, and then offer the Dental Trauma Guide as the way to become fully updated on treatment and prognosis while the patient is waiting in the chair. In other words, the site does not issue its own guidelines; it renders somebody else's, with animations and prognosis numbers attached.

The structure follows the way a trauma case actually arrives. There is a patient examination section the site recommends for clinicians inexperienced in handling trauma. There is a trauma pathfinder that guides the user to the correct diagnosis through a series of yes and no questions based on clinical and radiographic findings. Experienced practitioners, the site says, will typically have identified the diagnosis before logging on and can go straight to the treatment advice and prognosis page for that injury through the left side panel. Injuries are organized by dentition, then split into six luxation injuries (concussion, subluxation, extrusion, lateral luxation, intrusion, avulsion) and eight fracture injuries (enamel infraction, enamel fracture, uncomplicated crown fracture, complicated crown fracture, uncomplicated crown-root fracture, complicated crown-root fracture, root fracture, alveolar fracture). The site runs in English, Portuguese, Spanish, French, Arabic, Greek and Dutch, with named regional anchorpersons responsible for the quality of the Portuguese, Spanish and Arabic versions.

The evidence base is described on the site's evidence page and its history page. Patient records have been collected at the University Hospital in Copenhagen for 40 years; standardized documentation of long-term effects of trauma treatments has been collected since 1965; and that material, given as 4,000 cases, together with the results of 80 clinical studies and 65 experimental animal studies using monkeys, forms the scientific basis for the tool. The same page is candid about why the evidence looks the way it does: randomized clinical trials in acute trauma face nearly prohibitive consent problems, most studies in dental traumatology sit at low levels of the evidence pyramid, and the current treatment guidelines rely heavily on animal experiments, with monkey studies described as reliable and dog and rat models less so for pulp and periodontal healing respectively. The site's justification for existing at all is the claim, attributed to surveys across many countries, that knowledge of adequate treatment of traumatized teeth is deficient and that up to half of all treatments offered are either unnecessary or directly harmful.

The commercial terms are stated on three pages. The site started in 2008, was funded by a number of foundations, and was able to provide its services free of charge to what it describes as more than 350,000 users worldwide annually. By January 2017 it became a paid-for service to ensure its survival and progression, and the About page says the texted guidelines issued by the IADT are still offered free of charge. Individual membership covers 1 to 9 users at US$60.00 per user per year, from US$60.00 for one user to US$540.00 for nine, with logins shareable within that band; all memberships run one year from the purchase date and renew automatically. Group membership, recommended for organizations with many users under one administrator, is 10 or more users at a price quoted on request, and the site warns that a group membership takes several days to register while an individual membership is immediate. The subscriber benefits listed are animation-based treatment procedures, individual prognosis determination for treatment options plus patient instructions, a regular electronic newsletter, and support for ongoing research. Universities and dental schools that are not already subscribing are offered free full access for a 2-year trial period, with a unique organization code that lets students register with a school email address.

Who it applies to#

Any dentist who might be the first clinician to see an avulsed or luxated tooth, which in practice means general dentists and their assistants as much as pediatric dentists, oral surgeons and endodontists. The site's own framing is that dental trauma care runs through a long chain of referrals, and that control of the overall quality of treatment is often lost along the way.

It explicitly does not apply to patients or parents. The terms page states that the website is not designed for laypersons, that the products and procedures described are only to be applied in specially designed environments by specially certified and trained medical professionals, and that no suggested test or procedure should be carried out unless, in the clinician's professional judgment, its risk is justified. The same page disclaims liability on behalf of the Dental Trauma Guide, the University Hospital of Copenhagen and the IADT, and it limits reuse: prints and downloads are permitted for educational and research purposes or personal use only, nothing may be reproduced on another website or intranet without written permission, and no material may be used for any commercial purpose. Danish law governs, and disputes go to the courts in Denmark.

What changed#

The one change the site documents is the business model. From 2008 the Dental Trauma Guide was free, foundation-funded and, by its own account, used by more than 350,000 people a year. In January 2017 version 2.0 arrived as a subscription-based, paid-for service, with the stated reason that this ensures the viability of the guide to the benefit of professional users and their patients. The free tier that survived is the IADT guideline text for primary and permanent teeth; the pathfinder, the examination section and the injury-specific treatment and prognosis pages moved behind the login. The other shift the site records is in its team: founder Jens Ove Andreasen, whom the team page calls the father of dental traumatology and who served as IADT president from 1989 to 2001, died in 2020, and the site describes itself as continuing in his name.

Where the source is#

Everything above comes from pages on dentaltraumaguide.org fetched and read for this entry: the home page, About, Vision, History, the team page, Evidence based dental trauma treatment, Professional and public objectives, How to use the Dental Trauma Guide, Membership plans, Your money's worth, Dental Schools, the free guides for primary and permanent teeth, and the terms, copyright and disclaimer page. The subscriber sections, patient examination and the trauma pathfinder, return a notice that the page is available only to subscribers, so this entry describes the subscriber experience only as the site advertises it, not from use. Two internal inconsistencies are worth flagging to anyone quoting the site: the vision page puts the world's dental trauma victims at around 1 billion while the professional objectives page says around 3 billion, and the evidence page counts 8 fracture and 6 luxation entities producing 48 combinations and 96 distinct trauma events, while the professional objectives page counts 9 fractures and 6 luxations combining in 54 ways. The figures that repeat consistently, 50 to 60% of the world's population affected and 60 million new patients a year, are the ones used here. The IADT guidelines themselves are published separately by the IADT and are covered by their own entries in this directory.