Bleeding Injuries in Dental Trauma and Emergency Medical Management: A Literature Review
AJTES Vol 10, No. 1, January 2026
Lenjani, I., et al. - Bleeding Injuries in Dental Trauma and Emergency Medical Management

Keywords

Dental trauma
oral bleeding
emergency management
hemorrhage control
first aid

How to Cite

Lenjani, I., Lenjani, B., & Dogjani, A. (2026). Bleeding Injuries in Dental Trauma and Emergency Medical Management: A Literature Review. Albanian Journal of Trauma and Emergency Surgery, 10(1), 2034-2037. https://doi.org/10.32391/ajtes.v10i1.516

Abstract

Introduction: Dental and maxillofacial trauma is often associated with significant hemorrhage due to the rich vascular supply of the oral and perioral tissues. Uncontrolled bleeding can lead to airway obstruction, aspiration, hypovolemic shock, and increased morbidity, particularly in emergency settings. Prompt recognition and effective hemorrhage control using dental-specific emergency protocols are therefore critical.

Materials and Methods: This narrative literature review synthesizes current evidence on the etiology, patterns, and severity of bleeding injuries from dental trauma, as well as contemporary emergency medical management strategies. Emphasis was placed on airway assessment, direct pressure techniques, local and systemic hemostatic agents, dental and maxillofacial immobilization, and timely activation of emergency medical services. Relevant publications were identified through major medical databases and guideline sources.

Results: The reviewed literature indicates that early hemorrhage control, combined with systematic airway evaluation and stabilization, significantly reduces complications in dental trauma. Interventions such as gauze compression, suturing, topical hemostatic agents, splinting of dentoalveolar injuries, and coordinated prehospital–hospital care have shown favorable outcomes. However, many studies are limited by small sample sizes, heterogeneous methodologies, and low levels of evidence, underscoring the lack of universally accepted, standardized protocols.

Conclusion: Hemorrhagic complications following dental trauma represent a potentially life-threatening but largely preventable cause of adverse outcomes. Effective emergency medical management—incorporating early bleeding control, appropriate use of hemostatic agents, structured referral pathways, and trained responders—is essential for improving patient survival and recovery. Strengthening standardized, evidence-based dental trauma protocols and enhancing multidisciplinary training remain key priorities for future clinical practice and research.

https://doi.org/10.32391/ajtes.v10i1.516
Lenjani, I., et al. - Bleeding Injuries in Dental Trauma and Emergency Medical Management

References

Maniaci, A., Lentini, M., Vaira, L., Lavalle, S., Ronsivalle, S., Rubulotta, F. M., Lentini, L., Paternò, D. S., Galletti, C., Sorbello, M., Lechien, J. R., & La Via, L. (2025). The Global Burden of Maxillofacial Trauma in Critical Care: A Narrative Review of Epidemiology, Prevention, Economics, and Outcomes. Medicina (Kaunas, Lithuania), 61(5), 915. https://doi.org/10.3390/medicina61050915

Bratteberg, M., Thelen, D. S., Klock, K. S., & Bårdsen, A. (2018). Traumatic dental injuries-Prevalence and severity among 16-year-old pupils in western Norway. Dental traumatology: official publication of International Association for Dental Traumatology, 34(3), 144–150. https://doi.org/10.1111/edt.12399

Welbury, R., and J M Whitworth, 'Traumatic injuries to the teeth', in Richard Welbury, Monty S Duggal, and Marie Thérèse Hosey (eds), Paediatric Dentistry, Fifth Edition (Oxford, 2018; online edn, Oxford Academic, 12 Nov. 2020), https://doi.org/10.1093/oso/9780198789277.003.0021, accessed 19 Dec. 2025.

American College of Surgeons. Advanced Trauma Life Support (ATLS) Student Course Manual, 10th Edition. 2020.

Lammers, D. T., & Holcomb, J. B. (2023). Damage control resuscitation in adult trauma patients: What you need to know. The journal of trauma and acute care surgery, 95(4), 464–471.https://doi.org/10.1097/TA.0000000000004103

Lenjani, I., Lenjani, F., Mustafa, M., Dogjani, A., & Lenjani, B. (2025). Basic Medical Emergency Treatment for Maxillofacial Injuries. Albanian Journal of Trauma and Emergency Surgery, 9(1), 1676– 1681.https://doi.org/10.32391/ajtes.v9i1.435

de Campos, N., Furlaneto, F., Buischi, Y.D.P., Bleeding in Dental Surgery: Contemporary Applications of Biologic Hemostatic Agents across Surgical Specialties - Volume 2, publisher Intech Open, London, 2019; chapter 7, doi: https://doi.org/10.5772/intechopen.89992

Gianola, S., Castellini, G., Biffi, A., Porcu, G., Napoletano, A., Coclite, D., D'Angelo, D., Di Nitto, M., Fauci, A. J., Punzo, O., Iannone, P., Chiara, O., & Italian National Institute of Health guideline working group (2023). Volume replacement in the resuscitation of trauma patients with acute hemorrhage: an umbrella review. International journal of emergency medicine, 16(1), 87. https://doi.org/10.1186/s12245- 023-00563-4

Maegele M. (2024). Update on the pathophysiology and management of acute trauma hemorrhage and trauma-induced coagulopathy based upon viscoelastic testing. Clinical and experimental emergency medicine, 11(3), 259–267. https://doi.org/10.15441/ceem.24.202

Petti, S., Glendor, U., & Andersson, L. (2018). World traumatic dental injury prevalence and incidence: a meta-analysis. One billion living people have had traumatic dental injuries. Dental traumatology: official publication of International Association for Dental Traumatology, 34(2), 71–86.https://doi.org/10.1111/edt.12389

Andreasen, J. O., Bakland, L. K., Flores, M. T., Andreasen, F. M., & Andersson, L. (2011). Traumatic dental injuries: a manual. John Wiley & Sons.

Surdu, A., Foia, C. I., Luchian, I., Trifan, D., Budala, D. G., Scutariu, M. M., Ciupilan, C., Puha, B., & Tatarciuc, D. (2025). Telemedicine and Digital Tools in Dentistry: Enhancing Diagnosis and Remote Patient Care. Medicina (Kaunas, Lithuania), 61(5), 826. https://doi.org/10.3390/medicina61050826

Namdev, R., Jindal, A., Bhargava, S., Bakshi, L., Verma, R., & Beniwal, D. (2014). Awareness of emergency management of dental trauma. Contemporary clinical dentistry, 5(4), 507–513.https://doi.org/10.4103/0976-237X.142820

Wagner, H. J., Goossen, K., Hilbert-Carius, P., Braunschweig, R., Kildal, D., Hinck, D., Albrecht, T., & Könsgen, N. (2025). Endovascular management of haemorrhage and vascular lesions in patients with multiple and/or severe injuries: a systematic review and clinical practice guideline update. European journal of trauma and emergency surgery: official publication of the European Trauma Society, 51(1), 22. https://doi.org/10.1007/s00068-024-02719-0

Kenyon, R. M., & Leighton, J. L. (2024). Control of Haemorrhage in Orthopaedic Trauma. Journal of Clinical Medicine, 13(14), 4260. https://doi.org/10.3390/jcm13144260

Kim, J. Y., & Kim, O. H. (2025). Recent Advances in Prehospital and In-Hospital Management of Patients with Severe Trauma. Journal of Clinical Medicine, 14(7), 2208. https://doi.org/10.3390/jcm14072208

van Wyk, P., Wannberg, M., Gustafsson, A., Yan, J., Wikman, A., Riddez, L., & Wahlgren, C. M. (2024). Characteristics of traumatic major haemorrhage in a tertiary trauma center. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 32(1), 24. https://doi.org/10.1186/s13049-024-01196-z

Lenjani, B., Lenjani, D., Lenjani, E., & Dogjani, A. (2025). Tourniquet Use for Major Hemorrhage in Prehospital and Hospital Settings: A Systematic Review of the Literature. Albanian Journal of Trauma and Emergency Surgery, 9(2), 1829 - 1836. https://doi.org/10.32391/ajtes.v9i2.482

Valcarcel, C.R., Bieler, D., Bass, G.A. et al. ESTES recommendations for the treatment of polytrauma—a European consensus based on the German S3 guidelines for the treatment of patients with severe/multiple injuries. Eur J Trauma Emerg Surg 51, 171 (2025). https://doi.org/10.1007/s00068-025-02852-4

Latif, R. K., Clifford, S. P., Baker, J. A., Lenhardt, R., Haq, M. Z., Huang, J., Farah, I., & Businger, J. R. (2023). Traumatic hemorrhage and chain of survival. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 31(1), 25. https://doi.org/10.1186/s13049-023-01088-8

Coccolini, F., Shander, A., Ceresoli, M., Moore, E., Tian, B., Parini, D., Sartelli, M., Sakakushev, B., Doklestich, K., Abu-Zidan, F., Horer, T., Shelat, V., Hardcastle, T., Bignami, E., Kirkpatrick, A., Weber, D., Kryvoruchko, I., Leppaniemi, A., Tan, E., Kessel, B., … Catena, F. (2024). Strategies to prevent blood loss and reduce transfusion in emergency general surgery, WSES-AAST consensus paper. World journal of emergency surgery: WJES, 19(1), 26. https://doi.org/10.1186/s13017-024-00554-7

Trentzsch, H., Goossen, K., Prediger, B., Schweigkofler, U., Hilbert-Carius, P., Hanken, H., Gümbel, D., Hossfeld, B., Lier, H., Hinck, D., Suda, A. J., Achatz, G., & Bieler, D. (2025). Stop the bleed " - Prehospital bleeding control in patients with multiple and/or severe injuries - A systematic review and clinical practice guideline - A systematic review and clinical practice guideline. European journal of trauma and emergency surgery: official publication of the European Trauma Society, 51(1), 92.https://doi.org/10.1007/s00068-024-02726-1

Thomas, H. M., Kahf, H., Bush, B., Nahmias, J., & Lim, P. K. (2025). Use of tranexamic acid in trauma surgical specialties: a narrative review. World Journal of Emergency Surgery: WJES, 20(1), 76. https://doi.org/10.1186/s13017-025-00649-9

Dogjani, A., Selmani, E., Zaimi, E., Haxhirexha, K., Biberaj, P., Lenjani, B., Subashi, K., Hasmuca, I., Zogaj, E., Blloshmi, A., & Doci, K. (2025). ATLS® Protocols: Establishing the Benchmark for Excellence in Trauma Care Delivery. Albanian Journal of Trauma and Emergency Surgery, 8(2.8), 1-7. https://doi.org/10.32391/ajtes.v8i2.8.425

Dogjani, A., Vassiliu, P., Georgiou, C., et al. (2025). The 9th Albanian Congress of Trauma and Emergency Surgery. Albanian Journal of Trauma and Emergency Surgery, 9(2.9), 1-159. https://doi.org/10.32391/ajtes.v9i2.9.508

Dogjani, A., Haxhirexha, K., Puyana, J., Georgiou, C., Mariani, D., Zago, M., Pfeifer, R., Teuben, M., Shehu, A., Hasani, I., Adami, E., Beqiri, A., Lenjani, B., & Doci, K. (2024). The 8th Albanian Congress of Trauma and Emergency Surgery. Albanian Journal of Trauma and Emergency Surgery, 8(2.8), 1-172. https://doi.org/10.32391/ajtes.v8i2.8.431

Jänig, C., Schmidbauer, W., Kollig, E., Gruebl, T., Lefering, R., Hackenberg, L., Schroeder, D. C., Bieler, D., & Committee on Emergency Medicine, Intensive Care, Trauma Management (Sektion NIS) of the German Trauma Society (DGU) (2025). Pre-hospital assessment of trauma associated severe hemorrhage (phTASH) - analysis of TraumaRegister DGU® data from 2015-2021. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 33(1), 115. https://doi.org/10.1186/s13049-025-01404-4

Copyright (c) 2026 Ilirian Lenjani, Basri Lenjani, Agron Dogjani