Trauma to baby teeth occurs frequently. Fortunately, most children have little if any visible damage to the baby teeth after trauma, however, it is possible for problems to develop following a traumatic dental incident so the teeth should be monitored closely. Trauma to permanent front teeth is also very common but the effects can be more severe. These injuries can affect the development of the teeth as well as the function and health of the child’s mouth. Sometimes root canals may be necessary to save permanent teeth after they have had a traumatic injury.
We recommend early evaluation after an accident to allow us to assess the severity of tooth trauma and form a plan for monitoring it over time, if needed. As a patient of record in our office, you will have access to an “on-call” pediatric dentist if an accident occurs after office hours.
Below are several different types of trauma and their descriptions.
Types of tooth trauma
Concussion – the tooth has received a blow or bump that has injured the supporting structures without loosening it. Usually you will notice a small amount of bleeding around the gums surrounding the tooth but the tooth is not mobile or “wiggly”. Treatment usually involves monitoring with X-Rays and monitoring for signs and symptoms that can indicate further problems.
Subluxation – the tooth has received a blow or bump that has bruised the surrounding structure of the tooth and its root causing the tooth to become mobile. There will usually be some bleeding around the gums surrounding the tooth and the tooth will be mobile or “wiggly”. Treatment usually involves monitoring with X-Rays and monitoring for signs and symptoms that can indicate further problems.
Luxation – the tooth has been knocked out of position by the injury and the surrounding structures of the tooth and its roots have been damaged. Treatment for primary teeth involves manipulating the tooth back into place if it can be done easily. If the tooth’s new position is not interfering with the child’s bite or with the growth of the permanent teeth then many times the tooth can be left as it is and it will be monitored for any signs and symptoms that indicate further problems. Sometimes the baby tooth has been knocked out of position so much that it has to be extracted (taken out). For permanent teeth the tooth has to be placed back in position. Usually the tooth will then need to be splinted in place. Many times a root canal is indicated.
Avulsion – the tooth has been knocked completely out of the mouth. For baby teeth there is no treatment indicated as it is not recommended to put the baby tooth back in. For permanent teeth the tooth is re-implanted (placed back in the socket) if it has not been out of the mouth too long. The tooth is then splinted in place for several weeks. A root canal or other advanced treatments of the root will be necessary to save the tooth.
Intrusion – the tooth has been hit and pushed back up into the gums. For baby teeth the position of the intruded tooth has to be determined to indicate whether the tooth will need to be removed or if it can remain and just monitor for signs and symptoms of further problems. If the baby tooth is left it will sometimes re-erupt over time. For permanent teeth the tooth will usually have to be repositioned orthodontically (with braces). A root canal or other advanced treatments of the root will be necessary to save the tooth.