Non fracture dental trauma

Dental infraction

This type of dental trauma is categorized by:

• An incomplete fracture (crack) of the enamel without loss of tooth structure.
• Not tender. If tenderness is observed evaluate the tooth for a possible luxation injury or a root fracture.

Treatment of dental infractions

• In case of marked infractions, etching and sealing with resin to prevent discoloration of the infraction lines. Otherwise, no treatment is necessary.
• No follow up is generally needed.

Concussions

This type of dental trauma is categorized by:

• The tooth is tender to touch or tapping; it has not been displaced and does not have increased mobility.

Treatment of dental concussions

• No treatment is needed.
• Monitor pulpal condition for at least one year.
• Follow up at 4 weeks, 6-8 weeks, and 1 year.

Subluxation

This type of dental trauma is categorized by:

• The tooth is tender to touch or tapping; it has not been displaced and does not have increased mobility.

Treatment of subluxation

• No treatment is needed.
• Monitor pulpal condition for at least one year.
• Follow up at 2 weeks, 4 weeks, 6-8 weeks, 6 months, and 1 year.

Lateral luxation

The first few hours are very critical. Try to gently move to the teeth back to their position. Use gauze or a napkin to place between the teeth and close the mouth. Visit the dentist immediately.

This type of dental trauma is categorized by:

• The tooth is displaced, usually in a palatal/lingual or labial direction.
• It will be immobile and percussion usually gives a high, metallic sound.
• Fracture of the alveolar process present.

Treatment of lateral luxations

• Reposition the tooth digitally or with forceps to disengage it from its bony lock and gently reposition it to its original location.
• Stabilize the tooth for 4 weeks using a flexible splint.
• Monitor the pulpal condition.
• If the pulp becomes necrotic, root canal treatment is indicated to prevent root resorption.
• Follow up at 2 weeks, 4 weeks, 6-8 weeks, 6 months, and yearly for 5 years.

Intrusive Luxation

Intrusive luxaations make the took appear shorter than it actually is. This type of dental trauma is categorized by:

• The tooth is displaced axially into the alveolar bone.
• It is immobile and percussion may give a high, metallic (ankylotic) sound.

Treatment of intrusive luxation

• Allow some natural eruption then tailor the treatment to the tooth prognosis.
• Follow up at 2 weeks, 4 weeks, 6-8 weeks, 6 months, and yearly for 5 years.

Extrusive luxation

Extrusive luxations make the affected tooth appear longer than it really is. This type of dental trauma is categorized by:

• The tooth appears elongated and is excessively mobile.

Treatment of extrusive luxations

• Reposition the tooth by gently reinserting it into the tooth socket.
• Stabilize the tooth for 2 weeks using a flexible splint.
• In mature teeth where pulp necrosis is anticipated or if several signs and symptoms indicate that the pulp of mature or immature teeth became necrotic, root canal treatment is indicated.
• Follow up at 2 weeks, 4 weeks, 6-8 weeks, 6 months, and yearly for 5 years.