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Tooth Luxation
Aka: Tooth Luxation, Luxated Teeth, Loose Tooth, Tooth Lateral Luxation, Tooth Extrusion, Tooth Intrusion, Tooth Subluxation, Tooth Concussion
- See Also
- Tooth Avulsion
- Tooth Fracture
- Types: Spectrum from slight to complete tooth loss
- Tooth Concussion
- Mild Trauma with no tooth mobility or Tooth Fracture
- Patient has tenderness on tooth percussion
- Treated with Analgesics, soft food and good Oral Hygiene
- Dental follow-up
- Tooth Subluxation
- Tooth loose with bleeding but without displacement
- Evaluate for movement on Occlusion
- If movement, apply a splint
- If no movement, treat in same way as a Tooth Concussion
- Tooth Intrusion (axial displacement)
- Tooth driven into socket with secondary periodontal ligament injury and crush of alveolar socket
- Do not reposition tooth
- Clean the Gingiva and tooth with sterile saline
- Dental evaluation is needed to determine next step
- Tooth Extrusion (apical displacement)
- Tooth dislocated from socket centrally
- Clean the Gingiva and tooth with sterile saline
- Reposition the tooth apically and apply Dental Splint in position
- Follow all measures of Tooth Concussion in addition to oral antibiotics (Penicillin VK)
- Dental follow-up
- Lateral Luxation
- Displaced tooth that may be accompanied by alveolar Fracture
- Clean the Gingiva and tooth with sterile saline
- Administer local Anesthetic
- Physician holds the tooth and Cortical Bone between fingers and repositions as a whole
- Follow all measures of Tooth Concussion in addition to oral antibiotics (Penicillin VK)
- Dental follow-up
- Tooth Avulsion
- Complete tooth displacement from its socket
- Dental Emergency (see Tooth Avulsion for management)
- Grading: Tooth Mobility
- Grade 1 Mobility
- Buccal or lingual tooth movement of 0.5 mm
- Grade 2 Mobility
- Buccal or lingual tooth movement of 1 mm
- Grade 3 Mobility
- Lateral movement and depressibility in socket in addition to buccal or lingual tooth movement
- Management: General
- Repositioning and Splinting of affected tooth as described above
- See Dental Splint
- Dental referral
- Root canal may be indicated in some cases
- Analgesics, soft food and good Oral Hygiene
- Antibiotics for Dental Infection indicated for Tooth Extrusion and Lateral luxation
- References
- Broderick and Deak (2015) Crit Dec Emerg Med 29(1): 2-8