Dental Trauma

Dental Trauma

Trauma to permanent teeth (adult teeth)

Concussive impacts can cause various tooth injuries and affect the jawbones, gums, lips, cheeks and tongue. In general, it is often the incisors and the canines that are involved. The molars are generally more protected because they are located at the rear of the mouth.

Depending on the force of the hit, the tooth will be broken, displaced, or totally expelled from its socket. It is important to consult your dentist immediately after the accident so that an assessment of the damage can be made, even if the tooth does not seem fractured. Remember: dental trauma can cause tooth mobility even if there is no apparent injury. The dentist will make sure that the nerve is not affected.

Here are three types of dental lesions that can be caused by a trauma:

  • Tooth fracture
  • Tooth displacement
  • Knocked-out tooth

Tooth fracture

Depending on the extent of alveolar nerve damage, the treatment can go from a simple polishing to a tooth restoration. Pain might be felt while chewing or when the tooth is in contact with cold or hot substances. If a piece of your tooth broke off, try to recover that fragment and quickly consult your dentist.

Tooth displacement

A trauma can cause a tooth to be displaced into another position instead of being completely knocked out of the mouth. That tooth will feel generally sore or tender to the touch.

A displaced tooth may be pulled out or pushed in. It may also be pushed forward, backward, sideways or rotated.

1. Luxated tooth (lateral displacement)

The tooth is out of line.

(Image source: Open Access Biomedical Image Search Engine)

2. Intrusion (tooth pushed into the alveolus)

The tooth was pushed into its socket and seems shorter because its crown is below the gum line.

(Image source: University of Rennes)

3. Extrusion (tooth pulled out of the alveolus)

The tooth looks longer and is mobile. It is partially out of the tooth socket.

(Image source: Société Odontologique de Paris)

Knocked-out tooth

An avulsed tooth is a tooth that has been completely pulled out of its socket. Pain is normally present and is caused by some damage to the gums or a fracture of the alveolar bone. It is urgent to retrieve the tooth and to see your dentist so that he or she can quickly place the tooth back into the socket.

What to do before you go to the dentist?

A few actions can minimize damage immediately after a trauma:

  • Clean the wounds around the mouth and put a cold compress on the affected area.
  • Do not use mouthwash. This would be an irritant for the teeth and gums that suffered an injury.
  • Use a painkiller (acetaminophen) if necessary.

Reminders in case of a fractured or avulsed tooth:

  • If a tooth is fractured, it is recommended to try to find the tooth fragment and to keep it in milk or in the mouth (under the tongue or on one side of the cheek), being careful not to swallow it. The saliva prevents the tooth piece from drying out.
  • If a permanent tooth is knocked out, get to the dentist as soon as you can because the tooth must be reimplanted very quickly to ensure the best possible prognosis. Pick up your tooth by the crown (not by the root). Do not clean it or rinse it with water. Store it in milk, in your saliva or in your mouth to keep it moist.

Treatments

The dentist will assess the severity of the trauma. A tooth fracture can be repaired by reattaching the broken piece as long as the nerve is not affected. The reconstitution of the tooth can also be done with a composite resin filling or a dental veneer.

In summary, the options are as follows:

  • Reattaching the tooth piece (if the nerve is not affected);
  • Tooth restoration using composite resin or ceramic;
  • Dental veneers.

If the tooth is displaced, it will be repositioned and stabilized with a splint.

If the tooth is completely knocked out (avulsed)

The tooth may be reimplanted as long as it is done within an hour after the accident.

Otherwise, a dental implant will be required to replace the tooth.

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