Dental trauma. Dislocation and avulsion.
The mouth being a cavity that communicates with the outside, it is always vulnerable to accidents.
Trauma of any kind, regardless of its intensity, can affect the dental crown or progress to the root and even compromise the integrity of the tooth at the level of the arches.
Treatment is complex, influenced by the intensity and direction of propagation of the trauma.
Tooth dislocation or luxation
Following an accident involving the cephalic region, one or more dental units may be displaced either further to the left, right or even inwards into the socket.
The ligaments supporting the tooth are damaged in this case but not entirely lost and the dentist can reposition it.
Endodontic treatment is also necessary, especially for permanent teeth.
Then, after repositioning and endodontic treatment, the tooth will be fixed by metal or composite bars to the neighboring teeth, so that it can be kept in place until the ligaments are fully restored.
The pulp chamber and canals, the structures that house the nerve, are not fully developed in children up to 11-12 years of age. Endodontic treatment may therefore not be necessary.
Regardless of the chosen treatment plan, regular follow-up therapy should be carried out as indicated by the dentist.
This allows the dentist to closely monitor the progress and effects of the repositioning of the tooth in the arches.
Possible complications can be detected early and corrected in order to have a complete and correct healing.
Tooth avulsion or expulsion
If the tooth is severely damaged by trauma and the tooth becomes dislodged from the arch, a race against time will begin to save it.
Timing is very important as the chances of re-implantation decrease considerably with delay in seeing the dentist.
Patients or their guardians need to keep in mind a few essential things to preserve the tooth until they see the dentist:
The tooth will be preserved in the oral cavity; contact with saliva is beneficial for maintaining normal function. Keeping the tooth in milk is also an accepted option
If the tooth falls out following a trauma, it will be contaminated and it is recommended to wash it, especially at the root, with a little cold water.
Under no circumstances the tooth should be kept in a dry environment such as tissues or boxes. The collagen fibers will dehydrate and the chances of success after re-implantation decrease considerably.
It is not recommended that the tooth is washed with detergents, brushed or scrubbed with abrasive cleaners.
The tooth should be handled with care, avoiding touching the root tip or apex unless it is contaminated.
It is recommended that the patient is seen at the dental surgery no later than 3-4 hours after the accident.
This way, the tooth will not dehydrate too much and the re-implantation will be successful. Depending on the degree of development of the tooth, the dentist will be able to perform endodontic treatment in one or two sessions.
If the endodontic treatment lasts for two sessions, a calcium hydroxide-based material will be applied in the first session, which is considered to be a drug with therapeutic and palliative properties.
Stabilization of the torn ligament fibers will be complete within a few weeks.
Even after complete healing, regular radiological examination is important to monitor the condition of the apical periodontium, also damaged following the shock transmitted by the trauma.
The period of time the tooth has been out of its socket and the conditions of storage are crucial to healing and therapeutic success.
Knowing all the details of the trauma will enable your doctor to make a decision on the appropriate treatment plan in this situation.