Published on March 22, 2019, Updated on March 22, 2019
Teeth that have received a hard hit, but haven’t been knocked out or broken, are considered “concussed.” These dental concussions can cause teeth to hurt and discolor permanently or temporarily, but normally don’t require emergency treatment, unless black or dark. Dental concussions typically occur with toddlers. If you have noticed that your child’s tooth is a different shade than the others, he or she might have a concussed tooth. Learn what to do whenever your child has a dental concussion and what options you have to fix it!
Everyone, at some point in their life, will suffer from some kind of dental injury, such as getting hit in the face while playing a sport, a car accident or a fall. While not everyone will be seriously injured, some will experience severe trauma that will require dental or orthodontic treatment to properly repair the damage. Dental emergencies contribute to a high number of office visits each year, but many times can be prevented by simple means. More often than not, though, injuries to the mouth can heal almost entirely on their own, depending on the type of injury. Dental concussions include those teeth that have received a significant hit, but haven’t been knocked out or broken. When this occurs, a tooth is considered “concussed.” Contact sports like soccer, football and basketball, or something as simple as walking into something, can cause dental concussions.
While dental concussions typically occur in toddlers, they can occur at any age and cause a tooth to discolor temporarily or permanently. Normally, a concussed tooth does not require emergency treatment, unless the tooth is dark or black, indicating that the tooth is dying and likely will need a root canal treatment. Not all dental concussions cause the tooth to discolor, though. You can know whether you have a concussed tooth if it is tender to touching or tapping and has not been displaced in the mouth. After taking an X-ray, your dentist will most likely perform a pulp sensibility test to determine whether the pulp is still healthy. A positive test means that the pulp is vital, while a negative result shows that the pulp is unhealthy and not healing properly. Knowing how to recognize a concussed tooth and understanding what you can do to protect yourself from damaging other teeth is an important part of your oral health regimen.
Not all tooth-related injuries involve broken or missing teeth. Tooth luxation is the dislodgement of a tooth after trauma disrupts the ligaments and tissues, which hold the tooth in its proper position. Luxation also affects the nerve and blood supply to a tooth, causing dental concussions. There are five classes of luxation that can occur: concussion, subluxation, extrusive, lateral and intrusive. A concussion occurs when the periodontal ligaments that hold a tooth in place are damaged, and leads to discoloration. Subluxation describes a mobile tooth that has not been displaced, and typically has bleeding around the gum line and is sensitive to the touch. No treatment is needed, but if it becomes difficult to bite or chew, a flexible splint can be inserted to stabilize the tooth. Teeth that are extremely mobile and have an elongated surface are considered an extrusive luxation. Although the tooth has moved due to some separation of the ligament, the bony socket itself is still intact. If this occurs, your dentist will gently clean the exposed root surface and reposition the tooth in its socket along with a splint for stability. If the pulp is dead or decaying, a root canal will be necessary to save the tooth.
A lateral luxation involves the fracture of the alveolar bone (ridge of the jawbone that holds the teeth) and separation of the periodontal ligament. While immobile, the tooth appears to be pushed either forward or backward, and a metallic sound can be heard when tapped. To repair the tooth, your dentist will have to disengage the tooth from the socket and reposition it with forceps. A splint must be worn for four weeks, and the pulp must continuously be monitored to determine whether a root canal must be performed or not. Lastly, whenever a tooth pushes upward into the socket and fractures the alveolar bone, an intrusive luxation occurs. There is also a metallic sound heard whenever the tooth is tapped, but the tooth does not move like the other classifications. If the tooth is permanent or has undeveloped roots, the dentist may allow it to move into place by itself. If it has pushed into the socket more than 7 millimeters, though, surgical and orthodontic treatment is usually required.
While many dental emergencies, such as a dental concussion, cannot be avoided, there are certain steps that we can take to prevent injury as much as we can. For children and teenagers especially, mouth guards are a great way to protect developing teeth from injury and trauma, and should be worn during contact sports. When eating, avoid biting hard candy and ice, which can not only cause a luxation, but chip or break your tooth. If you have one of the five types of luxation, make sure to eat soft foods and continue carefully brushing your teeth. Your dentist may even prescribe you an antibacterial mouthwash to use while your tooth heals to prevent gum disease.
For more information about what to do if you or your child has a dental concussion or other type of luxation, call Hardy Pediatric Dentistry & Orthodontics at (720) 887-6003 to schedule a consultation. Our experienced team is ready to help your family improve your oral health one smile at a time!