Dislodged/Luxated Tooth - New York, NY

Specialists in Treating Dislodged Teeth

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Get Prompt Treatment for a Luxated Tooth

Lateral luxations are one of the most common dental injuries in the general population, accounting for up to 27% of all dental injuries. In children aged 6 and younger, luxation injuries are the most common type of traumatic dental injury, accounting for 18% of all types of injury. When trauma has caused a tooth to be dislodged from its normal position, it needs to be replaced gently and as soon as possible. The only exceptions are cases of intrusion that may not be possible or advisable to manipulate immediately. At Advanced Endodontics of New York, we’ll first perform tests to determine the extent of the damage. The goal of immediate treatment of a luxated tooth in New York, NY is to limit further damage to the periodontal ligament, which will enable the best possible healing. Follow-up visits are necessary for one year after an injury, due to complications (including internal or external root resorptions) that are relatively frequent and require additional endodontic treatment.

What is a Luxated Tooth?

The term “luxated tooth” refers to the dislocation or dislodgement of a tooth from its normal position. During an injury, the tooth may be pushed forward, backward or sideways, or partially out of or into the socket. Luxation can impact the hard white outer surface of a tooth (enamel), the middle layer (dentin), the soft tissue containing blood vessels and nerves (pulp), and/or the bone that supports your teeth (alveolar), which includes the tooth socket. All luxation injuries cause some damage to the periodontal ligament.

Diagnostic Tests

During a percussion test, we try to replicate pain by applying pressure to the chewing surface of the impacted tooth, first with our finger and then with the handle end of an instrument. A luxated tooth is nearly always sensitive to percussion. Radiographic imaging is useful, except for concussion and subluxation injuries, which typically appear normal.

Symptoms and Signs of a Luxated Tooth

What Are the Causes of Luxated Teeth?

In young children, falls are the most common cause of luxated teeth. Although falls are also responsible for a number of luxated teeth in permanent teeth, sporting activities account for a large majority of these injuries.

Different Types of Tooth Luxation

Luxation injuries are classified into five subcategories, with concussion and subluxation being the mildest. While no immediate treatment is needed for those injuries, follow-up is critical because the pulp tissue can die, which then requires prompt endodontic intervention. Studies show that fractured crowns (with or without pulp exposure) and a coinciding luxation Injury incur pulp damage and infection more often.

Concussion

An injury to the tooth-supporting structures without abnormal loosening or displacement of the tooth. The tooth may be tender to percussion and feel sore.

Subluxation

An injury to the tooth-supporting structures with abnormal loosening, but without fracture or displacement of the tooth. The tooth may be mobile, tender on percussion, and sore. Sometimes the tooth feels higher than normal when biting, due to swelling of the periodontal ligament.

Extrusive luxation (peripheral dislocation, partial avulsion)

Partial displacement of the tooth out of its socket with an elongated appearance. In many cases, the tooth is very loose and attached only to the palatal gum tissue, and the gums are bleeding.

Lateral luxation

Displacement of the tooth in a direction other than axially. This is often accompanied by fragmentation or fracture of the alveolar socket. Clinically, the tooth appears laterally displaced and is generally stable in its new position because the root apex (root end) is “locked” in the bone fracture.

Intrusive luxation (central dislocation)

Displacement of the tooth into the alveolar bone. This injury is accompanied by fragmentation or fracturing of the tooth socket.

How Are Luxated Teeth Treated?

Our team will reposition your tooth and stabilize it if necessary. Splinting of a luxated tooth is only recommended for teeth that are still mobile after repositioning. For subluxation, extrusive and lateral luxations, the splint stays on for two weeks, while four weeks are required for intrusive luxation. Root canal treatment is usually needed for dislodged permanent teeth. The intracanal medicament calcium hydroxide is placed one to two weeks after injury, for up to one month. Calcium hydroxide has been shown to stop and repair external inflammatory root resorption, eliminate harmful bacteria from the root canal system, and protect the apex in non-vital immature teeth. A permanent root canal filling is placed at a later date.

In children aged 7–12, root canal treatment may not be necessary because the pulp in immature teeth has considerable healing capacity. Research shows that stem cells present in the pulp of immature teeth can be stimulated to complete root growth and heal pulp following injuries or infection. Therefore, we’ll carefully monitor our younger patients’ healing progress during follow-up visits, and intervene immediately only if unfavorable changes appear.

Get prompt treatment for a dislodged tooth!

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