How to cure fractures and dislocations of teeth

Causes of traumatic tooth damage

The most vulnerable to injury are the treated teeth, which have already suffered from the pathological process and their integrity is broken. Common causes of trauma (dislocations, fractures) of teeth are:

• trying to chew something too hard;
• domestic injury;
• fall;
• shock;
• bruxism – involuntary strong clenching of the teeth in a dream.

Cases of fractures and dislocations of teeth due to bruxism increased significantly with the onset of full-scale invasion and increased stress levels. As a result of the hypertonicity of the masticatory muscles in a dream, the enamel suffers, fragments of the tooth chip off, or even the orthodontic structures are destroyed.

Types of dislocations and fractures of teeth

A fracture (fracture) of a tooth is a violation of its integrity: as they say, instead of one tooth, there are two. The classification of tooth fractures depends on which part of the tooth was broken: crown fracture and root fracture are distinguished. Also, a tooth fracture can be longitudinal, vertical or oblique. A special case is a crack in the tooth, when the enamel and dentin are damaged, but part of the tooth has not separated. In this case, there is a chance to save the tooth by strengthening it with a composite material, but only if the integrity of the pulp chamber is not violated.

Dislocation (intrusion) is displacement of a tooth in a socket or its complete loss. Types of dislocations:

• full, when the tooth fell out of its place in the mouth;
• incomplete – the tooth remained in the mouth, but changed its position;
• impaled dislocation of a tooth – after an impact from above, the tooth is in its socket, but the pulp and periapical tissues around it are destroyed.

Displacement of teeth is usually well treated. If we are talking about dislocation and fracture of a child’s tooth, everything depends on the stage of development of the baby tooth. The root of the milk tooth dissolves over time, and it itself falls out. Therefore, it does not always make sense to dislocate a baby tooth, but it is worth visiting a dentist to establish a diagnosis.

What signs indicate a tooth injury?

A crown fracture is indicated by the separation of a part of the tooth. Most often, the tooth breaks vertically or diagonally. In this case, it makes no sense to bring the fragment that fell off to the dentist, because it is impossible to glue it back. Signs that indicate damage to the tooth root:

• severe pain when pressing on the tooth;
• although the crown looks intact, the tooth (or part of it, if both the root and the crown are broken) acquires unusual mobility;
• appearance of sensitivity to temperature;
• pain and discomfort when trying to close the mouth.

The symptoms of a tooth dislocation are somewhat similar: it is also increased mobility of the tooth and pain, but at the same time a noticeable change in the position of the tooth. If the tooth has completely fallen out of the mouth, but looks intact, it should be placed in saline or unpasteurized milk and stored until a visit to the dentist (it is advisable to visit the doctor within a day to have a chance for a successful replantation).

How is tooth damage diagnosed?

Before doing any research, it is necessary to consult a dentist or maxillofacial surgeon. It is he who decides what will be more informative in this case — computed tomography or X-ray, and which projection is needed for a better understanding of the situation.

How are tooth dislocations and fractures treated?

Usually, the treatment of injured teeth is the combined work of a dentist-therapist and a maxillofacial surgeon. Exceptions are a fracture and a cracked crown, where the therapist is quite capable of depulping the tooth and restoring the missing part with the help of a composite material or treating and strengthening the cracked tooth independently. Therefore, each injury has its own specificity, which requires different actions from the team of doctors:

• if the tooth is broken under the root, a couple of millimeters below the level of the gums, the surgeon removes the broken fragment, and the dentist-therapist decides how best to restore the tooth;
• a completely dislocated tooth is returned to its place by a maxillofacial surgeon, and the task of a dental therapist is to fix the tooth by gluing it to the neighboring ones with dental splints. If the vascular-nerve bundle near the root of the tooth was damaged during the intrusion, the dentist removes the nerve and seals the canals before the procedure. This is relevant for both complete and incomplete tooth dislocation;
• with a fracture of the root of a tooth, tooth extraction is the only option, this is done by a maxillofacial surgeon. The most difficult is a fracture of the root in the lower third, because then it is extremely difficult to get the fragment. Already after the treatment, we offer the patient options for restoring the lost tooth: installation of a dental implant or a bridge-like prosthesis;
• in case of blocked dislocation of the tooth, it must be depulped (because the surrounding tissues have died) and fixed with a dental splint. Sometimes, before applying a dental splint, the dentist performs professional dental hygiene to ensure a better fixation of the tooth after an injury.

In the Sirius Dent Medical Center, a maxillofacial surgeon, a dentist, and an orthodontist are ready to connect to the treatment of a tooth fracture at any time to provide the necessary assistance to the patient.

Complications of dental trauma

It is important to consult a dentist or maxillofacial surgeon on the day of the injury, when the chances of saving the tooth are maximum. If inflammation begins, it will greatly complicate both the treatment and the recovery period. Another possible complication is traumatic periodontitis (inflammation of tissues near the root of the tooth), when the pulp dies and the tooth darkens.

How is recovery after a tooth injury?

After the dislocation is removed, the tooth is fixed to two adjacent ones with a fiberglass dental splint and heals in this way for two to three months. In order to avoid rejection of the replanted tooth, it is necessary to regularly visit the maxillofacial surgeon for check-ups and follow his recommendations. And while the tooth is healing, it is better to avoid too hot, cold or hard food.