Almost everyone at least once in his life was a patient in a dental office. Most often, we turn to doctors when caries reaches such a development that pain begins that cannot be tolerated. We visit dentists and, if necessary, perform prosthetics or cosmetic oral care. But there are situations when patients come to the reception, because there was a dislocation of teeth. What kind of pathology is this, for what reasons does it arise and is it possible to cope? We will try to answer these questions.
What is a dislocation of teeth?
If the tooth deviates from its axis relative to the location of other teeth, then we can talk about such a pathology. During dislocation, damage to the ligamentous apparatus occurs, which leads to tooth displacement.
Most often, tooth dislocation is observed in the upper jaw, sometimes it can also be on the lower.
Provocative Dislocation Factors
The causes of such an injury can be many factors. Dislocations and fractures of teeth in both children and adults can occur for the following reasons:
- Swipe. It is not necessary that someone give a jaw, you can get such an injury by falling off a bicycle, during an accident or any accident. Professional athletes, such as hockey players, often suffer from such an injury. Most often, the front teeth are affected.
- If the teeth do not differ in their strength as a result of some pathologies, for example, periodontal disease, then an accidental hit of a hard object on the tooth during chewing can result in dislocation.
- Unprofessional dentists may occur who overdo it during treatment and provoke tooth dislocation with tools.
- The presence of bad habits can also cause pathology, for example, if you use your own teeth as a bottle opener or bite walnuts with them.
Varieties of dislocations
Such an injury can be of several varieties:
- Incomplete dislocation of the tooth. It is characterized by a violation of the integrity of the periodontal, injured pulp. With such an injury, there is still a chance to return the tooth to its place. He does not fall out of the hole, just deviates from its axis.
- Full dislocation of the tooth. It happens most often in the upper jaw when the tooth practically falls out of the alveoli. With a strong blow, in addition to such an injury, there can also be a fracture of the jaw or tooth.
- Hammered tooth dislocation. Such a dislocation is considered the most dangerous, since there are multiple tissue damage. As a result of a large force impact, the tooth penetrates deep into the hole. You will have to make a lot of efforts to return a beautiful smile.
A dislocation can be observed as an independent injury, and can also be accompanied by a fracture of the crown or root, and in severe cases, a fracture of the jaw is diagnosed. Given the type of injury, the doctor will take measures and choose treatment tactics.
Symptoms of dislocations
Various injuries differ among themselves and their manifestations. An incomplete dislocation of the tooth usually manifests the following symptoms:
- A sharp pain appears, which can intensify with food.
- If you look at the tooth, the crown has an atypical arrangement, it is deflected to the side. When trying to shake a tooth, a root movement is observed.
- It is impossible to close the jaw well and close the mouth, sharp pain occurs.
- At the site of injury, hematomas can be seen on the skin. According to this symptom, parents may suspect a dislocation of the baby tooth in the child. If the baby fell, then it is worthwhile to carefully examine the oral cavity, especially with the appearance of blood.
- The tooth becomes excessively mobile. Some will try to snatch it, but this should not be done.
- Swelling of the lips and gums appears, if you touch them, you feel pain.
- If you take a picture, you can see the shortening of the root of the damaged tooth.
If the dislocation is complete, then the symptoms will be as follows:
- Such a tooth dislocation (a photo can prove that) is accompanied by bleeding from the alveoli where the tooth was located.
- Pain in the area of injury.
- Speech defect appears.
- There is a transformation of the gums, so its swelling, hematomas are visible.
If there is a stick-in dislocation of the tooth, then the symptoms are as follows:
- Severe pain at the site of damage.
- There is a slight bleeding from the hole in the damaged tooth.
- It is difficult for the patient to grit his teeth.
- Without any adaptations, it is clearly visible that the tooth has decreased in height in size.
- Mobility is completely absent, because the jaw bone firmly fixes the tooth. If you try to stagger him, then the pain is not felt.
- The gums become swollen.
This dislocation is especially dangerous for children with milk teeth, since, penetrating deep into the jaw, the crown can injure the rudiments of permanent teeth. They then grow damaged or may not appear at all.
The danger of tooth dislocation in children
Children are very mobile, so such injuries are not uncommon for them. And if you consider that this can happen in early childhood if there are still milk teeth, then you should not be surprised at all.
If such an injury occurs, then many parents believe that it is urgent to put the tooth in place. But experienced dentists do not always agree with this, especially if the tooth is milk, and the dislocation does not interfere and does not harm the child.
Moms and dads should know that it is not recommended to fix such a defect on their own. You can make it worse and cause severe pain to the baby. If it comes to a baby tooth, then all the more so because the gum already contains the rudiments of permanent teeth that can cause irreparable harm.
It is better to visit a specialist and decide with his help how to help the child.
First aid after tooth dislocation
After receiving such an injury (it does not matter whether it is a child or an adult), it is necessary to be in the dentist’s chair as soon as possible, but the first steps are very important:
- If possible, eliminate bleeding.
- It is forbidden to press on the site of injury or directly on the tooth. Do not try to put the tooth in its place on its own.
- Apply cold to the cheek from the side of the injured tooth.
- If the dislocation is complete, then apply a swab, but not cotton.
- When a pressure dressing is applied, it should not be held for more than 15 minutes.
Some believe that since such an injury occurred, you will have to remove the tooth. But a competent specialist resorts to this measure quite rarely, only with serious evidence, which will be discussed below.
Tooth dislocation treatment
If a tooth dislocation is diagnosed, the treatment will depend on the type of injury, the age of the patient, and also, if it concerns a child, the degree of damage and the formation of a permanent tooth in the gums. For a specialist in the first place is the issue of preserving the tooth, but this will depend on many factors and includes several mandatory measures:
- The return of the tooth to its original position. Different methods can be used for this, depending on the dislocation.
- If a tooth dislocation occurs, treatment implies an initial return to its original place, if possible. If such a trauma is in a milk tooth, then most often, if the child is already more than 2 years old, it is removed.
- Incomplete dislocation of the tooth is easiest to return to its place. To do this, use various designs, and then fix.
Getting rid of an incomplete dislocation
Treatment of incomplete dislocation of the tooth is reduced to the following procedures:
- Reposition of the tooth, that is, its return to its place.
- Lock to prevent displacement.
- Hygiene.
After the tooth is installed in its rightful place, it must be fixed. For this, various devices are used:
- Binding teeth with a thin soft bronze-aluminum wire. This manipulation is possible if the victim has the correct bite and adjacent teeth are stable. This method has its drawbacks: the complexity of the process and the lack of rigid fixation.
- Wire overlay. It is also important to have a permanent bite and stable adjacent teeth.
- Using splint tires, it is made of plastic.
- Tooth-gingival splints can be used if there are no reliable abutments nearby.
- In some cases, dentists resort to using composite materials to fix wire arches or tires.
After fixation, such a design is usually located in the oral cavity for about a month. The doctor will explain that during this period it is important to maintain oral hygiene in order to prevent the infection process.
Full Dislocation Therapy
If the injury led to a complete dislocation of the tooth, then the following treatment will be performed:
- Removal of pulp and filling of channels.
- Tooth implantation.
- Fixation.
- Following a sparing diet.
During the examination, the doctor carefully examines the tooth hole and evaluates its integrity. Whether replantation is possible or not depends on several factors:
- The age of the patient.
- The condition of the tooth.
- The tooth is temporary or permanent.
- The root is well formed or not.
After filling the canals, they begin to replant the tooth. It can be simultaneous, when immediately put the tooth in place and splint it. But there is delayed replantation, then the tooth is placed in a special solution and sent to the refrigerator. And after a few days they begin to return to his place.
The replantation process consists of the following steps:
- Tooth preparation.
- Well treatment.
- Tooth implantation and fixation.
- Therapy after surgery.
After the procedure of tooth replantation is carried out, then after about 1.5-2 months, engraftment is possible according to several scenarios:
- Engraftment by type of primary tension. This type is most favorable for the tooth and the patient, but it will depend on the viability of the periodontal tissues.
- Bone adhesion engraftment. This is observed if the death of periodontal tissues has occurred, of course, this is not a very favorable result.
- A mixed type of engraftment of periodontal-fibrous-bone can also be observed.
Usually, if tooth re-implantation after an injury occurs almost immediately, the root is minimally destroyed and the tooth can be preserved for a long time. But if a lot of time passes from the moment of getting a dislocation, then, as a rule, replantation ends with a gradual resorption of the root and its complete destruction.
We treat an implanted tooth dislocation
If an incomplete dislocation of a permanent tooth is, in principle, easily amenable to therapy, then it is quite difficult to cope with an implant. Some experts prefer to wait a while, hoping that a tooth will spontaneously return to its place. But this, if possible, is only in the presence of deciduous teeth, when the extension is due to the ongoing formation of the root.
At a young age, if there is a shallow pounding, self-extension is also possible, but provided that the root formation has not ended and there is a sprout zone. The first signs of this phenomenon can be observed no earlier than 2-6 weeks after the injury.
If there are signs of an inflammatory process, then it is necessary to trephine the tooth and remove the pulp.
If the injected dislocation almost completely immersed the tooth crown in the gum, then self-extension is unlikely, as well as in the presence of inflammation and foci of infection in the periapical tissues.
After an injury, reposition of an implanted tooth can be carried out almost immediately or within 3 days. Crown trepanation and pulp cleansing are carried out after the tooth is firmly installed in the hole.
If the crown is shallowly submerged, then orthodontic appliances can be used to extend it. With deep-knocked-in teeth, one has to resort to surgical techniques, so that later the apparatus can be applied. This manipulation must be carried out as soon as possible after the injury, since ankylosis develops on the 5-6th day.
You can go the other way: remove the implanted tooth, and then carry out replantation.
In which cases the only way out is to remove the tooth.
If the patient goes to the dentist with a tooth dislocation, the doctor decides to remove it if there are the following predisposing factors:
- A serious inflammatory process is detected. To resolve the problem, use implants, if it comes to the child, they will be temporary, and for adults they choose permanent.
- Severe damage to the bone tissue is observed after the injury.
- If there is a dislocation of the milk tooth. But here, there is disagreement between doctors, some believe that there is no need to save a tooth, while others are convinced of the need for the opposite.
In any case, only a doctor will make a decision on tooth extraction after a thorough study of the situation, determining the degree of complexity of the injury and the condition of the dental system.
Is it possible to prevent such an injury?
Of course, you cannot completely insure yourself against a tooth dislocation, because boys who prove themselves right in a fight cannot guarantee that they will not receive a strong blow to the jaw. But you can take other measures that will reduce the risk of injury:
- Careful approach to the selection of foods that you eat.
- Go to the store and get a bottle opener, do not test your teeth for strength.
- It is not necessary to chop nuts with your teeth, you can use improvised tools.
- Personal oral hygiene has not harmed anyone yet, and its absence leads to weakening of bone formations. Plaque leads to the gradual destruction and weakening of tooth enamel.
- Eat more fresh vegetables and fruits, they not only cleanse teeth well from plaque, but also strengthen them.
Beautiful teeth are not only health, but also beauty. Damaged or crooked teeth make us shy of our smile. To avoid this, it is necessary to observe oral hygiene and carefully treat your teeth. At first glance, it seems that they are so strong and they are not afraid of anything, but, it turns out, one opening of the bottle can end in failure. It is important to teach children from early childhood to take care of their teeth, then, becoming adults, they will not sit for hours in a queue at the dentist's office. Protect your teeth from dislocations, let your smile shine!