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Concussion

Summary

Dental trauma can be described as concussion when the tooth has received a blow which has NOT broken the tooth,  NOT caused the tooth to be displaced and has NOT caused any significant damage to the surrounding tissues except mild stretching or crushing of the ligament around the tooth (periodontal ligament). 

It is closely related to a subluxation which may be considered as a slightly more severe concussion with moderate damage to the supporting tissues.

Features of Dental Concussion

  • Tender to touch and bite
  • No displacement of the tooth
  • No disturbance of the occlusion - the teeth still meet normally
  • Still able to feel a cold stimulus on the tooth (although might be a little more sensitive)

Concussion injuries can occur in adult teeth and deciduous/primary teeth. The management is the same for each. A soft diet to avoid any pressure on the tooth and good brushing should be employed. The tooth should be x-rayed to rule out a more serious traumatic injury.

A subluxation injury may cause more damage to the periodontal ligament. There might be some bleeding around the neck of the tooth and the tooth is likely to be a little more tender. However the tooth still has not moved position. Your dentist may want to splint (stick it to the tooth either side of it) if the tooth if it is very tender.

Home care advice

Advise is the same for both Adult teeth and Deciduous (baby) teeth.

  • Soft diet
  • Normal brushing
  • Attend dentist when possible to exclude more serious injury
  • Pain killers if tooth is very sore (subluxation)

Look out for signs of the nerve/tooth dying and getting infected. Teeth can darken (especially primary teeth), but this alone may not mean that the tooth is infected. 

If there is pain/swelling in the gum overlying the root of the tooth or swelling in your face then contact a dentist to discuss treatment.

Any damage to the lips or gums should be cleaned with salty water or chlorhexidine mouthwash (on cotton wool if necessary)

PLEASE NOTE ANY FAST SPREADING SWELLING IN YOUR FACE OR NECK REQUIRES IMMEDIATE ATTENTION AS IT CAN BECOME A MEDICAL EMERGENCY

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Treatment

Dental Concussion

  • Soft diet
  • Normal brushing as soon as possible
  • Review to check for signs of pulp damage
  • If pulp dies then may require root canal treatment / extraction

Subluxation

  • Soft diet
  • Normal brushing as soon as possible
  • Possibly a flexible splint if very tender for 2 weeks
  • If pulp dies then may require root canal treatment / extraction
Written by Andrew Bain BDS MJDF (RCS Eng)
May 5, 2020