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Extrusive luxation

Summary

Extrusive luxation is a traumatic injury to a tooth which causes the tooth to be displaced out of its socket.

Features

  • The tooth will appear longer than the adjacent teeth.
  • Mobility - the tooth is often loose
  • Occlusal disturbance - the tooth may get in the way when biting down
  • Painful - this can be a painful injury especially when biting on the extruded tooth.

Extrusive luxation injuries can occur in adult teeth and deciduous/primary teeth. Ideally the tooth should be replaced back into its socket and then splinted (secured to the adjacent teeth) for 2 weeks. If the nerve of the tooth dies then a root canal treatment may be necessary.

In deciduous teeth if the permanent tooth is near to eruption or the amount of displacement is very great then an extraction is often the best course of action.

Image by Noah Hickman

Home care advice

In general all luxation injuries need to be treated as a dental emergency and a prompt dental visit is necessary. A tooth that has been displaced in its socket generally should be repositioned as soon as possible back to its original position. This is likely to be extremely painful and best performed by a dentist under local anaesthetic.

Lateral luxations tend to be firm and not easily moved we therefore do not recommend trying to reposition the tooth yourself.

In decidous/baby teeth a minor luxation with no bite disturbance or swelling/pain should be manageable with the measures below.

To keep the area clean in the mean time

  • Soft diet and avoid biting on area
  • Brush the area as normal if possible
  • Use a chlorhexidine mouthwash (in children use by dabbing area with cotton wool socked in the mouthwash)
  • Attend a dentist as soon as possible
  • Over the counter pain relief - Paracetamol (or Paracetamol with Codeine) and NSAIDs
  • Topical gels may provide some pain relief

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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Written by Andrew Bain BDS MJDF (RCS Eng)
May 5, 2020