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Intrusive luxation

Summary

Intrusive luxation is a traumatic injury to teeth where the tooth has been shunted up into its socket. 

Features

  • Displaced tooth is shorter as moved up into socket.
  • Immobility - the tooth can often lock firmly in this displaced position
  • Often gives a metallic sound when tapped
  • Cold insensitive - often the tooth gives no response to cold as the nerve has ruptured in the trauma

Intrusive luxation injuries can occur in adult teeth and deciduous/primary teeth. 

In adult teeth the tooth if the displacement is less than 3mm then treatment is to wait 2-4 weeks for it to reposition naturally, if this does not happen then it needs to be moved surgically or using braces. If the displacement is more than 3mm then surgical or orthodontic movement is definitely required.

In deciduous/baby teeth if the root tip can be felt in the gum above the tooth then the tooth can be left to move naturally. If not then the root may damage the tooth underneath so extraction is necessary

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

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