Almost everyone has been a patient in a dentist's office at least once in their life. 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, carry out prosthetics or cosmetic oral care. But there are situations when patients come to the appointment because there was a dislocation of the teeth. What is this pathology, for what reasons does it occur and can it be de alt with? We will try to answer these questions.
What is dislocation of teeth
If a tooth deviates from its axis relative to the location of other teeth, then we can talk about such a pathology. During a dislocation, damage to the ligamentous apparatus occurs, which leads to displacement of the tooth.
Most often, dislocation of teeth is observed in the upper jaw, sometimes it can be in the lower.
Provoking dislocation factors
Many factors can be the cause of this injury. Dislocations and fractures of teeth in both children and adults can occur for the following reasons:
- Strong blow. It is not necessary for someone to hit the jaw, you can get such an injury,falling from a bicycle, during an accident or any incident. Professional athletes, such as hockey players, often suffer from such an injury. The front teeth are most commonly affected.
- If the teeth do not differ in their strength as a result of some pathologies, such as periodontal disease, then accidentally hitting a hard object on the tooth during chewing can result in dislocation.
- There may be non-professional dentists 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 crack walnuts with them.
Varieties of dislocations
This injury can be of several varieties:
- Incomplete dislocation of the tooth. It is characterized by a violation of the integrity of the periodontium, trauma to the pulp. With such an injury, there is still a chance to return the tooth to its place. It does not fall out of the hole, it just deviates from its axis.
- Complete 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 may also be a fracture of the jaw or tooth.
- Impacted dislocation of the tooth. Such a dislocation is considered the most dangerous, since multiple tissue damage is observed. As a result of a blow of great force, the tooth is embedded deep into the hole. It will take a lot of effort to return a beautiful smile.
Dislocation can be seen asindependent trauma, and may also be accompanied by a fracture of the crown or root, and in serious cases, a fracture of the jaw is diagnosed. Given the type of injury, the doctor will take action and choose the tactics of treatment.
Symptoms of dislocations
Different injuries differ from each other and their manifestations. Incomplete dislocation of the tooth usually shows the following symptoms:
- There is a sharp pain, which can increase during eating.
- If you look at the tooth, the crown has an atypical location, it is tilted to the side. When trying to shake the tooth, root movement is observed.
- It is impossible to close the jaw well and close the mouth, there is a sharp pain.
- Hematomas on the skin can be seen at the site of injury. According to this symptom, parents may suspect a dislocation of a milk tooth in a child. If the baby has fallen, then you should carefully examine the oral cavity, especially when blood comes out.
- The tooth becomes too mobile. Some will try to rip it out, but you shouldn't.
- There is swelling of the lips, gums, 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 signs will be as follows:
- Such a dislocation of the tooth (the photo can be proof of this) is accompanied by bleeding from the alveoli where the tooth was.
- Pain in the injured area.
- A speech impediment appears.
- Happeningtransformation of the gums, so its swelling, hematomas are visible.
If there is an impacted dislocation of the tooth, then the symptoms are as follows:
- Severe pain at the site of injury.
- There is slight bleeding from the socket of the damaged tooth.
- Patient finds it difficult to clench his teeth.
- Without any devices, 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 shake it, then the pain is not felt.
- Gum becomes swollen.
This dislocation is especially dangerous for children with milk teeth, because, penetrating deep into the jaw, the crown can injure the rudiments of permanent teeth. They then grow damaged or may not appear at all.
Danger of tooth dislocation in children
Children are very mobile, so such injuries are far from uncommon for them. And if you consider that this can happen in early childhood with milk teeth still present, then you should not be surprised at all.
If such an injury occurs, 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 or harm the child.
Moms and dads should know that it is not recommended to correct such a defect on your own. You can make it even worse and cause severe pain to the baby. When it comes to a milk tooth, then even more so, because the gums already have the rudiments of permanent teeth, which can be irreparably harmed.
Better visitspecialist and decide with his help how to help the child.
First aid after tooth dislocation
After receiving such an injury (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 injury site or directly on the tooth. Do not try to put the tooth in its place yourself.
- Apply something cold to the cheek on the side of the injured tooth.
- If the dislocation is complete, then apply a swab, but not cotton.
- When applying a pressure bandage, it should not be left on for more than 15 minutes.
Some believe that since such an injury has occurred, the tooth will have to be removed. But a competent specialist resorts to such a measure quite rarely, only if there are serious indications, which will be discussed below.
Treatment of dislocation of teeth
If a dislocated tooth is diagnosed, treatment will depend on the type of injury, the age of the patient, and also, in the case of a child, the degree of damage and the formation of a permanent tooth in the gum. For a specialist, the issue of preserving the tooth is in the first place, but this will depend on many factors and includes several mandatory measures:
- Return of the tooth to its original position. Different methods may be used for this, depending on the dislocation.
- If impacted avulsion of the tooth occurs, treatment involves initially returning it to its original place, if possible. If such an injurymilk tooth, then most often, if the child is already more than 2 years old, it is removed.
- Incomplete dislocation of the tooth is the easiest to return to its place. To do this, use various designs, and then fix it.
Get rid of incomplete dislocation
Treatment of incomplete dislocation of the tooth is reduced to the following procedures:
- Reposition of the tooth, that is, returning it to its place.
- Lock to prevent drift.
- Keeping hygiene.
After the tooth is installed in its rightful place, it must be fixed. To do this, use various devices:
- Teeth binding with thin soft bronze-aluminum wire. This manipulation is possible if the victim has a correct bite and adjacent teeth are stable. This method has its drawbacks: the complexity of the process and the lack of hard fixation.
- Applying a wire tire. It is also important to have a permanent bite and stable neighboring teeth.
- Using a mouth guard, it is made of plastic.
- Gingival splints can be used if there are no reliable supporting teeth nearby.
- In some cases, dentists use composite materials to fix wire archwires or splints.
After fixation, such a design, as a rule, is in the oral cavity for about a month. The doctor will explain that during this period it is important to observe oral hygiene in order to prevent the processinfection.
Total Dislocation Therapy
If the injury has led to a complete dislocation of the tooth, then the following treatment will be necessary:
- Pulp removal and canal filling.
- Tooth replantation.
- Fixation.
- Following a sparing diet.
During the examination, the doctor carefully examines the hole of the tooth and evaluates its integrity. Whether replantation is possible or not depends on several factors:
- Age of the patient.
- Tooth conditions.
- The tooth is temporary or permanent.
- Root well formed or not.
After filling the canals, the replantation of the tooth begins. It can be simultaneous, when the tooth is immediately put in place and splinted. But there is a 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 it to its place.
The process of replantation consists of the following steps:
- Tooth preparation.
- Processing the hole.
- Tooth replantation and fixation.
- Therapy after surgery.
After the tooth replantation procedure has been carried out, then after about 1.5-2 months engraftment is possible according to several scenarios:
- Primary tension engraftment. This type is the most favorable for the tooth and the patient, but it will depend on the viability of the periodontal tissues.
- Engraftment by type of bone fusion. This is observed if the death of periodontal tissues has occurred, naturally, this is not a very favorable result.
- Maybethere is also a mixed type of engraftment periodontal-fibrous-bone.
Usually, if the replantation of a tooth after an injury is carried out almost immediately, then the root is minimally destroyed and the tooth can be saved for a long time. But if a lot of time passes from the moment of receiving a dislocation, then, as a rule, replantation ends with a gradual resorption of the root and its complete destruction.
Treat impacted tooth dislocation
If an incomplete dislocation of a permanent tooth is, in principle, easy to treat, then it is quite difficult to cope with an impacted tooth. Some specialists prefer to wait a while, hoping that the tooth will spontaneously return to its place. But this, if possible, is only in the presence of milk teeth, when the extension occurs due to the ongoing formation of the root.
At a young age, if there is a shallow drive-in, self-promotion is also possible, but on condition that the formation of the root has not ended and there is a sprout zone. The first signs of such a phenomenon can be observed no earlier than 2-6 weeks after the injury.
If there are signs of the development of an inflammatory process, then it is necessary to trepan the tooth and remove the pulp.
If an impacted dislocation has almost completely immersed the crown of the tooth into the gum, then self-advancement is unlikely, as well as in the presence of inflammation and foci of infection in the periapical tissues.
After an injury, the impacted tooth can be repositioned almost immediately or within 3 days. Trepanation of the crown and cleansing of the pulp is carried out afterhow the tooth is securely seated in the socket.
If the crown is shallow, orthodontic appliances can be used to advance it. With deeply driven teeth, one has to resort to surgical techniques so that later the apparatus can be applied. This manipulation should be carried out as soon as possible after the injury, since ankylosis develops on days 5-6.
You can go the other way: remove the impacted tooth, and then replant.
When the only way out is to extract a tooth
If a patient goes to the dentist with a dislocated tooth, the doctor decides to remove it if there are the following predisposing factors:
- A serious inflammatory process is detected. Implants are used to fix the problem, if it concerns a child, they will be temporary, and for adults, permanent ones are chosen.
- Severe damage to bone tissue observed after injury.
- If there is a dislocation of a milk tooth. But even here there is disagreement between doctors, some believe that there is no need to save the tooth, while others are sure that the opposite is necessary.
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.
Can this injury be prevented
Of course, you can’t completely insure yourself against tooth dislocation, because the boys who prove their case in a fight cannot guarantee that they will not receive a strong blow injaw. But there are other steps you can take to reduce your risk of injury:
- Be careful about what you eat.
- Go to the store and get a bottle opener, don't test your teeth.
- Cracking nuts is also not necessary with your teeth, you can use improvised tools.
- Personal oral hygiene has never harmed anyone, 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 clean the teeth well from plaque, but also strengthen them.
Beautiful teeth are not only he alth, but also beauty. Damaged or crooked teeth make us feel embarrassed about our smile. To avoid this, it is necessary to observe oral hygiene and take care of your teeth. At first glance, it seems that they are so strong and they are not afraid of anything, but it turns out that 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, as adults, they will not sit in line at the dentist's office for hours. Protect your teeth from dislocation, let your smile shine!
