Tooth Luxation

What is tooth luxation?

Tooth luxation occurs when trauma, such as a fall, disrupts the tissues, ligaments and bone that hold a tooth in place. Tooth luxation can also affect the tooth’s nerves and blood supply.

A luxated tooth is sometimes loose, angled or moved out of the socket. Sometimes a luxated tooth has no noticeable signs but feels tender.

Luxated teeth are most common in children and young adults, although anybody can have tooth luxation. If you suspect a luxated tooth, see a dentist right away. You may need immediate treatment, depending on the severity of the luxation.

What parts of a tooth can become luxated?

Teeth consist of two parts:

• The crown is visible outside of your gums.
• The root lies within your gums.

Both the crown and root consist of several layers:

• Enamel: Hard white outer surface.
• Dentin: Middle layer of the tooth.
• Pulp: Soft inner tissue containing blood vessels and nerves.

Your tooth sits within the alveolar bone, the part of the jaw that holds the tooth sockets. Connective tissue fibers called periodontal ligaments attach the root of your tooth to the alveolar bone.

Tooth luxations affect the periodontal ligaments and alveolar bone. They can also lead to pulp damage. Treatment for a luxated tooth depends on which tooth structure is injured and how severe it is.

Who might get a luxated tooth?

Tooth luxations occur frequently in children and young adults. Though dental trauma can happen at any age, most occurs in kids ages 11 to 15. Luxation makes up 18% to 33% of injuries to permanent teeth in the United States.

Dental trauma also accounts for 18% of all injuries to children up to age 6. Luxation of primary teeth makes up 21% to 81% of all dental injuries. Males have tooth luxation more often than females do.

What causes tooth luxation?

Damaging a tooth’s tissues and ligaments requires a large amount of force. In young children, falls are the most common cause of luxated teeth. For people of all ages, other causes of tooth luxation include:

• Assaults and violence.
• Bicycle accidents.
• Car accidents.
• Sports injuries.

What are the symptoms of a luxated tooth?

Luxated tooth symptoms depend on the type of tooth luxation. Symptoms may include:

• Bleeding around the gums.
• High-pitched metallic (ankylotic) sound when tooth is tapped.
• Loosening of the tooth.
• Tooth pain, sensitivity or tenderness.

How do healthcare providers diagnose a luxated tooth?

To diagnose a luxated tooth, your provider asks about your symptoms and what caused the possible tooth luxation. They also ask about any trauma or injury you’ve experienced.

For a thorough evaluation of your teeth, you’ll need to see a dentist. They ask about your dental history.

After that, your dentist may:

• Check your tooth for any looseness.
• See whether your tooth is sensitive or tender to the touch.
• Tap your tooth to listen for high-pitched metallic (ankylotic) sounds.
• Take an X-ray of your teeth.
• Do a pulp sensibility test to see whether there’s damage to the pulp.

What are the types of tooth luxation?

Tooth luxations can range from mild to serious. The five types of luxated teeth, in order of severity, are:

• Concussion: A concussion occurs when there’s an injury to the structures supporting your tooth (periodontal tissues). Though your tooth hasn’t moved or loosened, it often feels tender when touched.
• Subluxation: A subluxated tooth occurs when there’s an injury to the periodontal tissues. Your tooth is loose but hasn’t moved from its original location. The tooth often feels tender when touched. It may bleed near the gumline.
• Extrusive luxation: An extrusive luxation occurs when the periodontal ligament separates. Your tooth has moved out of its socket, but the socket is still intact. The tooth is very loose and looks longer than usual (elongated).
• Lateral luxation: A lateral luxation happens when the bone that holds your teeth (alveolar bone) fractures and the periodontal ligament separates. The tooth isn’t loose but looks angled either forward or backward from the gumline. Your provider will hear a high-pitched metallic (ankylotic) sound when they tap your tooth.
• Intrusive luxation: An intrusive luxation happens when your tooth moves up into the socket, which results in an alveolar bone fracture. The tooth isn’t loose. Your provider hears an ankylotic sound when tapping your tooth.

Can I treat a luxated tooth myself?

You can’t treat a luxated tooth by yourself. To treat a luxated tooth, you need to visit a dentist or endodontist. An endodontist is a dental specialist who focuses on dental pulp and root issues.

How do dentists treat a luxated tooth?

Treatment for a luxated tooth depends on the type of luxation you have. Sometimes your dental provider may recommend not repairing a luxated tooth at all.

During tooth luxation treatment, your dentist aims to stabilize your tooth. They also want to monitor and maintain the health of the pulp. The treatments for each type of tooth luxation include:

Concussion: You may not need any treatment. Your dentist will regularly check your pulp for at least one year.

Subluxation: You may not need any treatment. If you have pain when chewing, your dentist may splint your luxated tooth to the surrounding teeth to help stabilize the tooth.

Your dentist will regularly monitor your tooth with X-rays and exams. They will check the condition of your pulp for at least a year.

Extrusive luxation: Your dentist will clean your root with saline solution. They will reposition your tooth back into the socket.

You may need a splint for about two weeks to stabilize your tooth. If your pulp has been injured, you may need a root canal. During a root canal, your dentist or endodontist removes your pulp. They then clean the tooth before filling and sealing it.

Lateral luxation: Your dentist will remove your tooth from the socket. They then use forceps to reposition it back into the socket.

You will need a flexible splint for about four weeks. After that, your dentist will monitor your pulp. You’ll need checkups after two months, three months, six months and one year. After that, your dentist should check your tooth yearly for at least five years. At any of these times, you may need a root canal if your pulp shows signs of inflammation or dying (necrosis).

Intrusive luxation: Your dentist may leave your tooth alone to see if it moves back into place. If your tooth hasn’t moved back into place in one month, you may need surgery to reposition it. Another reason for surgery is if your tooth has been pushed more than 7 millimeters into the socket.

You’ll need a splint for at least four weeks after surgery. Splints support your tooth while it heals by attaching it to one tooth on either side. Splints may be made of wire, metal or resin.

You may also need a root canal two to four weeks following surgery, if your pulp becomes inflamed or dies. You’ll also need checkups after two months, three months, six months and one year. After that, your dentist should check your tooth each year for at least five years.

How do I take care of myself after repair of my luxated tooth?

To help protect your tooth after repair, you should:

• Brush gently with a soft toothbrush after each meal.
• Consume only soft food and liquids for one week.
• Rinse with an antibacterial chlorhexidine mouthwash two times a day for one week.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain relief.

You’ll also need to visit your dentist for regular checkups. Your dentist will monitor the luxation over time to make sure it doesn’t get worse. This follow-up is especially important for a minor luxation that didn’t need initial treatment.

Can I prevent tooth luxation?

Many times, a luxated tooth is an accident. You can reduce the chances of a luxated tooth by:

• Using a seatbelt when in a vehicle.
• Wearing a helmet when riding a bike, scooting or playing certain sports.
• Wearing a mouthguard if you play sports.

What is the outlook for people with a luxated tooth?

Prompt treatment of a luxated tooth can preserve your original tooth. Good dental hygiene and regular checkups can help extend the life of your tooth.

Your tooth may still serve you for many years, but providers can’t predict how long your tooth may last. Many complications can affect repaired teeth, including:

• Ankylosis happens when the tooth fuses to the bone and starts sinking into the gum tissue.
• Apical periodontitis is inflammation of the tissue surrounding your teeth.
• Inflammatory root resorption is a breakdown of your tooth’s root structure. This can cause your tooth to loosen.
• Pulp canal obliteration (PCO) involves hard tissue deposits along the walls of the root canal. PCO is usually painless but can lead to pulp necrosis.
• Pulp necrosis occurs when the pulp (tissue in the center of your teeth) dies. If you have pulp necrosis, your dentist may need to remove the whole tooth.

When should I see my healthcare provider about a luxated tooth?

You should see your provider about a luxated tooth if you experience:

• Bleeding.
• Continued tooth pain, tenderness or sensitivity.
• Swelling.
• Tooth discoloration.

A note from Cleveland Clinic

Tooth luxation happens when the structures that support your tooth become injured. If you suspect a luxated tooth, you should see a dentist for prompt diagnosis and treatment. Treatments for tooth luxation vary depending on the type and seriousness of the injury. If you continue to see your dentist for checkups and monitoring, your repaired tooth can last for years.