Tooth Displacement

Tooth displacement (luxation) means one of your teeth has been moved out of its normal position but not knocked out. It can happen to a baby tooth or a permanent tooth. Usually, it happens to the teeth in the front of the mouth (incisors). The 3 types of tooth displacement are:

  1. Extrusion. The tooth is pulled up and out of its normal position, and it appears longer than it did in its normal position.

  2. Lateral displacement. The tooth appears to be in front or behind the normal row of teeth.

  3. Intrusion. The tooth appears shorter than its normal position and pushed into the gum.

CAUSES

  • Trauma to the mouth or jaw is the most common cause.

  • Disease. This is rare. Tooth displacement can occur as a result of diseases, such as:

  • Tumors.

  • Bone infection.

  • Gum (peridontal) disease.

SYMPTOMS

  • You can see that the tooth position has changed.

  • The tooth is loose. This does not include baby teeth that are about to come out.

  • Pain.

  • Bleeding.

  • Gums are swollen or bruised.

  • Facial swelling.

  • Tooth discoloration.

DIAGNOSIS

To diagnose tooth displacement, a dentist will:

  • Ask about symptoms and history of trauma.

  • Examine your mouth and teeth. This may include:

  • Using a bright light to look for any cuts or chipped teeth.

  • Gently moving the tooth to see how loose it is.

  • Checking your bite. This is the way your upper and lower teeth come together.

  • Tapping on the tooth. This checks the health of the gum tissue and supporting bone around the teeth (periodontium).

  • Applying something hot or cold on the tooth. This checks the nerve in the tooth to see if it is vital (still connected to a nerve and has a blood supply). 

  • X-ray exams for evaluation of possible fractures.

TREATMENT

In general, treatment may include:

  • Repair of any wounds around the tooth and mouth.

  • Removal of any chipped pieces of tooth.

  • An antibiotic medicine.

  • Pain medicine. 

  • Referral to a dentist as soon as possible.

Treatment will also depend on the type of tooth displacement you have and whether your tooth injury involves a baby tooth or a permanent tooth.

  • Extrusion and lateral displacement.

  • With extrusion and lateral displacement of baby teeth, extraction is often needed if excessive force is needed to reposition the tooth. This will be determined by your caregiver on an individual basis. 

  • With extrusion and lateral displacement of permanent teeth, the dentist will try to reposition the tooth to its normal position. If this is successful, a splint will be needed for 1 to 2 weeks to keep the tooth in place. If this does not work, orthodontic treatment will be needed to obtain proper alignment.

  • Intrusion.

  • For a baby tooth that was pushed into the gum, the dentist may let it grow back on its own or take the tooth out. The baby tooth may be taken out if it could harm the permanent tooth under it.

  • For a permanent tooth that was pushed into the gum, the dentist may let it grow back out on its own or may need to reposition the tooth orthodontically or surgically.

HOME CARE INSTRUCTIONS

  • Take any medicines that your caregiver and dentist suggest. Follow the directions carefully.

  • Brush your teeth gently, if possible.

  • For a few weeks, try not to chew in the area of the displaced tooth.

  • Check around the tooth daily. Look for redness or swelling. This could be a sign of infection.

  • Keep all follow-up appointments. This is how your caregiver can tell if you are recovering like you should.

SEEK IMMEDIATE DENTAL CARE IF:

  • Your pain gets much worse even after taking pain medicine.

  • The area around the tooth swells.

  • Your tooth becomes loose or the splint becomes loose.

  • You have bleeding near the tooth that does not stop in 10 minutes.

  • You have trouble swallowing or opening your mouth.

  • Your permanent tooth comes out after repositioning.

  • You have a fever.

  • You develop facial swelling.