Dental traumas damage the teeth, the periodontium, and the surrounding soft tissues. (Austė Antipovienė, Julija Narbutaite, Jorma I Virtanen, 2021) These dental damages to the gums and teeth may occur without your knowledge. If you do not visit your dentist regularly, this issue could become increasingly visible with time. So, what are the most common types of dental trauma? To know this, let’s read in-depth.
Types of dental traumas
All across the world, children frequently have a traumatic dental injury (TDI). (Austė Antipovienė, Julija Narbutaite, Jorma I Virtanen, 2021) Falls, baseball injuries, bicycle accidents, and other incidents can all result in common pediatric trauma. Children can experience dental damage due to their uneven balance and inexperience with walking. According to a study, falling is the primary factor in 56% of TDI cases. (Austė Antipovienė, Julija Narbutaite, Jorma I Virtanen, 2021)dental trauma is classified depending on the extent of the tissue damage and the severity of the injury, which in turn depends on which tissue or tissues have been affected.
Concussion
A concussion is minor damage or harm to teeth. Although the periodontal ligament’s fibers are sometimes stressed, and some may even be damaged, there is still sufficient support to hold the tooth in its socket and prevent a discernible rise in movement. The gums could be somewhat inflamed and occasionally even bleed mildly; the tooth will show sensitivity to touch or diagnostic tapping.
Subluxation
An aggravation of a concussion is a subluxation. In this type, because of the weakness of the supporting structures, the tooth may be more mobile or loose. There is more gingival capillary severing or stretching, and the periodontal ligament has experienced more injury. When the tooth is lightly touched or pressed, pain is produced.
Avulsion
The whole displacement of a tooth from its dental socket occurs in avulsion. Permanent tooth avulsion is among the fatal dental injuries. (Fouad AF, Abbott PV, Tsilingaridis G, et al. , 2020) The pulp neurovascular supply and the periodontal root ligament are entirely damaged
Extrusion
The outward displacement of a tooth in the direction parallel to the tooth root or displacement away from the alveolar bone is called extrusion. Due to the protruding tooth root, the tooth appears to have grown longer and is initially mobile. (K. Humphreys, S. Al Badri, M. Kinirons, R.R. Welbury, Cole, R.A.E. Bryan, O. Campbell, D.E. Fung, 2003)
Intrusion
The displacement of the tooth towards the alveolar bone (Alex Rovira-Wilde , Nick Longridge, Sarah McKernon, 2020) or inward displacement of a tooth is an intrusion. Pulpal necrosis is the result of almost all invasive luxations.
Tooth fracture
A large crack or break in the tooth’s hard outer shell is associated with this type:
Classification by Ellis (1970)
The Ellis fracture classification system determines the severity of a broken tooth injury. This approach determines severity degrees based on whether or not the damage has harmed the enamel, dentin, or pulp.
This classification is: (Sasikala Pagadala, Deepti Chaitanya Tadikonda, 2015)
- Ellis class I fracture: Involves only enamel layer with no dentin layer affected and is not a medical emergency.
- Ellis class II fracture: Both the enamel and dentin layers are affected and require either direct or indirect dental restoration.
- Ellis class III fracture: involves enamel, the dentin layer, pulp, and extensive crown fracture and is a medical emergency.
Lateral luxation
When an adjacent bone fracture causes a tooth to move laterally, this condition is known as lateral luxation. This type of luxation always involves the fracture of the socket of the alveolar bone, which is relatively frequent along the labial or palatal/lingual side of either jaw arch.
Alveolar fracture
A bone fracture of the alveolar ridge is known as an alveolar fracture. This sort of fracture may or may not harm the tooth socket. This is a severe bone fracture that can involve several teeth. If it worsens, it has the potential to spread all across the entire mandible or maxilla.
Treatments for dental trauma
Treatment of subluxation and extrusion:
- In order to stabilize the teeth in cases of extrusion and subluxation, a flexible splint must be worn for 14 days. The reason is that dental splints reduce the probability of teeth necrosis.(Denise Pedrini, Sônia Regina Panzarini, […], and Daniela Atili Brandini, 2018)
- During this period, a soft diet is typically advised.
- When carefully restored and splinted for a brief period, extruded teeth seem to have a decent outlook.(K. Humphreys, S. Al Badri, M. Kinirons, R.R. Welbury, Cole, R.A.E. Bryan, O. Campbell, D.E. Fung, 2003)
- Regular examinations and management of the tooth (along with its pulp and nerves) are strongly advised. Although subluxation damage is presumed to be of small degrees, it needs to be examined because pulp necrosis is a risk.(Denise P, Sônia R. P, Adelisa Rodolfo, Valéria Marisel, Celso Koogi, Wilson Roberto, Daniela Atili, 2018)
Treatment of lateral luxation:
- The displaced tooth must first be relocated as the first step in treatment.
- It necessitates using splints for longer, usually up to 4 weeks.(Dental trauma, Wikipedia., 2022)
- Most people can recover completely from this kind of dental trauma with the help of soft food, competent care, and professional supervision.
Treatment for intrusion:
Treatments for incursion may differ based on the particular reason for the displacement.
- An unexpected or abrupt incursion will probably result in a spontaneous eruption if the tooth has not finished developing.
- Surgical repositioning(Alex Rovira-Wilde, Nick Longridge, Sarah McKernon, 2020) and orthodontic realignment for serious dental incursions are further effective treatments.
- If the incursion is severe enough, a root canal may be performed to preserve the tooth from eroding.
Avulsion treatment:
- Repositioning and splinting for at least two weeks are used to manage avulsions.
- If the avulsion was caused by a sports accident, the orthodontist might suggest a protective mouth guard in addition to a root canal to prevent further difficulties. The root canal procedure might include the administration of medication within the tooth. Afterward, a permanent root canal filling will be inserted.
Treatment of tooth/root fracture:
- Initial treatment: Initial therapy is used to fix the broken portions of bone in tooth fractures.
- Removing nerves, known as a pulpectomy, can also be done if required
- Final treatment: One of the following techniques will likely be used to conclude the therapy.
- A crown
- An orthodontic extrusion
- A surgical extrusion
- Complete extraction
Medical coverage for dental trauma
A dentist will most frequently make a medical claim due to trauma. Medical payers define and assess dental trauma according to specific standards. The terminology used in each payer’s policy fluctuates, but they all state in some manner that any dental work required as a consequence of “accidental trauma that harms a sound tooth” will be reimbursed. Most dental insurers view trauma-related tooth loss or damage as medical; thus, medical insurance is prioritized above dental insurance.
The following are some of the processes that medical payers commonly agree to pay:
- Tooth examination
- Restoration such as crowns to fix cracked or chipped teeth
- Diagnostic radiography
- Stabilization of avulsed teeth
- Endodontic therapy, if necessary
- Some payers may provide coverage for dental implants needed to replace a tooth lost due to trauma
- Some health insurance policies, however uncommon, offer compensation for dentures that sustain damage from an exterior accident
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