Tooth Luxation vs Subluxation – Treatment, Symptoms, Meaning Definition, Surgery

Key Facts

• Tooth luxation refers to the displacement of a tooth from its normal position in the socket
• It can be caused by traumatic injuries, dental procedures, or underlying dental conditions
• The severity varies from slight looseness to complete dislodgement
• Immediate dental care is often essential to preserve the tooth
• Treatment options include repositioning, splinting, and in severe cases, extraction
• Maintaining good oral hygiene and using mouthguards during sports can help prevent tooth luxation

What is Tooth Luxation?

Tooth luxation is a dental injury that affects the position of the tooth in the mouth. This injury is common in both children and adults and can result from various causes including accidents, sports injuries, or even dental procedures. Immediate care is often required to prevent complications or tooth loss. Tooth luxation refers to the displacement of a tooth from its original position in the socket. Unlike avulsion, where the tooth is completely knocked out of the socket, luxation involves a partial displacement. This means that the tooth remains attached to the socket but is either moved to a different position or becomes loosened. Depending on the direction and severity of the displacement, tooth luxation is classified into various types including lateral luxation, extrusive luxation, and intrusive luxation.
Lateral Luxation: In lateral luxation, the tooth is displaced sideways, but still remains attached to the socket. This usually occurs due to a direct impact to the side of the tooth and can affect the periodontal ligament and the alveolar bone.
Extrusive Luxation: Extrusive luxation, often referred to as partial avulsion, occurs when the tooth becomes partially displaced out of its socket. This can cause the tooth to appear longer than adjacent teeth and to feel particularly loose.
Intrusive Luxation: In intrusive luxation, the tooth is driven into the alveolar bone. This type of luxation is usually the result of an impact on the occlusal surface of the tooth and is often the most severe form of tooth luxation.

What Parts of a Tooth Can Become Luxated?

In tooth luxation, various parts of the tooth and surrounding structures are affected. The crown may become visibly misaligned or elongated, the root may be pushed into a different position, and the supporting structures such as the periodontal ligament and alveolar bone may be damaged.

Who Might Get a Luxated Tooth?

Tooth luxation can occur in individuals of all ages, but there are certain groups who might be more susceptible:

• Children: Due to their active lifestyle, children are more prone to falls and accidents which can cause tooth luxation.
• Athletes: Individuals involved in contact sports or activities that pose a risk of facial injuries have a higher chance of experiencing tooth luxation.
• Patients undergoing dental procedures: In some cases, a tooth might become luxated during dental procedures, especially extractions or the placement of dental implants.
• Individuals with periodontal disease: Those with weakened periodontal ligaments due to gum disease are more susceptible to tooth luxation even from minor trauma.

It’s important to understand that tooth luxation is a dental emergency. Quick and appropriate intervention is crucial to preserving the health and integrity of the affected tooth. Moreover, wearing protective gear during sports and ensuring a safe environment for children can help in preventing such injuries.

What Causes Tooth Luxation?

Tooth luxation can be caused by various factors, including:

• Physical Trauma: A common cause of tooth luxation is physical trauma to the mouth or face. This could be due to falls, accidents, or being hit by an object. Such incidents can cause the tooth to become displaced from its normal position in the socket.
• Sports Injuries: Athletes, especially those involved in contact sports like football, hockey, or martial arts, are at an increased risk of tooth luxation due to the nature of their activities.
• Dental Procedures: Sometimes, a tooth can become luxated during dental procedures, especially if excessive force is applied. This is more common in procedures such as tooth extractions.
• Periodontal Disease: In cases of advanced gum disease, the supporting structures of the teeth are weakened, which may result in the loosening and luxation of the teeth even with minor forces.
• Bruxism: Chronic grinding or clenching of the teeth (bruxism) can also lead to tooth luxation over time as it places excessive pressure on the teeth.

What are the Symptoms of a Luxated Tooth?

The symptoms of tooth luxation can vary depending on the severity and type of luxation.
Common symptoms include:

• Misalignment of the Tooth: One of the most obvious signs is that the tooth appears to be out of place or misaligned compared to the surrounding teeth
• Pain and Discomfort: There may be pain or discomfort when biting down, or when the tooth is touched
• Tooth Mobility: The affected tooth may be loose in its socket
• Bleeding: There might be bleeding from the gums around the affected tooth
• Swelling: Swelling of the gums or face around the affected area can occur
• Sensitivity: The tooth may become sensitive to hot or cold temperatures

How do Healthcare Providers Diagnose a Luxated Tooth?

Diagnosing a luxated tooth usually involves a combination of a clinical examination and imaging:

• Clinical Examination: The dentist will start by asking about the history of any trauma or injury. This will be followed by a visual examination of the mouth to assess the position of the affected tooth and surrounding structures. The dentist will also check for tooth mobility and may gently probe the tooth to assess the level of pain or discomfort.
• X-rays: In many cases, a dental X-ray is essential to visualize the position of the tooth in the socket and to evaluate the extent of injury to the surrounding bone and tissues. This helps in making an accurate diagnosis and planning the appropriate treatment.
• Additional Tests: In some cases, additional tests like vitality tests may be done to check the health of the tooth’s nerve.

Once the dentist has gathered all the necessary information through clinical examination and imaging, a diagnosis is made and a personalized treatment plan is developed based on the severity and type of tooth luxation.

What are the Types of Tooth Luxation?

There are several types of tooth luxation, each varying in severity and position of displacement:

• Concussion: The tooth is not displaced but is tender when touched or bitten down on. This is usually the mildest form of luxation.
• Subluxation: The tooth is slightly mobile but not displaced. There may be bleeding from the gum line.
• Extrusive Luxation (Partial Avulsion): The tooth is partially out of its socket, making it excessively mobile.
• Lateral Luxation: The tooth is displaced in a direction other than axially, with the crown often driven into or away from the oral cavity. This is often associated with a fracture of the alveolar bone.
• Intrusive Luxation (Intrusion): The tooth is driven into the alveolar bone. This may result in the tooth appearing shorter or pushed below the gum line.

Tooth luxation vs subluxation

Subluxation is considered to be a milder form of luxation. In subluxation, the tooth is loosened but not visibly moved or displaced from its socket. This means that the supporting structures of the tooth are damaged, but the tooth remains in its original position.
Tooth subluxation can cause pain and increased mobility of the tooth, but it doesn’t exhibit the noticeable displacement that is seen in other forms of luxation. Treatment for subluxation is typically conservative and might include monitoring the tooth, advising a soft diet, and possibly using a mouthguard or splint for a short period of time to reduce mobility.

Can I Treat a Luxated Tooth Myself?

It’s highly advisable not to attempt to treat a luxated tooth by yourself. Doing so can cause further damage to the tooth and surrounding tissues.
However, there are steps you can take to manage the situation before seeing a dentist:

• Stay Calm: Try to remain calm and avoid touching or probing the luxated tooth with your tongue or fingers.
• Cold Compress: Apply a cold compress to the outside of the mouth to help reduce swelling and numb the area to alleviate pain.
• Take Over-The-Counter Pain Relievers: Take over-the-counter pain relievers to help manage the pain but avoid taking aspirin as it can promote bleeding.
• See a Dentist ASAP: It’s crucial to see a dentist as soon as possible. The sooner the tooth is treated, the better the chances of saving it.

How do Dentists Treat a Luxated Tooth?

The treatment for a luxated tooth depends on the type and severity of luxation:

• Repositioning and Splinting: For extrusive and lateral luxation, the dentist may reposition the tooth and use a splint to stabilize it. This splint is usually left in place for a few weeks to allow the tooth to heal.
• Root Canal Therapy: In cases of intrusive luxation, or if there’s evidence of nerve damage, a root canal treatment might be necessary.
• Monitoring and Follow-up: In cases of concussion and subluxation, the dentist might not perform any immediate treatment but will closely monitor the tooth. It’s important to follow the dentist’s recommendations and attend all follow-up appointments.
• Extraction and Replacement: In severe cases where the tooth cannot be saved, extraction may be necessary. The tooth can be replaced with an implant, bridge, or partial denture.
• Medications: Antibiotics and pain relievers may be prescribed to prevent infection and manage pain.

Can I Prevent Tooth Luxation?

While it is not always possible to prevent tooth luxation, especially when caused by unforeseen accidents, there are steps that can be taken to minimize the risk:

• Wearing Protective Gear: If you engage in contact sports or activities that pose a risk of injury to the face and mouth, it is essential to wear mouthguards and helmets.
• Avoiding Hard Foods and Objects: Refrain from biting down on hard foods, like ice or hard candies, and avoid using your teeth to open packages or bottles.
• Regular Dental Check-ups: Regular dental visits help in the early detection of dental issues that may weaken the teeth and make them more susceptible to luxation.
• Maintaining Oral Hygiene: Practicing good oral hygiene by regularly brushing and flossing can keep the teeth strong and healthy.
• Addressing Bruxism: If you grind your teeth, talk to your dentist about options to manage bruxism, as this can weaken teeth over time.

What is the Outlook for People with a Luxated Tooth?

The outlook for a luxated tooth largely depends on the severity of the luxation and the timeliness of treatment. If addressed promptly and appropriately, many luxated teeth can be saved. However, severe luxation may result in tooth loss or require more complex restorative procedures. The affected tooth will likely need monitoring over time, as complications can sometimes develop later.

When Should I See My Healthcare Provider About a Luxated Tooth?

If you experience any of the following signs or symptoms, it’s essential to see a healthcare provider or dentist as soon as possible:

• Loose or Displaced Tooth: If a tooth is noticeably loose or displaced following trauma or for no apparent reason.
• Pain or Discomfort: Experiencing pain, especially when biting down, or discomfort around the affected tooth.
• Bleeding or Swelling: If there is bleeding from the gums around the tooth or swelling in the mouth or face.
• Changes in Bite: If there are changes in the way your teeth fit together when you bite.

Remember that the sooner you seek treatment for a luxated tooth, the better the chances of preserving the tooth and preventing complications.

Bottom line

In summary, while tooth luxation cannot always be prevented, taking steps to protect the teeth can minimize the risk. When luxation occurs, seeking prompt professional care is crucial for the best outcome. Following your healthcare provider’s advice for treatment and follow-up is key to ensuring long-term dental health.

This article is complete and was published on July 06, 2023, and last updated on August 25, 2023.