Dental Trauma or Infection Clinical Pathway — Emergency Department

Luxation Injuries of Permanent Teeth

The primary concern of luxation injuries in permanent teeth is increased mobility of the tooth which results in pain, and in some cases, injury to the root and nerve of the tooth. Treatment of these injuries depends on the extent of mobility, and frequently, these teeth require splinting in the emergency department and possible root canals in the future.

Injury	Clinical Signs	Management	Follow-Up
Subluxation	Increased mobility but no displacement from socket with or without biting Associated with: Sensitivity to palpation and percussion of the tooth	If no increased mobility upon biting, no need for emergent treatment Consult Dental Increased mobility upon biting may need splinting Diet Soft food diet for at least 3 days Analgesia NSAIDs/Acetaminophen Oral Care Chlorhexidine gluconate 0.12%	Personal dentist or Penn Dental Medicine
Extrusive Luxation	Tooth is extruded from gingiva and socket, giving it an elongated appearance Associated with: Bleeding/blood around the gingival margin Mobility and slight displacement of tooth	Consult Dental Reposition and splint Splint will remain on for at least 2 wks Diet Soft food diet for the duration of the splint being in place Analgesia NSAIDs/Acetaminophen Oral Care Chlorhexidine gluconate 0.12%	Personal dentist or Penn Dental Medicine
Lateral Luxation	Displacement of tooth outside of the bony confines of the alveolar socket with crown displaced toward the tongue Tooth may display mobility or immobility depending on severity of alveolar fracture	Consult Dental Reposition and splint Splint will remain on for at least 2 wks, 4 wks being preferable Diet Soft food diet for the duration of the splint being in place Analgesia NSAIDs/Acetaminophen Oral Care Chlorhexidine gluconate 0.12%	Personal dentist or Penn Dental Medicine
Intrusive Luxation	Tooth is displaced apically (in the axial dimension) into the alveolar bone Tooth is likely immobile	Consult Dental Reposition and splint Diet Soft food diet for the duration of the splint being in place Analgesia NSAIDs/Acetaminophen Oral Care Chlorhexidine gluconate 0.12%	Personal dentist or Penn Dental Medicine to assess potential need for root canal

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The clinical pathways are based upon publicly available medical evidence and/or a consensus of medical practitioners at The Children’s Hospital of Philadelphia (“CHOP”) and are current at the time of publication. These clinical pathways are intended to be a guide for practitioners and may need to be adapted for each specific patient based on the practitioner’s professional judgment, consideration of any unique circumstances, the needs of each patient and their family, and/or the availability of various resources at the health care institution where the patient is located.

Accordingly, these clinical pathways are not intended to constitute medical advice or treatment, or to create a doctor-patient relationship between/among The Children’s Hospital of Philadelphia (“CHOP”), its physicians and the individual patients in question. CHOP does not represent or warrant that the clinical pathways are in every respect accurate or complete, or that one or more of them apply to a particular patient or medical condition. CHOP is not responsible for any errors or omissions in the clinical pathways, or for any outcomes a patient might experience where a clinician consulted one or more such pathways in connection with providing care for that patient.

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Dental Trauma or Infection Clinical Pathway — Emergency Department

Luxation Injuries of Permanent Teeth

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Dental Trauma or Infection Clinical Pathway, Emergency Department – Luxation Injuries of Permanent Teeth

Dental Trauma or Infection Clinical Pathway — Emergency Department

Luxation Injuries of Permanent Teeth