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

Dental Trauma or Infection Clinical Pathway — Emergency Department

Luxation Injuries of Primary Teeth

The primary concern of luxation injuries in primary teeth is increased mobility of the tooth which results in pain, and in some cases, injury to developing teeth in the jaw. Treatment of these injuries depends on the extent of mobility.

Injury Clinical Signs Management Follow-up
Subluxation
  • Tooth is sensitive to palpation and percussion
  • Increased mobility but no displacement from socket
  • No need for emergent treatment
  • Analgesia
  • NSAIDs/acetaminophen
  • Diet
  • Soft food diet for at least 3 days
 Personal dentist or Penn Dental Medicine
Minor Luxation Injury
  • Tooth/teeth may be laterally luxated, intruded, or extruded < 3 mm and slightly loose (but not an imminent risk of avulsion)
  • Evaluate occlusion making sure that the teeth are aligned and child can bite without interference (confirm bite didn’t change since injury)
  • Consult Dental
    • For luxation injuries > 3 mm
    • If teeth are not in traumatic occlusion (bite is stable) and child is in no pain, no management is necessary
  • Analgesia
  • NSAIDs/acetaminophen
  • Diet
  • Soft food diet for at least 3 days
 Personal dentist or Penn Dental Medicine
Severe Luxation Injury
  • Tooth/teeth may be laterally luxated, intruded, or extruded beyond 3 mm
  • Severe mobility – tooth is at risk of being spontaneously avulsed/aspirated
  • If no signs of alveolar ridge fracture and primary tooth is almost completely extruded, ED may extract tooth at bedside
  • Consult Dental
  • For more complicated luxation injuries and possible extraction
  • Analgesia
  • NSAIDs/acetaminophen
  • Diet
  • Soft food diet for at least 3 days
 Personal dentist or Penn Dental Medicine