Subluxation

Subluxation is defined as an injury to the tooth's supporting structures with abnormal loosening but without tooth displacement. The diagnosis and treatment is similar to a concussion injury except for managing the increased mobility of the injured tooth. Treatment objectives are to optimize healing of the periodontal ligament and maintain pulp vitality. This is accomplished by relieving the tooth from occlusion. Splinting is usually not indicated unless the patient complains of tooth mobility. The patient should be placed on a soft diet for two weeks.

Parents should be informed the traumatized tooth may darken, however, no treatment, other than observation, needs to be undertaken unless the patient complains of pain, the tooth becomes mobile, or infection develops. Primary teeth do not require treatment for minor mobility and only need to be followed for pathology. The prognosis is usually favorable and the mobile tooth returns to its normal condition within two weeks. Follow up treatment is clinical observation at one week and six-to-eight weeks.

Mobile permanent teeth may need to be stabilized and occlusal interferences relieved. A flexible splint may be placed for no more than two weeks. Mature permanent teeth with closed apices may undergo pulpal necrosis due to associated injuries to the blood vessels at the apex.

Follow up treatment consists of splint removal after no more than two weeks, pulp sensibility testing and radiographic examination at one week, six-to-eight weeks and one year.