Authors of section

Editors

J Andreasen, CP Cornelius, N Gellrich, S Hillerup, K Kusumoto, W Schubert

Executive Editors

Edward Ellis III, Kazuo Shimozato

General Editor

Daniel Buchbinder

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No active treatment

1. Decision/Indication

In cases of subluxation, generally no active treatment is indicated. There is a small risk of pulp necrosis for which reason the tooth vitality should be reevaluated in 6 months with pulp testing and apical x-ray.

If the tooth is sore on occlusion, for patient comfort it may be splinted to healthy neighboring teeth for 2 weeks.

Concurring lack of response to pulp testing with periapical radiolucency and discoloration of the crown indicates pulp necrosis, and requires endodontic treatment.

Tooth luxation

2. Treatment

Generally no active treatment is needed. There is a small risk of pulp necrosis and the tooth vitality should be reevaluated in 6 months with pulp testing and apical x-ray. Stability of the tooth has to be assessed and should be regained within 2 weeks.

Note: the patient should be put on soft diet for 2 weeks. Exposure to temperature extremes should be avoided.

Note: care has to be taken that there is no occlusal loading to the affected tooth.

This illustration demonstrates electric pulp testing.

Electric pulp testing

3. Aftercare following treatment of subluxation

Aftercare is given by the general practitioner and may include endodontic treatment. The decision for endodontic treatment may be taken after 2 months of follow-up if the tooth still does not respond to electrometric or thermal pulp testing.

Diet
Patients are encouraged to restrict themselves to a semi-solid diet and avoid clenching and any other traumatic overload to the traumatized tooth for a period of 1 or 2 weeks posttrauma.

Further treatment
Further dental treatment may be needed as elective procedures, for example management of discoloration, cosmetic correction, porcelain restoration, etc.