Emergency Department Care

Provide adequate pain management, tetanus vaccination, and ensure proper follow-up care.^{[10, 11, 13, 14]}

Document arrangements for follow-up care with a dentist.

Consultations

Consult a dental or oral maxillofacial surgeon for splinting.

Subluxation or extrusion injury

A dentist should adjust and splint.^[15]

Intrusion injury

A tooth should be allowed to re-erupt. Dentoalveolar ankylosis of a primary tooth hinders eruption of the succedaneous permanent tooth.

Intruded primary teeth: Allow teeth to re-erupt before possible repositioning.
Intruded adult teeth: Allow re-eruption then stabilize.

Surgical Care

A study investigated differences in the periodontal outcomes of palatally displaced canines (PDC) exposed with either an open or a closed surgical technique. The study concluded that there is a periodontal impact when a unilateral PDC is exposed and aligned, however, this impact is small and unlikely to have clinical relevance in the short term.^[16]

Medication

Litsas G, Acar A. A review of early displaced maxillary canines: etiology, diagnosis and interceptive treatment. Open Dent J. 2011 Mar 16. 5:39-47. [QxMD MEDLINE Link]. [Full Text].
Gutmann JL, Gutmann MS. Cause, incidence, and prevention of trauma to teeth. Dent Clin North Am. 1995 Jan. 39(1):1-13. [QxMD MEDLINE Link].
Goswami M, Rahman B, Singh S. Outcomes of luxation injuries to primary teeth-a systematic review. J Oral Biol Craniofac Res. 2020 Apr-Jun. 10 (2):227-32. [QxMD MEDLINE Link].
Josell SD, Abrams RG. Traumatic injuries to the dentition and its supporting structures. Pediatr Clin North Am. 1982 Jun. 29(3):717-41. [QxMD MEDLINE Link].
Devlin DH. A historical review of dental and facial skeletal trauma. J Calif Dent Assoc. 1996 Feb. 24(2):29-34. [QxMD MEDLINE Link].
Majorana A, Bardellini E, Conti G, Keller E, Pasini S. Root resorption in dental trauma: 45 cases followed for 5 years. Dent Traumatol. 2003 Oct. 19(5):262-5. [QxMD MEDLINE Link].
Harwood-Nuss A, Linden C, Luten R, eds. Dental injuries. The Clinical Practice of Emergency Medicine. Philadelphia, Pa: Lippincott, Williams & Wilkins; 1996. 418-421.
Al-Jundi SH. Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study. Dent Traumatol. 2004 Feb. 20(1):1-5. [QxMD MEDLINE Link].
Bakland LK, Andreasen JO. Examination of the dentally traumatized patient. J Calif Dent Assoc. 1996 Feb. 24(2):35-7, 40-4. [QxMD MEDLINE Link].
Josell SD. Evaluation, diagnosis, and treatment of the traumatized patient. Dent Clin North Am. 1995 Jan. 39(1):15-24. [QxMD MEDLINE Link].
Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Dent Traumatol. 2007 Apr. 23(2):66-71. [QxMD MEDLINE Link].
Iwase M, Ito M, Katayama H, Nishijima H, Shimotori H, Fukuoka A, et al. Traumatic displacement of maxillary permanent canine into the vestibule of the mouth. Case Rep Dent. 2015. 2015:360160. [QxMD MEDLINE Link].
Robert JR, Hedges JR. Emergency dental procedures. Clinical Procedures in Emergency Medicine. Philadelphia, Pa: WB Saunders Co; 1991. 1045-1064.
Rosen P, Barkin R. Dental emergencies. Emergency Medicine Concepts and Clinical Practice. 3rd ed. St Louis, Mo: Mosby-Year Book; 1992. Vol 3: 2381-2398.
Belmonte FM, Macedo CR, Day PF, Saconato H, Fernandes Moça Trevisani V. Interventions for treating traumatised permanent front teeth: luxated (dislodged) teeth. Cochrane Database Syst Rev. 2013 Apr 30. 4:CD006203. [QxMD MEDLINE Link].
Parkin NA, Milner RS, Deery C, Tinsley D, Smith AM, Germain P, et al. Periodontal health of palatally displaced canines treated with open or closed surgical technique: a multicenter, randomized controlled trial. Am J Orthod Dentofacial Orthop. 2013 Aug. 144 (2):176-84. [QxMD MEDLINE Link].

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Author

Lynnus F Peng, MD Assistant Clinical Professor, Department of Anesthesia, University of California at Irvine; Chairman of Anesthesia, Department of Surgery, St Jude Medical Center at Fullerton

Lynnus F Peng, MD is a member of the following medical societies: Alpha Omega Alpha, American Society of Anesthesiologists

Disclosure: Nothing to disclose.

Coauthor(s)

Amin Antoine Kazzi, MD Professor of Clinical Emergency Medicine, Department of Emergency Medicine, American University of Beirut, Lebanon

Amin Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Willard Peng, DDS, MS Keck School of Medicine of the University of Southern California

Willard Peng, DDS, MS is a member of the following medical societies: American Dental Association, California Dental Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Anil P Punjabi, MD, DDS Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, Loma Linda University School of Dentistry; Clinical Associate Professor, Department of Plastic Surgery, Loma Linda University School of Medicine; Chairman, Department of Plastic, Maxillofacial and Reconstructive Surgery, Vice Chairman, Department of Surgery, Redlands Community Hospital; Medical Director, Terracina Surgical Arts

Anil P Punjabi, MD, DDS is a member of the following medical societies: American Cleft Palate-Craniofacial Association, American Medical Association, American Society of Plastic Surgeons

Disclosure: Nothing to disclose.

Additional Contributors

Michael Glick, DMD Dean, University of Buffalo School of Dental Medicine

Michael Glick, DMD is a member of the following medical societies: American Academy of Oral Medicine, American Dental Association

Disclosure: Nothing to disclose.

Acknowledgements

Mark W Fourre, MD Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine; Program Director, Department of Emergency Medicine, Maine Medical Center

Disclosure: Nothing to disclose.