Intrusion - Treatment Guidelines

Treatment

Tooth intrusion is associated with a potential risk of damage to the permanent tooth bud.

Spontaneous eruption
If the apex is displaced toward or through the labial bone plate, the tooth should be left for spontaneous repositioning. In order to evaluate re-eruption, the degree of intrusion should be assessed by measuring the distance between the incisal edge of the intruded tooth and that of adjacent unaffected teeth.

Extraction
If the apex is displaced into the developing tooth germ the tooth should be extracted to minimize the damage done to the permanent successor.

Patient instructions

Soft food for 10-14 days.

Good healing following an injury to the teeth and oral tissues depends, in part, on good oral hygiene. Brush with a soft brush after every meal and apply chlorhexidine 0.1 % topically to the affected area with cotton swabs twice a day for one week. This is beneficial to prevent accumulation of plaque and debris along with recommending a soft diet , restrict the use of a pacifier.

Parents should be further advised about possible complications that may occur, like swelling, dark discoloration of the crown, increased mobility or fistula. Children may not complain about pain; however, infection may be present and parents should watch for signs of swelling of the gums and bring the child in for treatment.

Inform the parent about possible complications in the development of the permanent successor, especially following intrusion injuries sustained in children under 3 years of age.

Follow-up

Clinical control after 1 week. Clinical and radiographic control at 3-4 weeks, 6-8 weeks, 6 month, 1 year and yearly clinical and radiographic control until eruption of the permanent successor.