Treatment

Spontaneous repositioning
If there is no occlusal interference, as is often the case in anterior open bites, the tooth should be allowed to reposition spontaneously.

Repositioning
When there is occlusal interference local anesthesia should be applied where after the tooth should be repositioned by gentle combined labial and palatal pressure.

Extraction
For teeth with severe displacement in a labial direction, extraction is the treatment of choice. Extraction is indicated in these cases because of the collision between the primary tooth and the permanent tooth germ.

Slight grinding
In cases with minor occlusal interference, slight grinding is indicated.

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.

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.

Follow-up

Clinical control after 1 and 2-3 weeks. Clinical and radiographic control at 6-8 weeks and 1 year.