A tooth bruise is a common injury that can go virtually unnoticed or lead to serious complications. This is due to the fact that after a blow, the position of the tooth does not change, and the periodontal tissue can suffer greatly. The consequences of a bruise depend on the force of impact. Significant damage can cause tooth loss. Since nerve endings and blood vessels are affected during a bruise, you should contact the dentist immediately, even if there are no external changes or painful sensations.
Symptoms
External signs will also differ depending on the strength of the impact. Externally, a bruise manifests itself with the following symptoms:
- The tooth hurts after a blow. Any mechanical injury leads to pain, but if it is intense and does not go away for a long time, severe injury can be suspected.
- The crown has darkened. This indicates that the blood vessels are damaged and hemorrhage has occurred in the soft tissue.
- Numbness of the face, swelling. These signs indicate severe damage to the nerve endings.
- Mobility of teeth after bruise. They begin to wobble, the gums swell.
Even if your teeth don’t hurt much after the blow, the pain goes away quickly and there are no other external manifestations, you should consult a dentist. It is possible to speak accurately about possible complications only after examination and x-rays.
The gum has moved away from the tooth: treatment
If the gum has moved away from the tooth, treatment will largely depend on the severity of the inflammation. For example, if a patient seeks help at a fairly early stage of inflammation (when the depth of periodontal pockets does not yet reach 3 mm and there is no tooth mobility), significant success can be achieved in the treatment of periodontitis and the process can be completely stopped. Advanced cases of gum inflammation will require much more complex treatment and serious financial costs. Next we list the main stages of treatment.
1) Consultation and x-ray diagnostics –
It is necessary to begin treatment with a consultation with a periodontist and a panoramic photograph of the teeth, which will allow you to create an optimal treatment plan taking into account the condition of your teeth and gums. The image will allow you to determine the amount of destruction of bone tissue around each tooth, the location and depth of periodontal pockets, and will help guide the patient in the need for splinting of mobile teeth, the need for prosthetic replacement of missing teeth, and make the correct diagnosis.
An example of a panoramic image of a patient with periodontitis –
Looking closely at the image, you may notice that the level of bone tissue (the bone looks in the image as fine-mesh looped tissue and normally should reach the necks of the teeth) is reduced in different teeth by 1/4 to 4/5 of the length of their roots. The patient has decayed teeth that need to be removed, as well as carious teeth that require treatment (24stoma.ru). The level of bone tissue is most reduced in the front teeth of the upper and lower jaw, which in this case was the result of not only inflammation of the gums, but also the absence of the chewing group of teeth.
To treat gums, it is best to contact not ordinary dental therapists or hygienists, but periodontists. These are the dentists who specialize in gum treatment. The first and most important stage of treatment will be ultrasonic teeth cleaning. Next, a course of anti-inflammatory therapy is carried out, which in most cases can be successfully carried out at home.
2) Removal of dental plaque –
First of all, it is necessary to remove the cause of inflammation - microbial plaque and dental deposits. They are removed from the teeth using an ultrasonic scaler (Fig. 15), usually over several visits. It is simply impossible to remove all dental deposits in just 1 visit in a patient with periodontitis, because... It takes a lot of time to remove subgingival dental plaque, which is localized in periodontal pockets below the gum level.
It is subgingival dental plaque that poses the main danger for further progression of inflammation, so sometimes it is necessary to prescribe the patient even 3-5 times. Learn that without professional cleaning, all other stages (for example, anti-inflammatory therapy, splinting) will be completely meaningless.
Most dentists and hygienists won't bother with finding and removing subgingival calculus...as experience has shown. Therefore, it is very important to find a competent specialist. Anti-inflammatory therapy is prescribed immediately after 1 session of removing tartar, and within the first 24 hours you will be able to notice changes in the appearance of the gums. In parallel with the reduction in gum swelling, their volume will also decrease, which will allow you to see new portions of dental plaque and remove them during subsequent visits.
Removing dental plaque with ultrasound: video
You can see in the following photos what happens when subgingival tartar is removed poorly. The first photograph shows that the gums are visually in good condition, although a periodontal probe revealed the presence of a periodontal pocket about 5 mm deep. The second photograph was taken after the gums were detached from the teeth, and it shows a very large amount of destruction of bone tissue, which arose due to the presence of small subgingival tartar on the surface of the tooth root.
3) Anti-inflammatory therapy –
The course of anti-inflammatory therapy usually lasts 10 days. In most cases, it is carried out by the patient himself at home, after doctor’s prescriptions and patient education. However, if the patient has deep periodontal pockets with purulent discharge, the doctor may additionally prescribe washing the periodontal pockets, which is done using a syringe and antiseptic solutions. In some cases, antibiotic therapy may also be prescribed for periodontitis.
Anti-inflammatory treatment regimen - usually a complex is prescribed, consisting of an antiseptic mouth rinse and application of gel to the gums. The procedures are carried out 2 times a day (morning and evening, after meals and subsequent oral hygiene), for 10 days. Most often, a complex of the following drugs is prescribed:
- rinsing with Chlorhexidine (instructions)
- “Cholisal-gel” applications (instructions)
In patients with periodontitis, the correct choice of treatment agents is very important. For example, a standard 0.05% solution of chlorhexidine, sold in pharmacies for 40 rubles, is advisable to use only for superficial inflammation of the gums (gingivitis), but for periodontitis it is better to use a 0.2-0.25% concentration of this antiseptic. It is a big plus when such a solution contains not only a good concentration of chlorhexidine, but also other active ingredients (for example, aluminum lactate for bleeding gums or extracts of medicinal plants).
Antiseptic mouth rinse is carried out after breakfast and oral hygiene, rinse your mouth for 1 minute. After this, the gums need to be dried with a dry gauze pad to remove excess saliva, and an anti-inflammatory gel should be applied to the gum edge. The gel is applied in front of a mirror using a finger, and usually only on the front side of the teeth. After such treatment, it is not recommended to eat for 2-3 hours, and also not to drink for 30 minutes. There are a lot of remedies for treating gums, and we hope that our next articles will help you understand their diversity -
→ The best antiseptics for mouth rinsing, → Rating of the best gels for treating gums.
4) Oral hygiene training –
If you have not yet forgotten the beginning of the article, then remember that the cause of periodontitis and destruction of the dental-gingival attachment is unsatisfactory oral hygiene, which leads to the accumulation of microbial plaque and tartar on the teeth. Therefore, in addition to the basic treatment that we described above, it is very important to constantly maintain high-quality oral hygiene.
Good hygiene doesn't mean just brushing your teeth twice a day, that's not enough. Good oral hygiene includes brushing your teeth after every meal, not snacking on cookies or candy between meals, and regularly using dental floss. You can read about absolutely all the recommendations in the article at the link above. Below, you can watch the video on how to properly use a toothbrush and dental floss.
How to use dental floss and brush correctly -
In the presence of periodontal pockets and mobile gingival margins, it is important to carry out hygiene below the gum level. This can be done using special devices - home irrigators. Special attachments allow you to rinse at home not only areas of the oral cavity that are difficult to reach for hygiene, but also periodontal pockets below the level of the gingival margin. Irrigators can use both ordinary boiled water and special medicinal solutions.
Causes
There are many reasons for a tooth bruise. The most common is a strong direct blow to the jaw. Athletes often receive such injuries; they are almost always the consequences of accidents. It is impossible not to notice it, since after a blow the front tooth hurts, and the pain is usually sharp.
There is another reason - the so-called chronic jaw injury. The peculiarity of such injuries is that they are insignificant in their impact, but a person is constantly exposed to them. Examples include some human habits: biting nails, holding a pen or pencil in the mouth, cracking nuts, etc. Under the influence of such seemingly insignificant factors, the enamel becomes thinner and microchips form on it. The result of these innocent habits is tooth loss.
Injury can also occur during dental procedures performed by an inexperienced dentist or using old equipment. Any violation of the treatment or removal technique can lead to damage to healthy tissue. That is why our clinic employs experienced, highly qualified specialists. We are responsible for the health of our patients.
What to do?
The main thing is never to heat the place that hurts. Once upon a time, grandmothers said that you need to bandage your cheek with a warm scarf, but you shouldn’t do this. Inflammation cannot be heated. If the temperature rises, the process becomes even stronger. If there is pus, you should apply a piece of ice to the area that hurts.
If the pus comes out of the gums, you shouldn’t think that everything is gone. Drug treatment is necessary to stop the process. But antibiotics must be prescribed by a doctor.
Complications
What to do after a tooth injury? The answer is clear - contact your dentist immediately. Even if it seems to you that the injury was not severe, you do not experience pain, there is no bleeding. Not a single blow passes without leaving a trace on the body, and its consequences will sooner or later make themselves felt. A bruise can lead to various complications:
- Dying of the pulp. During a bruise, nerve endings are damaged, neighboring tissues gradually die, an inflammatory process develops, purulent formations and cysts form.
- Darkening of the crown. Occurs due to rupture of blood vessels. At first the enamel takes on a pink tint and then darkens. The crown tissues do not receive the necessary nutrients. Even if it is possible to maintain the integrity of the tooth, it will stand out in the row due to the changed color. Regular bleaching cannot remove darkening.
- Periodontal damage. In this case, the bruise leads to the development of periodontitis.
Children's bruises do not go away without a trace, so if your baby falls and hits himself, he needs to be shown to the dentist. A long-term consequence of such injury is abnormal growth of permanent teeth.
