What should I do if a tooth becomes loose after an accident while wearing braces?

Contact your orthodontist immediately. They will assess the situation and provide appropriate care, which may include repositioning the tooth or recommending additional treatment.

Can a loose tooth after an accident affect my orthodontic treatment?

Yes, a loose tooth can impact your treatment plan. Your orthodontist may need to adjust your braces or recommend additional procedures to ensure proper healing and alignment.

How long does it take for a loose tooth to stabilize after an accident?

The healing time varies depending on the severity of the injury. It can take several weeks or even months for a loose tooth to fully stabilize. Follow your orthodontist's instructions for proper care and recovery.

Managing a Loose Tooth After an Accident with Braces

Trauma to front tooth — The front tooth was saved from complete loss by the thin wire of braces

Here we will share a case of a 14-year-old girl with a 6-year follow-up after a trauma that caused the upper front tooth to get almost completely loose.

She was playing with her sister and cousin and having too much fun till her front tooth was hit accidentally and got out of its place.

She was lucky to have braces as the thin wire kept the tooth dangling in her mouth and prevented the complete loss of the tooth. Her mom rushed her to our office, and the tooth was gently placed back into its place.

braces with trauma — 12 month progress picture of the case with the traumatized front tooth in a straight position

Usually, a traumatized tooth must get a root canal treatment in 46% of the cases. however, in this case, the endodontist and Dr Kanaan decided to wait on the root canal to observe the natural healing process of your body. The tooth was monitored for vitality every month during her orthodontic visit to make sure the tooth was not dying and we took x-rays every 6 months.

This case demonstrates how lucky this patient was that the tooth did not die and there was no need for a root canal treatment. The tooth maintained its natural beautiful color as proven by a 6-year follow-up.

6 year follow up — Notice how the tooth has healed after 6 years with a slight apical root resorption. Tooth is still vital.

Please note that the bone between the Upper right central and lateral incisor did not heal completely causing a small distortion in her gum " Papilla"

Trauma tooth follow up — A 6 year follow up. No root canal was needed. Notice the slight defect in her gum between UR1-UR2

Call us today at 281-249-9999 for a FREE trauma evaluation with Dr. Kanaan during business hours.

Things to keep in mind

Do not panic. But, you need to act quickly and get professional dental care to have the best results.
The right fixation is crucial for proper long-term healing.
In older children, the traumatized tooth has less chance to heal without a root canal.
Not all traumatized teeth will die immediately, this process might happen even after years!

What to do if the tooth is not completely out and you can not reach professional care?

If it is the middle of the night or you are on a farm away from professional dental care, AND THE TOOTH IS STILL IN ITS PLACE, you might follow these tips:

Do's:

Keep the area clean with good oral hygiene.
Take over-the-counter painkillers. Advil will work better than Tylenol.
Eat soft foods that need little chewing.
Use a cold compress on the area to help reduce swelling.

Don'ts:

Don’t play or wiggle the loose tooth.
Don’t chew on the side of the loose tooth.
Avoid hard, sticky, hot, or crunchy foods.

Prevention of Dental Trauma

As the old saying is always true "An ounce of prevention is worth a pound of cure", preventive education for children at home and school is very important to prevent the problems of dental trauma. Also, proper gear should be worn during certain sports such as boxing and football.

Also, if the front teeth are pushed out like in severe overbite cases, then orthodontic treatment might be recommended to bring them to a more protective position. Studies have shown that there is "An increased risk of incisor trauma in children with an overjet greater than 6 mm"

References:

Zerman N, Cavalleri G. Traumatic injuries to permanent incisors. Endod Dent Traumatol. 1993 Apr;9(2):61-4. doi: 10.1111/j.1600-9657.1993.tb00661.x. PMID: 8404697.

Kaba AD, Maréchaux SC. A fourteen-year follow-up study of traumatic injuries to the permanent dentition. ASDC J Dent Child. 1989 Nov-Dec;56(6):417-25. PMID: 2681301.

Kadulkar N, Kataki R, Deka A, Thonai S. Replantation of an Avulsed Tooth: A Case Report. Cureus. 2023 May 18;15(5):e39198. doi: 10.7759/cureus.39198. PMID: 37332457; PMCID: PMC10276759.

Dearing SG. Overbite, overjet, lip-drape and incisor tooth fracture in children. N Z Dent J. 1984 Apr;80(360):50-2. PMID: 6588330.