Primary tooth concussion injuries occur when a tooth sustains a relatively minor blow that neither displaces nor chips it. Often, the tooth is not mobile, but is tender to percussion and often to biting. If the tooth exhibits minor mobility, it is generally not splinted, and avoidance is the only treatment necessary.
If the child complains of pain, the bite can be adjusted such that no direct chewing pressure can be applied to the tooth. Avoidance of the tooth during chewing will typically prevent the child from complaining further. Generally, concussion injuries have a good prognosis, but follow-up is important to rule out development of infection and/or chronic inflammation.
As with all types of dental injury, it’s a good idea to have a baseline X-ray exposed soon after the injury occurs, if a recent image is not available (how soon depends on the severity of the injury). A baseline X-ray image is the standard against which potential changes due to the injury can be compared. The earliest radiographic changes would appear no sooner than 3-4 weeks, and often longer than that. Usually, once the tooth has been diagnosed with a concussion injury, the first follow-up occurs at about 6 weeks following the injury. A second follow-up with an X-ray image occurs at around 3 months, a third at six months and then annually after that. Your dentist’s recommended follow-up schedule may vary from this.
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