Tooth splinting is a specialized dental procedure used to stabilize a tooth that has become loose or displaced due to traumatic injury. This technique involves temporarily joining the injured tooth to one or more healthy, stable neighboring teeth. This immobilization allows the delicate periodontal ligament and surrounding bone to heal properly. Splinting creates a secure environment, significantly increasing the chances that the tooth can be preserved and function normally.
Injuries Requiring Tooth Stabilization
Splinting becomes necessary following specific types of dental trauma where the tooth’s connection to the jawbone is compromised. The most common indication is luxation, which describes an injury where the tooth is still in the socket but has been displaced. This displacement can range from subluxation, where the tooth is only slightly loosened, to more severe lateral, intrusive, or extrusive luxations where the tooth is pushed sideways, inward, or outward.
A serious injury requiring stabilization is avulsion, which is when the tooth is completely knocked out of the socket. In this case, the tooth is reimplanted and then immediately splinted to allow the severed periodontal ligament fibers to reattach to the tooth root and the bone. Splinting is also employed for certain root fractures or when a fracture of the alveolar bone, the bone supporting the teeth, has occurred. Stabilization is needed in these cases to hold the fractured segments in correct alignment, giving the bone or root structures the necessary time to mend.
Emergency Care Before Professional Treatment
The actions taken immediately following a dental injury can directly impact the chances of saving the tooth. If there is bleeding, gentle pressure should be applied to the area with clean gauze or a cloth. For pain management, a cold compress held to the outside of the mouth can help reduce swelling and discomfort until professional help is reached.
For a tooth that has been completely knocked out, known as an avulsed tooth, time is extremely important, with the best outcomes occurring when the tooth is replanted within 30 to 60 minutes. The tooth should only be handled by the crown, which is the white chewing surface, to avoid damaging the root surface and the remaining ligament cells. If possible, the tooth should be gently rinsed with water or milk, but never scrubbed, and then carefully reinserted into its socket.
If reinsertion is not possible, the tooth must be kept moist while transporting it to the dentist. The best storage media are cold milk, a specialized tooth preservation solution, or the patient’s own saliva, which can be accomplished by keeping the tooth inside the cheek. A tooth that is merely displaced, such as a luxated tooth, should be gently nudged back into its normal position with light finger pressure, taking care not to use excessive force. Immediate contact with a dental professional is mandatory for all these injuries.
How Dentists Apply a Tooth Splint
The professional application of a tooth splint begins with a thorough assessment, which includes X-rays to determine the exact nature and extent of the injury. Before stabilization, the dental professional carefully cleans the injured area to minimize the risk of infection. If the tooth is luxated, it is precisely repositioned into its correct anatomical location within the socket before the splinting procedure starts.
Dentists generally prefer to use a flexible or semi-rigid splinting technique for most luxation and avulsion injuries. Unlike rigid splints, flexible options permit a small degree of physiologic tooth movement, which has been shown to be beneficial for the healing of the periodontal ligament. The splint is created using a thin, flexible material, often a wire, nylon fishing line, or fiber-reinforced composite strip. This material is bonded across the injured tooth and at least one stable, uninjured tooth on either side.
To apply the splint, the dentist first prepares the tooth surfaces, typically using an etching gel followed by a dental bonding agent. A small amount of tooth-colored composite resin is then placed on the teeth, usually on the tongue-side or lip-side surface, and the splinting material is embedded into this resin. Once the material is secured in place, a curing light is used to harden the composite resin, firmly attaching the splint to the teeth. The dentist must then carefully check the patient’s bite, known as occlusion, ensuring the splint does not interfere with the opposing teeth.
Duration and Removal of the Splint
The length of time a tooth requires splinting is determined by the type and severity of the dental injury. For minor luxations, such as subluxation or extrusion injuries, the splint is maintained for a short period, often around seven to ten days. A longer duration is required for more complex injuries, such as avulsions or root fractures, where the splint may remain in place for two to six weeks to ensure adequate healing.
After the prescribed healing period, the splint is removed in a relatively straightforward process, usually involving the use of a dental bur or a polishing disc to carefully take away the composite resin. Once the composite is gone, the wire or fiber material is easily detached from the teeth. Following the removal, the injured tooth is then checked for stability and signs of continued healing.
Long-term follow-up care is necessary after the splint is removed, as the injured tooth requires monitoring for potential complications. The dentist will check for signs of pulp necrosis, which is the death of the tooth nerve, or root resorption, where the body’s immune system begins to dissolve the tooth root. These checks may involve periodic X-rays and vitality testing to ensure the tooth remains viable and healthy.