Dental splinting stabilizes a tooth injured or loosened by trauma by securing it to one or more adjacent, healthy teeth. This technique limits movement and provides temporary support, allowing surrounding tissues, primarily the periodontal ligament and bone, a chance to heal properly. Stabilization reduces pain, prevents further damage, and increases the likelihood of the tooth surviving the injury.
Identifying Injuries Requiring Stabilization
A splint is necessary when a dental injury causes a tooth to become mobile or displaced from its normal position. Injuries include subluxation (loosened but not displaced) and luxation (moved out of position), such as intrusion, extrusion, or lateral luxation. Any visible movement or displacement after trauma requires immediate professional dental assessment. Avulsion, where a tooth is completely knocked out, also necessitates splinting after successful reimplantation.
Immediate Temporary Stabilization Steps
When a traumatic injury occurs, the immediate priority is stabilizing the tooth until professional care can be reached. If a tooth is avulsed (knocked out), gently rinse it without scrubbing and immediately reinsert it into the socket, holding it with a clean cloth. If reinsertion fails, the tooth must be kept moist by placing it in milk, saline solution, or saliva, but never in plain water.
Creating a Makeshift Splint
For a tooth that is severely loose or slightly displaced but still in the mouth, temporary stabilization is needed to minimize further trauma during transport. A makeshift splint can be created using softened, sugar-free chewing gum, dental wax, or temporary dental cement. The material should be molded to cover the injured tooth and the adjacent one or two stable teeth, adhering the loose tooth to its neighbors. This temporary bond must be passive, simply holding the current position until the patient seeks professional dental care immediately.
Professional Dental Splinting Procedures
The professional splinting procedure begins with a thorough examination, including X-rays, to assess damage to the tooth root and surrounding bone. The dentist ensures the tooth is correctly positioned, repositioning it gently if necessary, before cleaning and preparing the teeth for bonding. The most common method uses a thin, flexible material, such as a wire or fiber ribbon, bonded with composite resin. This material is applied across the injured tooth and typically two stable neighbors on either side. Dentists prefer a flexible splint because it allows slight physiological movement, promoting better healing of the periodontal ligament (PDL) fibers.
Splint Duration
The duration the splint remains in place is determined by the injury type and severity. Simple injuries like subluxation or extrusion may require stabilization for about two weeks. Severe injuries, such as avulsion or a root fracture, require longer stabilization, sometimes ranging from four weeks up to four months.
Managing the Splint and Recovery
Careful patient management is necessary once the professional splint is in place to ensure successful healing. Maintaining meticulous oral hygiene is paramount to prevent infection around the splinting material. Patients must use a soft-bristled toothbrush and clean gently around the splint, focusing on the gum line and bonded areas. Special cleaning aids, such as floss threaders or proxy brushes, may be recommended to clean beneath the splint without dislodging it.
Diet and Monitoring
A soft diet is mandatory during the entire splinting period to avoid placing excessive biting force on the injured tooth. Patients must avoid hard, crunchy, or sticky foods and refrain from biting directly with the front teeth. Patients must monitor the splint for loosening or breakage and report any pain, swelling, or color changes to their dentist immediately. Once the healing period is complete, the dentist performs the straightforward splint removal and a final evaluation of the tooth’s long-term viability.