A tooth has sustained a concussion or subluxation injury. What is the essential follow-up?

Correct answer: D. Monitor pulp vitality over time for the development of necrosis

• A. Concussion needs no splint at all; subluxation needs a flexible splint for up to two weeks only if the mobility is bothersome. Rigid splinting for six weeks promotes ankylosis and replacement resorption.
• B. Immediate endodontic treatment is unwarranted. Most of these teeth retain vitality, and a tooth may test unresponsive for weeks after trauma before recovering.
• C. Transient mobility after subluxation is expected and resolves.
• D. CORRECT. Concussion and subluxation are the two mildest luxation injuries — the tooth is tender, may be slightly mobile in subluxation, but is NOT displaced. Both usually heal without intervention, but pulp necrosis can still develop weeks to months later, so serial vitality testing and radiographs are the whole management.

Note: Follow-up schedule for concussion and subluxation: review at 4 weeks, 6–8 weeks, 6 months and 1 year with clinical examination, vitality testing and radiographs. Warn the patient that a tooth may test negative for several weeks and still recover, so do not open it prematurely on a single negative test.