A bruised tooth is a common term for dental trauma where the external structure remains intact, but the injury causes pain and sensitivity. Medically, this is often called a dental concussion, meaning the tooth suffered an impact without being fractured or visibly displaced. The primary concern is damage to the delicate supporting structures surrounding the tooth, which can often be managed with careful self-care.
What Causes a Bruised Tooth
A bruised tooth results from a sudden, forceful impact that causes trauma to the tissues holding the tooth in its socket. The most affected structure is the periodontal ligament, a network of fibers that acts as a shock absorber between the tooth root and the jawbone. When excessive force is applied, these ligaments become stretched, inflamed, or damaged, similar to a sprained joint elsewhere in the body.
Common causes include accidental falls, blows to the mouth during sports, or biting down unexpectedly hard on solid objects like bone or ice. The impact can also affect the internal nerve and blood vessels (the dental pulp), causing inflammation inside the tooth. Symptoms often include a dull, persistent ache, tenderness when chewing or tapping the tooth, and heightened sensitivity to temperature changes. While the tooth may appear stable, it can feel slightly loose or elevated, confirming the supporting ligaments have been stressed.
Immediate Steps for Relief
The first 24 to 48 hours following the injury are when immediate steps can significantly reduce pain and limit inflammation. Applying a cold compress to the outside of the cheek, directly over the injured area, helps constrict blood vessels and minimize soft tissue swelling. Hold the compress for ten to twenty minutes at a time, with breaks in between, to manage the acute inflammatory response.
Rinsing the mouth gently with a solution of warm salt water (one teaspoon of salt dissolved in eight ounces of water) can provide soothing relief and maintain cleanliness around the injured site. For pain management, over-the-counter anti-inflammatory medications, such as ibuprofen, are often recommended. It is important to avoid placing any pressure on the affected tooth during this initial period, meaning all chewing should be done on the opposite side of the mouth.
Long Term Management and Recovery
The recovery period for a dental concussion typically spans several weeks, with mild cases improving within a week, but more moderate trauma requiring two to four weeks for full resolution. During this time, the primary goal is to provide the damaged periodontal ligament and any affected internal tissue with a period of uninterrupted rest. A sustained soft-food diet is necessary, meaning crunchy, sticky, or hard foods like nuts, raw carrots, or taffy must be completely avoided.
You should practice gentle oral hygiene to keep the area clean without causing further trauma. Brush the injured tooth carefully with a soft-bristled toothbrush, avoiding heavy pressure. Continually monitor the tooth for any changes in sensitivity or sensation, as gradual improvement indicates that the healing process is progressing correctly. Full healing occurs when the tooth no longer feels sensitive to pressure and normal function can be restored without discomfort.
When to Seek Dental Care
While many bruised teeth heal with self-care, every dental trauma should be assessed by a dentist to rule out unseen complications. A professional examination, often including X-rays, can determine if there are subtle root fractures or internal damages invisible to the naked eye. There are several clear warning signs that necessitate an immediate visit to a dental professional, as they can indicate more serious underlying issues.
The most concerning sign is a change in the tooth’s color, specifically if it begins to darken, turning gray, yellow, or blackish, which suggests possible damage or death of the internal dental pulp tissue. Persistent or increasing pain that does not improve after two weeks, or any swelling in the surrounding gum tissue, also warrants urgent attention. If the tooth becomes noticeably looser or moves out of alignment, a dentist must assess the injury immediately to prevent further damage and determine if a treatment like a root canal is necessary.