Traumatic Dental Injuries
Traumatic dental injuries often occur as a result of an accident or sports injury. The severity of tooth injury can range from a small chip to the complete dislodgement of the tooth from the mouth. Treatment depends on the type, location and severity of the injury. Regardless of the extent of the injury, however, your tooth requires immediate examination by a dentist or an endodontist. Sometimes, the neighboring teeth can also suffer additional, unnoticed injury that can only be detected by a thorough dental exam.
Endodontists specialize in treating traumatic dental injuries. Using their advanced skills, techniques and technologies endodontists can help you save your injured teeth. If you have a cracked or injured tooth, it’s important to seek treatment right away.
How will my injured tooth be treated?
A chipped or fractured crown can often be repaired by reattaching the broken piece or by placing a putting a tooth-colored filling. If a significant part of the crown is fractured, an artificial crown or “cap” may be needed.
When the pulp is exposed or damaged after a crown fracture, root canal treatment may be needed. If breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office. Never use topical oral pain medication (such as Anbesol®) or ointments, or place aspirin on the affected areas to eliminate pain symptoms.
During an injury, a tooth may be pushed sideways, out of or into its socket. Your endodontist or general dentist will reposition and stabilize your tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged. Medication may be put inside your tooth as part of the root canal treatment. A permanent root canal filling and/or crown will be put in place at a later date.
Younger children may not need root canal treatment since their teeth are still developing. New research indicates that stem cells present in the pulps of children’s teeth can be stimulated to help the pulp heal and to allow the root to continue to develop. When a child’s tooth is injured, an endodontist or dentist will monitor the healing carefully and intervene immediately if any unfavorable changes appear. Multiple follow-up appointments are likely to be needed.
If one of your teeth is completely knocked out of your mouth, see an endodontist or dentist immediately! Time is of the essence and if you receive treatment quickly, preferably within 30 minutes, there is a chance to save your tooth.
Handle a knocked-out tooth very carefully and try not to touch the root surface. If possible, place the tooth in milk while you travel to your dentist. Your endodontist or dentist will evaluate the tooth, place it back in its socket and examine you for any other dental and facial injuries. A stabilizing splint will be placed for the next few weeks. Depending on the stage of root development, your dentist or endodontist may start root canal treatment a week or two later.
Depending on the length of time your tooth was out of your mouth and how it was stored before receiving treatment it may be necessary to discuss other treatment options with your dentist or endodontist.
A traumatic injury to your tooth may also result in a root fracture. The location of the fracture determines the long-term health of your tooth. The closer a fracture is to the root tip, the better the chances of success and long-term health Fractures closer to the gum line are more debilitating for your tooth. Sometimes root canal treatment and/or stabilization with a splint is required.
A traumatic injury to your tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of your tooth. The closer a fracture is to the root tip, the better the chances of success and long-term health; fractures closer to the gum line are more debilitating for your tooth. Sometimes, stabilization with a splint is required while the tooth heals.
Factors that affect the long-term health of your tooth after an injury include: the nature of the injury, the length of time from injury to treatment, how your tooth was cared for after the injury and your body’s response. Getting treatment as soon as possible is very important with dislodged or knocked-out teeth in particular, in order to prevent root resorption.
Resorption occurs when your body, through its own defense mechanisms, begins to reject your own tooth in response to the traumatic injury. Following an injury, you should return to your dentist or endodontist to have the tooth examined and/or treated on a regular basis for up to five years to ensure that root resorption is not occurring and that surrounding tissues continue to heal. Unfortunately, some types of resorption are untreatable.