Traumatic Injuries to the Mouth

The decisions made in the first 5 minutes after tooth injury have the greatest effect on the long term outcomes of treatment.

Dislodged Teeth

Injuries to the mouth can cause teeth to be pushed back into their sockets. Repositioning the tooth must be done as soon as possible. Drs. Roda, Bennett, Kogan or your general dentist may reposition and stabilize your tooth. Root canal treatment is usually started within a few weeks of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be placed.

Sometimes a tooth may be pushed partially out of the socket. Repositioning the tooth must be done as soon as possible. Again, your endodontist or general dentist wil reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. Yet, if the pulp becomes damaged or infected, root canal treatment will be required. Sometimes the need for root canal therapy cannot be determined until some time after the acute injury so you must follow your endodontist’s schedule of re-evaluation.

 If left untreated, many different complications can arise. These complications can include but are not limited to: Infection of the tooth’s root canal system or surrounding tissue, inability to chew due to an improper position of the dislodged tooth, resorption (dissolving) of the tooth root, discoloration of the tooth, and even loss of the tooth.

Avulsed Teeth

If an injury causes a tooth to be completely knocked out of your mouth, it is important that you are treated immediately! If this happens to you, keep the tooth moist. If possible, put it back into the socket. You can even put the tooth in milk but do not store it in plain water. Drs. Roda, Bennett or Kogan may start root canal treatment based upon the stage of root development. The length of time the tooth was out of your mouth and the way the tooth was stored, will influence the type of treatment you receive.

Tooth Injuries in Children

An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:

Apexogenesis

This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.

Apexification

In this case, the unhealthy pulp is removed. The doctors place medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.

For More Information, please visit the International Association for Dental Traumatology website.