Traumatic dental injuries are most commonly caused by accidents and participation in sports. The most common injury is a chipped tooth, though teeth may also become dislodged or knocked out completely. These injuries happen less often but can be rather severe. Treatment of dental injuries depends on the type of injury and the severity of it. The location of the tooth can also change treatment.
Even if you don’t think your injury is severe, it is always important to have it checked out by a dentist or endodontist right away. Another tooth may also have problems from the injury, and the only way you can tell is by a dental examination and potential X-rays.
Endodontists are skilled at treating traumatic dental injuries. They have advanced training and special techniques to save teeth that are damaged, so it is important to find an endodontist right away if you injure your tooth.
Since endodontists do a lot of emergency work to treat injuries, they are often very flexible. Many have evening and weekend appointments and some have dentists on call when needed. It is their goal to relieve your pain as quickly as possible.
Traumatic injuries can be scary, so we have included a list of frequently asked questions (FAQs) to help answer questions that you may have.
What is endodontic treatment?
Endodontic comes from the Greek words “endo” meaning inside and “odont” meaning tooth. Basically endodontic work deals with the inside of the tooth.
The easiest way to understand what we do is to learn about what makes up your tooth. The outside of the tooth is white enamel and a hard layer called dentin. The inside of the tooth is soft and called pulp. The pulp is pretty large. It starts at the crown of the tooth and goes all the way to the root.
The pulp is filled with blood vessels, nerves, and connective tissue. The pulp is needed to make the hard dentin during tooth development. Since the pulp is mostly used for the growth and development of a tooth, once the tooth is finished growing, it can live without the pulp. The tissues surrounding the tooth nourish it.
Who performs endodontic treatment?
Since all dentists learn about endodontic treatment in dental school, they can all perform basic endodontic treatments. However, many are more comfortable referring their patients to endodontists.
Endodontists are dentists who furthered their education about endodontics. After dental school, they went through two or more years learning all they could about endodontics. They are able to perform basic and difficult treatments including surgery.
Since they are specialized, they offer only endodontic treatments. They do not perform general dentistry. They are great at finding and treating pain with which your general dentist can’t help you.
How will my injury be treated?
Chipped or broken teeth are usually fixed with a filling or a crown. However, there are times when an artificial crown (or cap) may be needed until a full crown can be placed.
If your pulp is visible or even damaged, you may need to have a root canal. It is important that these injuries be seen as soon as possible. You can bite on a clean and moist piece of gauze to help relieve pain until you are able to be seen. You should not use any topical medications for this type of injury.
If you damage your back teeth, you may fracture or crack them. You might even split your tooth, which is really serious. You may end up losing your tooth if you split it.
Dislodged teeth, also called luxated teeth, are teeth that have been pushed sideways. Sometimes, your tooth may be pushed out of its socket. We will do our best to reposition and stabilize your tooth. We usually need to perform a root canal within a few days, especially with permanent teeth. We may also put calcium hydroxide inside the tooth until we are able to perform a permanent root canal.
Younger children (between ages seven and twelve) may not need a root canal, but they will need to be watched closely. Intervention will be done immediately if needed. Because of this, we will need to have several visits with your child until we know that your child’s tooth is healing well. Stem cells in the pulp can often be stimulated to complete root growth after injury.
Knocked-out teeth, also known as avulsed teeth, need to be seen right away. It is also important to handle your tooth gently and avoid the roots to increase your chances of a successful tooth replacement.
The first thing that needs done is a thorough evaluation of your tooth. Hopefully, we will be able to place your tooth back into the socket before we look for any other injuries. We will need to place a stabilizing splint on your tooth for several weeks.
Depending on the extent of the injury, you may need to start root canal treatment in a week or two. We may also place some medication in your tooth until we complete your root canal.
How long the tooth was out and how it was treated prior to coming in will determine the chance of saving your tooth. It is important to store your tooth correctly and get into the dentist right away so that you can save your tooth.
Root fractures are also common. Trauma can fracture your tooth root. The location of the fracture can determine how healthy your tooth will be in the long run. If the fracture is close to the root tip, your tooth is more likely to stay healthy. If the fracture is close to the gum line, the tooth has less of a chance, but we will do everything we can to fix your root fracture. We may need to use a stabilizing splint while your tooth heals.
Do traumatic dental injuries differ in children?
Children’s baby teeth can be restored so that your child has a smile that he or she wants to show off. If your child dislodges his or her teeth, we will do our best to reposition the tooth, but it is difficult. We typically don’t place teeth that have been knocked out back in the mouth because it can harm the permanent teeth below the surface.
If your child damages permanent teeth that are not fully developed, we will need to monitor the situation closely to see if root canal treatment needs to be done. Stem cells can help regrow roots so that your child will not need a root canal.
Endodontists are skilled at caring for primary and permanent teeth. They do everything they can to save teeth. If that is not possible, they will do what they can to ensure that your child has a beautiful smile.
Will the tooth need any special care or additional treatment?
Your injury, how quickly it got treated, what treatment was done, and how your body responded to treatment are all factors in the long-term health of the tooth. It is really important to be seen right away when you knock out a tooth.
Unfortunately, resorption occurs. As your body tries to heal, it may reject your own tooth, so it is important to follow-up with your dentist or endodontist regularly (for up to five years) after the injury to monitor healing.
Please don’t hesitate to contact us today if you have any additional questions.