Traumatic Dental Injuries
CHIPPED OR FRACTURED TEETH
A chipped or fractured tooth crown, can be repaired either by reattaching the broken piece or by putting a tooth-colored filling in place. If a significant part of your tooth crown is broken off, an artificial crown or “cap” may be needed to restore it.
However, pulp exposure or damage after a crown fracture, root canal treatment may be needed. These injuries require special attention. 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.
Injuries in the back teeth, such as fractured cusps, cracked teeth require root canal treatment and a full coverage crown to restore function your tooth if the crack extends into the root. More seriously injured split teeth may require extraction.
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 and should be started within a few days following the injury. Medication may be put inside your tooth as part of the root canal treatment; once treatment is complete and has been deemed successful a permanent root canal filling or crown will be put in place at a later date.
Children ages 12 and under may not need root canal treatment since their teeth are still developing. New research indicates that stem cells present in the pulps of children can be stimulated to complete root growth and heal the pulp following injuries or infection. 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.
KNOCKED-OUT (AVULSED) TEETH
If a tooth has been completely knocked out of your mouth, you should 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.
It is very important to handle a knocked-out tooth very carefully and by all means, DO NOT touch the root surface. Following a few important steps will help increase the likelihood of saving your tooth. 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 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.