Traumatic Dental Injuries

While most traumatic dental injuries occur in children and teenagers, people of all ages can be affected. Usually, such injuries are the result of sports mishaps, automobile accidents or bad falls. No matter what the cause, the type and severity of the injury will determine the treatment necessary.

Dental injuries may affect the inner soft tissue of the tooth, known as the dental pulp. When the injured pulp becomes inflamed or infected, root canal treatment may be needed. Proper initial care significantly reduces the risk of tooth loss later.

Most chipped or fractured tooth crowns can be repaired either by reattaching the broken piece or by placing a tooth-colored filling. Sometimes, an artificial crown or “cap” may be needed.

If the pulp is exposed, root canal treatment may be needed. These injuries require special attention and it is important to seek professional help as soon after the injury as possible.

During the injury, a tooth may be pushed sideways, out of or into its socket. Your endodontist or general dentist will reposition and stabilize the tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged.

If the tooth is completely knocked out of your mouth, time is of the essence. The tooth should be handled very gently, avoiding touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If possible, the tooth should be placed back into the socket in the mouth as soon as possible. It needs to be kept moist in special solutions that are available at many local drugstores (such as Save-A-Tooth). If those solutions are not available, you should put the tooth in milk. Doing this will keep the root cells on your tooth surface moist and alive for a few hours. Another option is to simply put the tooth in your mouth between your gum and cheek.

Do not put the tooth in regular tap water because root surface cells do not tolerate water for long period of time.

Call a dentist immediately!

A traumatic injury to the tooth may result in a horizontal root fracture. After the diagnosis is made, the tooth will need to be repositioned if it has been displaced followed by placing a splint for a few weeks. Properly treated, teeth with horizontal root fractures usually have a good prognosis.

Chipped primary (or “baby”) teeth can be esthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted.

Children’s permanent teeth that are not fully developed the time of the injury need special attention and follow up, but not all of them will need root canal treatment. Endodontists have the knowledge and skill to treat incompletely formed roots in children so that, in some instances, the roots can continue to develop.