Traumatic Injuries to the Mouth
Dislodged Teeth
Injuries to the mouth can cause teeth to be pushed back into their sockets. Your endodontist or general dentist may reposition and stabilize your tooth. If needed, root canal treatment is usually started within a few weeks of the injury and a medication, such as calcium hydroxide, may 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. Again, your endodontist or general dentist may 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.
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 yourself. A tooth may be saved if it remains moist. You can even put the tooth in milk or a glass of water (add a pinch of salt) or even contact lens solution. Do not use cleaners or soap and do not scrub the tooth. A gentle rinse is all that should be required. Your Endodontist may start root canal treatment based upon the stage of root development. The type of injury, the length of time the tooth was out of your mouth and the way the tooth was stored may influence the type of treat-
ment you receive.
Tooth Injuries in Children
An injured immature permanent 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. The soft pulp tissue is covered with medication to encourage root growth. The tip of the root (apex) will continue to mature and 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 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 more susceptible to fractures. So it is important to have the tooth properly restored by your dentist.