While most traumatic dental injuries occur in children and teenagers, people of all ages can be affected, usually as a result of sports mishaps, automobile accidents, or bad falls. If you've experienced a traumatic dental injury it is important to visit your dentist in order to determine any necessary treatment. Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.
Chipped or Fractured Teeth
Chipped teeth account for the majority of dental injuries. Most chipped or fractured tooth crowns can be repaired either by placing a tooth-colored filling. If a significant portion of the tooth crown is broken off a porcelain restoration may be necessary.
Injuries in the back teeth often include fractured cusps, cracked teeth, or a more serious split tooth. If cracks extend into the root, root canal treatment and a crown may be needed to restore function to the tooth. Split teeth may require extraction.
Dislodged (Luxated) Teeth
During an injury, a tooth may be pushed sideways out of or into its socket. We may need to will reposition and stabilize your tooth for a while during the healing process.
Knocked-Out (Avulsed) Teeth
If a 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 its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it.
Once the tooth has been put back in its socket, your dentist will evaluate it and will check for any other dental or facial injuries. If the tooth has not been placed back into its socket, your dentist will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks. It is very likely you will need a root canal on this tooth.
A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of the tooth. If the fracture is close to the root tip, the chances for success are much better. The closer the fracture is to the gum line, the poorer the long-term success rate. Stabilization with a splint is sometimes required for a period of time.
Traumatic Dental Injuries in Children
Chipped primary (baby) teeth can be aesthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.
Children's permanent teeth that are not fully developed at the time of the injury need special attention and careful follow-up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable an endodontist (root canal specialist) to stimulate continued root growth.