Traumatic Dental Injuries
How will my injury be treated?
Chipped teeth account for the majority of all dental injuries. Dislodged or knocked-out teeth are examples of less frequent but more severe injuries. Treatment depends on the type, location and severity of each injury. 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.
How Dental Injuries Are Treated
- Dental injuries can affect the crown, root, or position of a tooth. Treatment depends on the type and severity of the injury.
- Chipped or fractured teeth can often be repaired by reattaching the broken piece or using a tooth-colored filling. If a large portion is missing, a crown may be needed. If the pulp is exposed or damaged, root canal treatment may be recommended. More serious cracks in back teeth may require a crown, root canal treatment, or extraction if the tooth is split.
- Dislodged teeth occur when a tooth is pushed sideways, inward, or partly out of its socket. A dentist will reposition and stabilize the tooth. Permanent teeth often need root canal treatment a few days after the injury. Children may not always need root canal treatment right away because their teeth are still developing, but careful follow-up is important.
- Knocked-out teeth need immediate care. Handle the tooth gently and avoid touching the root. If dirty, rinse it with water only. Place it back in the socket if possible, then call a dentist right away. If it cannot be placed back, keep it moist in a tooth-saving solution, milk, or inside the cheek. Do not store it in tap water. The sooner the tooth is treated, the better the chance of saving it.
- Root fractures can happen after trauma. The outlook depends on where the fracture is located. Fractures closer to the root tip have a better chance of healing, while fractures near the gumline are harder to treat. A splint may be needed to stabilize the tooth while it heals.
Will the tooth need any special care or additional treatment?
The long-term health of an injured tooth depends on the type of injury, how quickly it was treated, how the tooth was cared for after the injury, and how your body responds. Fast treatment is especially important for dislodged or knocked-out teeth to help prevent root resorption.
Root resorption happens when the body begins to break down or reject the tooth after trauma. After treatment, regular follow-up visits with your dentist or endodontist may be needed for up to five years to check healing and make sure resorption is not occurring. Some types of resorption may not be treatable.
Do traumatic dental injuries differ in children?
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. This is because the replantation of a knocked-out 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 your dentist or endodontist to stimulate continued root growth.
Endodontists have the knowledge and skill to treat incompletely formed roots in children so that, in some instances, the roots can continue to develop. Endodontists will do all that is possible to save the natural tooth. These specialists are the logical source of information and expertise for children who are victims of dental trauma.