Dental Trauma

Dental Trauma

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 immediately.
Sometimes, neighbouring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.
Often multiple follow-up appointments are likely to be needed to monitor the teeth.

Dental Traumaright

Chipped or Fractured Tooth

Most chipped or fractured tooth crowns can be repaired either by reattaching the broken piece or by placing a tooth-colored filling. If a significant portion of the tooth crown is broken off, an artificial crown or “cap” may be needed to restore the tooth.

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If the pulp is exposed or damaged after a crown fracture, root canal treatment may be needed. These injuries require special attention

Injuries in the back teeth often include fractured cusps, cracked teeth and the more serious split tooth.

If cracks extend into the root, root canal treatment and a full coverage crown may be needed to restore function to the tooth.

Split teeth may require extraction.

Dislodged or Luxated Tooth

Luxated Tooth

Injuries to the mouth can cause teeth to be pushed back, forward or pushed into their sockets.

Your dentist may reposition and stabilize your tooth and will monitor the status of the pulp.

If the pulp remains healthy, then no other treatment is necessary. However, if the pulp is damaged or if inflammation develops, root canal treatment will be required.

Root canal treatment is often started within a few weeks of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be placed.

Knocked out or Avulsed Tooth

Avulsed ToothIf 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. Call a dentist immediately!

If you cannot put the tooth back in its socket it needs to be kept moist.

You should put the tooth in milk this will keep the root cells in your tooth moist and alive for a few hours. Alternatively you could put the tooth in your mouth between your gum and cheek.
Do not place the tooth in regular tap water because the root surface cells do not tolerate it.

The length of time the tooth was out of your mouth and the way the tooth was stored, may influence the type of treatment you receive and will influence the survival of the tooth.

 

Dental Trauma in Young Children (Immature Roots)

An injured, immature 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 heals. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to 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 of the tooth surviving.

Apexification

In this case, the unhealthy pulp is removed. Medication is placed in the root to help a 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 susceptible to fractures. It is important to have the tooth properly restored by your dentist.

The nature of the injury, the length of time from injury to treatment, how your tooth was cared for after the injury and your body’s response all affects the long-term health of the tooth. Timely treatment is particularly important with dislodged or knocked-out teeth in order to prevent root resorption.

Resorption occurs when your body, through its own defence mechanisms, begins to reject your own tooth in response to the traumatic injury. Following the injury, you should return to your dentist to have the tooth examined and/or treated at regular intervals for up to five years to ensure that root resorption is not occurring and that surrounding tissues continue to heal. It has to be noted that some types of resorption are untreatable.