Traumatic injuries to the teeth should be addressed as soon as possible to initiate treatment and prevent further damage.
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. Root canal treatment is usually 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.
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. If left untreated, many different complications can arise. These complications can include but are not limited to: Infection of the tooth, root system or surrounding tissue, inadequate hygiene due to an inability to properly clean the dislodged tooth and the gums, and loss of the tooth.
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. A tooth can be saved if it remains moist. You can even put the tooth in milk or a glass of water (add a pinch of salt.) Your Endodontist may start root canal treatment based upon the stage of root development. 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.
Injuries in children
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
Apexogenesis/Vital Pulp Therapy
This procedure encourages the root to continue development as the pulp is healed. 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 to save the tooth.
In this case, the unhealthy pulp is removed. The doctors place medication into 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. So it is important to have the tooth properly restored by your dentist.
Regenerative endodontics is one of the most exciting developments in dentistry today and endodontists are at the forefront of this cutting-edge research. Regenerative endodontics uses the concept of tissue engineering to restore the root canals of a tooth to a healthy state, allowing for continued development of the root and surrounding tissue. An endodontists’ knowledge can be applied to deliver biologically based regenerative endodontic treatment of immature permanent teeth to result in continued root development, increased thickness in the dentinal walls and root-end closure. These developments in the regeneration of a functional pulp-dentin complex have a promising impact on efforts to retain the natural dentition, the ultimate goal of endodontic treatment.