Although mouth guards greatly reduce the risk, about 5 million teeth a year are avulsed (completely “knocked out”), extruded (partially dislodged), or cracked during sporting events. While cracked, or chipped teeth may not require immediate care, both avulsed and extruded teeth need immediate attention if the tooth is to be saved. It is often possible to save most or all of a tooth even in extreme circumstances.
Traumatic Tooth Injuries
Dental trauma can take a variety of different forms. This depends on a variety of different factors. The most common forms of dental trauma are:
Cracked or Fractured Tooth. Clenching and grinding teeth can cause fractures, which are the worst issues we currently treat. Tiny cracks cause nerves to become sensitive and make your teeth flex. As cracks widen, bacteria can get into your tooth and can cause infection. We first examine a cracked tooth microscopically to determine the crack’s extent and exact location and prepare minor, superficial cracks for immediate restorative treatment by your dentist. If a crack is extensive and jeopardizes a successful prognosis, your endodontist may discuss extraction and replacement options with you and your dentist.
Damaged Dental Pulp in Your Tooth. Dental pulp containing your tooth’s nerves and the blood supply, can be injured in many ways, including trauma to a tooth. Whether you’ve been hit by a baseball or softball, or been in a car accident, or a baby slammed their head into you… we’ve all been there. Consequently, you may have incurred damages to the dental pulp in your tooth if you have been hit in the face. The dental pulp can become inflamed as the result of a cavity that allows bacteria to enter your tooth. If you start noticing cold or heat sensitivity, throbbing, or sensitivity to sweets, call your dentist or an endodontist to take a look.
Dislodged Tooth. Having a tooth knocked out by a baseball, softball or a hockey puck is one of the few real dental emergencies. It’s very important that the tooth is placed back into its socket as quickly as possible. If the tooth is dirty, rinse it off and place it gently back into the socket. If you’re uncomfortable, put the tooth in a glass of milk or in a Hank’s solution and call your dentist or endodontist as soon as possible. Ideally, the tooth should be replaced in the socket within an hour of being dislodged.
Abscessed Tooth. An actual abscess is a swelling caused by infection. If you have an abscessed tooth, there’s swelling in your mouth caused by infection.
- Dental trauma takes many different forms and each one requires a different method of repair and subsequent treatment.
How Dental Trauma Can Be Repaired
Tooth damage can be repaired. The only question is the kind of procedure needed to address the issue.
Chipped: If only the surface is chipped or cracked, a filling or reattachment usually restores the tooth. But if the pulp is exposed then an experienced Endodontist will probably need to perform a root canal. The common symptoms for this include discomfort while breathing or drinking cold fluids.
Extruded: If the tooth is pushed out of position, patients over 12 usually require a root canal to mend the root. Sometimes calcium hydroxide or other prescription medication is used, as well. Younger patients may be able to heal on their own once the tooth is stabilized.
Root Fracture: A traumatic injury may result in a horizontal fracture of the root. The long-term health of the tooth is determined by the location of the fracture. A fracture that is closer to the root tip has a better chance for success. Sometimes, a splint is used to stabilize the tooth for a certain period of time.
Avulsed: If the avulsed tooth is handled very carefully and immediate care is given, the tooth can probably be replaced into the socket, and restored with a subsequent root canal. “Immediate attention” usually means 30 minutes or less. After that time, it is harder to save the tooth.
- An endodontist will first assess the damage to your tooth and then determine a plan and an approach to repairing that tooth.
Types of Treatment Ideal for Dental Trauma
Root Canal Treatment: Roughly 14 million people undergo root canals each year, making this procedure one of the most common types of dental treatments. That being said, many people today still put off necessary root canals because of the fear of discomfort. The truth is the discomfort from a diseased or damaged tooth is much worse than anything that occurs at a dental office.
The first step is to have an endodontist perform a thorough examination. We will assess the tooth damage and provide you with all available treatment options. Then, we work with you to minimize out-of-pocket costs and maximize results.
Endodontic Retreatment: Endodontic treatments usually tend to pick up where prior procedures left off. Even teeth that have undergone root canal treatment can endure a lifetime of daily use with appropriate care. However, sometimes, a root canal doesn’t fully heal and may become painful or infected shortly following, or long after the original treatment. If you notice new issues with your tooth post-treatment, or if it is not properly healing, there are supplementary remedial treatments available that can save your tooth.
Apicoectomy: The process of apicoectomies has as its objective the strengthening of teeth with advanced techniques. Minimally-invasive root canals almost never fail. However, if your root canal fails, a surgical back-up plan is available.
Pulpotomies and Pulpectomies: Adolescents between the ages of 7 and 12 may not require root canal treatment, as their teeth are still in the development phase. A child’s kiddy root canal or baby root canal is also known as a pulpotomy or pulpectomy. This procedure removes most of the pulp – the blood and nerve supply – from the tooth. Recent studies suggest that stem cells residing in the pulps of adolescents can spur full root growth, and heal the pulp after infection or injury.
Apexification And Apexogenesis: Apexification and apexogenesis are the best means of preserving your child’s teeth in emergency situations. When teeth in older children or adults are damaged, a root canal is often the best option. However, when younger children sustain similar injuries, these methods may not be the best possible approaches. Fortunately, young children usually heal rather quickly. An experienced endodontist can use advanced pulp therapy techniques to restore the damage and promote healthy long-term tooth development.
Endodontic Surgery: Endodontic surgery primarily serves the purpose of saving, conserving and preserving your natural dentition. In nearly all cases, minimally-invasive root canals are more than sufficient to repair even severely damaged teeth. In most cases, these repairs last a lifetime. That being said, sometimes the damage is too severe to address with these traditional techniques or, for various reasons, subsequent issues arise. Dental implants were really the only option in these situations. However, recent advances in endodontic microsurgery offers similar success rates to dental implants and a way to retain your natural dentition. In most cases, a new crown is not necessary following endodontic surgery offering a less expensive way to save your tooth than a dental implant.
- Based on the specific needs of a patient and the extent of damage from dental trauma, there a variety of different treatment options an endodontist will choose from to determine the best possible results.