Root Canal Treatment of Traumatic Injuries

Trauma to the mouth can injure teeth and result in their displacement in different ways. Depending on the type and extent of injury sustained, the tooth/teeth injured may or may not need endodontic treatment. Initial and follow up testing and radiographs are used to monitor the health of the injured tooth/teeth.
When teeth are knocked out, or avulsed, they can still be saved. The following recommendations will help insure survival of the tooth:
– No not touch the root of the tooth.
– Gently rinse the tooth under water (or sterile saline if accessible) if it is dirty, but do not scrub it, use soap or disinfectant.
– If possible place tooth back in the socket as soon as possible, this will allow for best chance of survival for tooth. If not, the tooth can be kept in milk or in the mouth between the cheek and the teeth (being very careful not to swallow it) . It is important to keep the tooth moist.
– See an endodontist or dental professional as soon as possible.

Treatment of Other Injuries 

Chipped or fractured tooth: If you’ve chipped or fractured your tooth’s crown, it’s likely it can be repaired either by reattaching the broken piece or by putting a tooth-colored filling in place. If a significant part of your tooth crown is broken off, an artificial crown or “cap” may be needed to restore it. When the pulp is exposed or damaged after a crown fracture, root canal treatment may be needed. These injuries require special attention. If breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office. Never use topical oral pain medication (such as Anbesol®) or ointments, or place aspirin on the affected areas to eliminate pain symptoms. Injuries in the back teeth, such as fractured cusps, cracked teeth require root canal treatment and a full coverage crown to restore function your tooth if the crack extends into the root. More seriously injured split teeth may require extraction.  

Dislodged (Luxated) TeethDuring an injury, a tooth may be pushed sideways, out of or into its socket. Your endodontist or general dentist will reposition and stabilize your tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started several days following the injury. Medication may be put inside your tooth as part of the root canal treatment; once treatment is complete and has been deemed successful a permanent root canal filling or crown will be put in place at a later date. Children ages 12 and under may not need root canal treatment since their teeth are still developing. New research indicates that stem cells present in the pulps of children can be stimulated to complete root growth and heal the pulp following injuries or infection. When a child’s tooth is injured, an endodontist or dentist will monitor the healing carefully and intervene immediately if any unfavorable changes appear. Multiple follow-up appointments are likely to be needed.

Knocked-Out (Avulsed) TeethIf one of your teeth is completely knocked out of your mouth, see an endodontist or dentist immediately! Time is of the essence and if you receive treatment quickly, preferably within 30 minutes, there is a chance to save your tooth. Handle a knocked-out tooth very carefully and don’t touch the root surface. Following a few important steps will help increase the likelihood of saving your tooth. Your endodontist or dentist will evaluate the tooth, place it back in its socket and examine you for any other dental and facial injuries. A stabilizing splint will be placed for the next few weeks. Depending on the stage of root development, your dentist or endodontist may start root canal treatment a week or two later. Depending on the length of time your tooth was out of your mouth and how it was stored before receiving treatment it may be necessary to discuss other treatment options with your dentist or endodontist.

Root FracturesA traumatic injury to your tooth may also result in a horizontal root fracture. The location of the fracture determines the longterm health of your tooth. The closer a fracture is to the root tip, the better the chances of success and long-term health; fractures closer to the gum line are more debilitating for your tooth. Sometimes, stabilization with a splint is required while the tooth heals.