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. After a sufficicent amount of time has passed and the tooth has been monitiored for healing a 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. If the pulp does not recover from the original trauma, suffers from another additional trauma ( gets knocked later on ) or becomes infected, root canal treatment will be required.
Avulsed Teeth ( KNOCKED OUT )
If an injury causes a tooth to be completely knocked out of your mouth, it is important that you are treated immediately! The best chance of saving the tooth is to act quickly and make an emergency dental appointment and follow a few important instructions.
Find the tooth and pick it up by the crown ( this is the part of the tooth that is visible in the mouth ), not the root of the tooth.
Inspect the tooth: if it is visibly dirty, clean with saliva by either spitting on the tooth or putting in your mouth. Plain milk can also be used to rinse the tooth. Do Not use water or any other drinks to clean the tooth.
If possible, carefully place the tooth into the socket. Gently close teeth together to prevent the tooth from falling out or being swallowed. If this proves to be difficult, place the tooth in a glass of milk or hold the tooth in your mouth between your cheek and teeth until you arrive at the dental clinic. Call your dentist, explain that a tooth has been knocked out and make an emergency appointment.
The Dentist will asses and treat the immediate emergency. Follow up appointments and a referral for further diagnosis and treatment with an Endodontist will also be organised.
It is also best practice protocol to take a course of antibiotics and make an appointment with your doctor to have your tetanus immunology checked and a booster vaccination may be given.
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 and the possibility of later complications.
Injuries in children
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
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 endodontist will place a medication into the root canal 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.