Traumatic dental injuries occur most often in children and teenagers, although people of all ages can experience them as well. Sports accidents, car accidents, and falls or trips are all examples of how someone can experience a traumatic dental injury. If you have experienced this type of injury, it’s important to visit your dentist as soon as possible. The longer you wait, the more severe the injury could become. Only through a dental exam can the extent of the damage and surrounding damage be assessed properly.
Types of Dental Injuries
Chipped or Fractured Teeth
Most chipped or fractured teeth can be repaired either by reattaching the broken piece or by placing a tooth-colored filling. If a significant portion of the visible portion of the tooth is broken off, an artificial crown or “cap” may be needed to restore the tooth. Injuries in the back teeth often include fractured cusps, cracked teeth, or a 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.
During an injury, a tooth may be pushed sideways out of or into its socket. Your dentist will reposition and stabilize your tooth. If the tooth root has been damaged, a root canal may also be necessary.
If 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. Once the tooth has been put back in its socket, your dentist will evaluate it and will check for any other dental or facial injuries. If the tooth has not been placed back into its socket, your dentist will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks. Depending on the stage of root development, your dentist may start root canal treatment a week or two later.
A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of the tooth. If the fracture is close to the root tip, the chances for success are much better. The closer the fracture is to the gum line, the poorer the long-term success rate. Stabilization with a splint is sometimes required for a period of time.
Resorption occurs when your body, through its own defense 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 or treated at regular intervals to ensure that root resorption is not occurring and that surrounding tissues continue to heal.
Traumatic Dental Injuries in Children
Chipped baby teeth can be aesthetically restored. Dislodged baby teeth can, in rare cases, be repositioned. However, baby teeth that have been knocked out typically should not be replanted. This is because the replantation of a baby tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone. Children's permanent teeth that are not fully developed at the time of the injury need special attention and careful follow-up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your dentist to stimulate continued root growth.