Traumatic injuries to teeth may cause a physical, psychological and social impact in children and adolescents. Teeth may be exposed to injuries such as fractures, loosening and displacement. Approximately 30% of 5 th and 6 th graders experience traumatic injuries to their anterior teeth every year; the main reasons being sport activities, falls and violence. Open mouth and buck teeth are predisposing factors to dental trauma. Prevention of traumatic injuries to teeth and early and effective treatment will save time, costs and unnecessary aggravation. Drs. Eichenberger, Kramp or Tomala provide emergency dental care for traumatic injuries. Our Endodontists are uniquely qualified to treat these teeth injuries.
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The crown of the tooth can be factured at different levels. In most of the cases, the fracture will not cause severe pain to the child.
Emergency care at the site of injury :
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Injuries to the mouth can cause teeth too be displaced out or pushed back into their sockets. Your endodontist or general dentist may reposition and stabilize your tooth. Root canal therapy 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 implanted.
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 therapy will be required.
1. Close the mouth with a piece of gauze between the upper and lower anterior teeth.
2. Refer the child or call immediately to the dentist or endodontist.
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. The best available solution to keep the tooth is milk. Your Endodontist may start root canal therapy 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.
Emergency care at the site of injury :
Act quickly! The best chance of saving the tooth is within the first 10 minutes of the accident.
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.
Even if the crown of the tooth is fully formed, the root keeps developing for 1-2 years after eruption. In cases of trauma to immature roots, a novel procedure called revascularization is a new and viable option. Using some topical medication, the soft tissue inside the tooth (called pulp) can re-enter the root canal space and continue the developmemt of the root.
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.
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