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. It is essential that these teeth be vigorously monitored for development of root canal disease. Often, but not always, root canal treatment of these teeth is indicated.
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 infected, root canal treatment will be required. If left untreated, many different complications can arise. These complications can include but are not limited to: Infection of the tooth, root system or surrounding tissue, inadequate hygiene due to an inability to properly clean the dislodged tooth and the gums, and loss of the tooth.
A tooth completely knocked out of the mouth is an emergency! Contact your dentist immediately, if you cannot get hold of them, go to an emergency room. Delay in treatment will lessen the prognosis. 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. You can even put the tooth in milk or a glass of water (add a pinch of salt). The length of time the tooth is out of your mouth and the way the tooth was stored, influence the prognosis. It is always best for a mature avulsed tooth to have root canal treatment 1-2 weeks following an accident.
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. Exposed 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 long-term prognosis.
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.
The goal in regenerative endodontics is to regrow live tissue into the root canal space that presents as infected tissue. This relatively new procedure has the advantage over apexification in that it promotes root thickening and increased length, and hopefully an improved long-term prognosis.