Traumatic Injuries
One common cause of dental problems requiring endodontic treatment is traumatic injury. Traumatic dental injuries are often a result of a sports injury, accident, or even traumatic occlusion (grinding, clenching, or a “bad bite”).
Trauma or injury to your tooth is one possible cause for a tooth to die. There are several types of traumatic injuries to the teeth which can cause pain and can even physically alter your teeth. Treatment depends on the type, location and severity of each injury.
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! If this happens to you keep the tooth moist. If possible put it back in the socket.
A tooth may be saved if it remains moist. You can even put the tooth in milk or a glass of water with a pinch of salt, or cover it with your saliva. The length of time the tooth was out of your mouth and the way it was stored during that time may influence the type of treatment you receive.
Dislodged Teeth
Traumatic injuries to the mouth may cause the tooth or teeth to be repositioned in a different direction; or pushed out of or into the socket. Your dentist may need to reposition and stabilize your tooth. Root canal treatment is usually started by your endodontist within a few weeks of the injury.
Injuries in Children
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
APEXOGENESIS
This procedure encourages the immature root to continue development by attempting to preserve the living pulp in the tooth. The pulp is covered with a medication “bandaid” to protect this soft tissue and encourage root growth. The tip of the root (apex) is expected to continue to close as the child gets older. In turn, the walls of the root canal should thicken. If the pulp heals sufficiently it’s possible that no additional endodontic treatment will be necessary, at least for a while. Apexogenesis is sometimes followed by additional endodontic treatment.
APEXIFICATION
In this case, the unhealthy or dead pulp is removed. The doctor places the 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 stage, root canal treatment is performed. The tooth is susceptible to fractures so as always it is important to have the tooth properly restored by your dentist.