ACCIDENTS SOMETIMES HAPPEN even when we’re doing our very best to keep our teeth healthy and strong. A bad fall, biting down on the wrong hard object, or a sports injury are just a few ways a tooth can become damaged or even knocked all the way out. The best person to see in the event of a traumatic dental injury is the endodontist.
Endodontists have special training for treating dental injuries that isn’t covered in dental school. They have the techniques, experience, and equipment to give an injured tooth its best possible outcome. They are also equipped to make sure that there isn’t additional damage not visible to the naked eye. Neighboring teeth could also be damaged, or there could be a crack hidden beneath the gumline.
The severity of the chip or crack in a tooth (and how quickly the patient arrives for treatment after being injured) will determine what can be done for it. If the tooth merely has a fractured crown, that can usually be repaired, whether by reattaching the broken piece or cementing a tooth-colored filling in the damaged spot.
If too much of the crown has broken off, the tooth might need an artificial crown or cap, and root canal treatment may be needed to save the tooth if the pulp is exposed or damaged. Likewise, a damaged molar might need root canal treatment and a crown to restore the tooth’s function. Some damage goes beyond what can be saved through root canal treatment, however, such as when the tooth splits down to the root.
A tooth that has been pushed deeper into its socket or knocked out of place (but not all the way out) may require root canal treatment, but the endodontist will likely be able to reposition it and restabilize it. If the tooth is knocked out all the way, time is of the essence. Get to the endodontist immediately. The less time between the accident and treatment, the better the chances the endodontist will be able to replant the tooth.
Be very careful when handling a knocked out tooth. Don’t touch the root and don’t try to clean it, because that will kill the pulp inside the root. Place it back in the socket if possible or store it in a glass of milk if not. To replant the tooth, the endodontist will attach a stabilizing splint (which resembles a bonded retainer) to hold it steady while it heals over the next few weeks. Sometimes root canal treatment is necessary, but that depends on the health of the root.
Ideally, you’ll be able to head straight to the endodontist or a dentist right after being injured, so there won’t be much time between injury and treatment. There are still some things you can do to manage the discomfort of the injury and protect the damaged tooth. Try biting down on clean, moist cloth or gauze if it hurts when breathing through your mouth or drinking cold fluids. Over the counter pain medication is okay, but avoid topical painkillers (and don’t put aspirin directly on the affected area).
We can’t always prevent accidents, but we can prepare for them by making a plan of what to do if one happens. For injuries that affect more than the teeth, it’s best to go to an emergency room first, but if the teeth are the only problem, have a plan for how to get to the endodontist quickly.
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