Traumatic Dental Injuries
Most traumatic dental injuries occur among children and teenagers, but people of any age can be affected, typically as a result of sports mishaps, automobile accidents, or bad falls. Regardless of the cause, you may need to visit an oral surgeon if you’ve experienced a traumatic dental injury.
Any dental injury, even if apparently mild, requires immediate examination by a dentist or oral surgeon. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected during a thorough exam.
Depending on the extent of your dental injury, the oral surgeon may work as a team with endodontists and restorative dentists to return your mouth, jaw, and teeth to proper form and function. It’s essential to take traumatic dental injuries seriously. If you suspect that your or a loved one’s jaw is broken, go to the emergency room immediately.
Injuries that extend past the teeth and bones into the soft tissue (gums, cheeks, and lips) need to be corrected by an oral surgeon. Taking aesthetics into consideration, your oral surgeon will repair your gums with sutures, and will take special care not to disturb salivary ducts and glands.
Dislodged (Luxated) Teeth
During an injury, a tooth may be pushed sideways, out of, or into its socket. Your oral surgeon will reposition and stabilize your tooth. Root canal treatment with an endodontist is usually necessary for permanent teeth that have been dislodged, and should be done a few days following the injury.
Children between seven and 12 years old may not need root canal treatment, since their teeth are still developing. For those patients, your oral surgeon will monitor the healing carefully and intervene immediately if any unfavorable changes occur.
Knocked-Out (Avulsed) Teeth
If a tooth is knocked completely out of your mouth, time is of the essence. It should be handled very gently; avoid 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 it’s out of its socket, the better the chances for saving it.
Once the tooth has been replaced in its socket, the oral surgeon will evaluate it and check for any other dental and facial injuries. If the tooth has not been placed back into its socket, your oral surgeon will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks.
Depending on the stage of root development, we may recommend that an endodontist start root canal treatment a week or two after your surgical procedure.
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. Sometimes, stabilization with a splint (wiring or bonding teeth together) is required for a period of time.
In theory, a fractured facial bone is treated just like any other bone in the body: The fracture together is held together for a period of time to enable it to heal. However, in practice, a cast can’t be applied to the face in the same way it can to an arm or a leg. For fractures of the upper and lower jaw, your oral surgeon may recommend wiring the jaws together or placing stabilizing plates to allow the bones to heal.
Traumatic Dental Injuries in Children
Chipped primary (baby) teeth can be aesthetically restored. Dislodged primary teeth can, in rare cases, be repositioned.
However, primary teeth that have been knocked out should not typically be replanted. The replantation of a knocked-out primary tooth may cause further (and potentially 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 an 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 oral surgeon to stimulate continued root growth.
With any traumatic dental injury, time is of the essence. Contact your oral surgeon immediately.