Traumatic Injury Management
Traumatic Injury Management Assessment and Causes
Traumatic injuries need careful assessment and may require long term management and evaluation. Contact us for the proper guidance.
Most traumatic dental injuries occur in childhood but people of all ages may experience an injury to their teeth. Some common ways injuries are sustained are through sports, automobile accidents or falls. The kind of injury you sustained and the timing of your care can determine the long term prognosis for your tooth. We can help you understand these things better.
Some injuries do not reveal themselves for many years. The 3D CBCT (Cone Beam Computed Tomography) and surgical operating microscope we have in our office can give us a much better impression of what is going on. This can help us plan your care.
Other injuries may also damage the soft inner tissue of your tooth known as the dental pulp. When the dental pulp is injured or infected, root canal therapy may be needed.
Chipped or Fractured Teeth
If your tooth is slightly chipped and involves only the enamel or whiter outer layer of your tooth it often can be repaired or simply smoothed off.
If the tooth is chipped or fractured into the dentin or thicker inner layer of the tooth it may require root canal therapy. We use the surgical operating microscope to evaluate the fracture inside your tooth to make sure it does not extend past the gum line. Sometimes teeth with fractures extending deeper than the level of the gum line cannot be saved predictably. We may opt to give your tooth some time or may suggest your only other option which sadly may be to have the tooth extracted.
Fractures can only be confirmed with a surgical operating microscope. The 3D CBCT scanner is helpful to see many things but oftentimes not fractures in teeth.
If your tooth is restorable a crown can help disperse biting forces more naturally. The crown can protect the tooth and not allow undue stresses which can worsen fractures in teeth. If fractures progress over time your tooth may become uncomfortable again and require an extraction.
Intrusive injuries occur when during the injury you tooth is pushed INTO it’s socket. This can be a serious injury to your tooth. Repositioning and restabilizing it is very important. Root canal treatment is also required shortly afterwards. Your tooth will need periodic monitoring to ensure healing.
Teeth can also be partially pushed out of it’s socket during an injury. Repositioning and restabalizing it is very important. Root canal treatment is not always needed. It depends on the severity of the injury. Monitoring by your dentist or endodontist is highly recommended. Sometimes root canal treatment becomes needed in the future.
When a tooth is completely knocked out of it’s socket it is “avulsed”. If this happens to you or someone you know, gently pick the tooth up by the chewing end not the thin more yellow root end. If there is dirt on the tooth GENTLY rinse in water. Do not use soap or any cleaning agents. Do not scrub or touch the root. Place the tooth gently back into it’s socket. If you are unable to place it back in the socket the best place for it is back in your mouth between your gum and cheek. Get to a dentist immediately. The long term prognosis for an avulsed tooth is hinged on the time out of the mouth. The sooner the tooth can be returned to it’s natural environment the better the chances for a recovery.
Traumatic Injuries to Children's Teeth
Children's permanent (adult) teeth may not be fully developed at the time of injury. Children's teeth need special attention to try to coax the tooth to continue to develop after a injury. If the tooth is not able to develop further the tooth may be much more fragile. You may refer to Endodontic (root canal) Regeneration for more information on encouraging a child's tooth to continue it's course of development.
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