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. Root canal treatment is usually started within a few weeks of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be implanted.
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 damaged or infected, root canal treatment will be required.
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 (saline, milk, saliva). 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 salt water (add a pinch of salt to a glass of warm water.) Your Endodontist may start root canal treatment based upon the stage of root development. The length of time the tooth was out of your mouth and the way the tooth was stored, may influence the type of treatment you receive.
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. Soft tissue 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 the chance to save the tooth.
Revascularization or Regeneration
This technique is completed for immature roots that become necrotic or infected prior to maturation or closure of the root apex. In this procedure, the internal portion of the tooth is disinfected with antibiotics for a short period of time and then the apical cells are stimulated to regrow into the canal space. The coronal part of the tooth is restored with a hard final restorative material and the tooth monitored with periodic radiographs to verify that the root closes as time progresses.
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