Dislodged and Luxated Teeth
Injuries to the mouth can cause teeth to be pushed into their sockets (Intrusion). 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, the medication will be removed and a permanent root canal filling placed.
Sometimes a tooth may be pushed partially out of the socket (Luxation). Again, your endodontist or general dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. However, 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. 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 water (add a pinch of salt.) 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 and the overall long-term prognosis.
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 encouraged to heal. Rather than removing the pulp tissue as in normal root canal treatment, the 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.
In this case, unhealthy pulp tissue is removed form an incompletely formed, immature tooth. The endodontist places 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. For this reason it is important to have the tooth properly restored by your dentist. It is important to understand that the long-term prognosis in a tooth such as this is guarded.