Traumatic Dental Injuries
The American Association of Endodontists provides Recommended Guidelines for the Treatment of Traumatic Dental Injuries.
Most traumatic dental injuries occur in children, but people of all ages can be affected. Chipped teeth account for the majority of all dental trauma. Whether the injury is the result of a car accident, a sports mishap or a bad fall, the severity and type of injury will determine the treatment necessary. When the pulp becomes injured or inflamed, a root canal treatment may be necessary.
(Source: American Assocation of Endodontists - http://www.aae.org)
Dislodged Teeth
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.
Avulsed Teeth
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.
Injuries in children
An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:
Apexogenesis
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.
Apexification
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.