Injuries to the mouth can cause teeth to be pushed up into the socket, which results in damage to the tooth, pulp or surrounding bone. Such a tooth can often be repositioned and stabilized by a dentist. Root canal treatment is usually started within several weeks of the injury, and in some cases an interim medicated filling, such as calcium hydroxide is placed inside the tooth. Eventually, this medication is replaced by a permanent root canal filling.
In other cases, a tooth can be pushed partially out of the socket. Again, the tooth can usually be repositioned and stabilized by a dentist. 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, immediate treatment is required if the tooth is to be saved. Between the time of the injury and your dental appointment, it is important to keep the tooth moist. If possible, attempt to place the tooth back into the socket. Otherwise put it in physiologic saline or milk (add a pinch of salt if you can). Root canal treatment may be started depending on the stage of root development of the tooth. 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.
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.