Traumatic Dental Injuries

While most traumatic dental injuries occur in children and teenagers, people of all ages can be affected—often due to sports accidents, automobile collisions, or unexpected falls. Regardless of the cause, it’s essential to see an endodontist promptly following any dental trauma to assess whether immediate or future treatment is needed. Even seemingly minor injuries should be evaluated right away, as nearby teeth may also be damaged in ways that aren't immediately visible. A thorough dental examination is the best way to ensure all affected areas are properly diagnosed and treated.

Chipped or Fractured Teeth

Chipped teeth account for a large percentage of dental injuries. Most chipped or fractured teeth can be repaired either by cementing the fractured segment or by placing a tooth-colored filling. If a significant portion of the tooth crown has fractured, an artificial crown or “cap” may be needed to restore the tooth.

Injuries in the back teeth often include fractured cusps, cracked teeth, and the more serious split tooth. If cracks extend into the root, root canal treatment and a full coverage crown may be needed to restore function to the tooth. Split teeth may require extraction.

Dislodged (Luxated) Teeth

During a traumatic injury, a tooth may be pushed sideways, out of, or into its socket. In these cases, your endodontist will reposition and stabilize the tooth. For permanent teeth that have been dislodged, root canal treatment is often necessary and should be initiated in a timely manner to ensure the best possible outcome.

In children, however, root canal treatment may not be needed right away, as their teeth are still developing. Instead, your endodontist will closely monitor the healing process and intervene promptly if any signs of complications arise.

Knocked-Out (Avulsed) Teeth

If a tooth is completely knocked out of the mouth (a dental avulsion), time is critical. The tooth should be handled very carefully—avoid touching the root surface. If the tooth is dirty, gently rinse it with water only. Do not use soap, chemicals, or scrub the tooth in any way. If possible, place the tooth back into its socket immediately. The sooner the tooth is reinserted, the better the chances of saving it.

Once the tooth is back in place, your endodontist will evaluate it and check for any additional dental or facial injuries. If the tooth cannot be reinserted right away, your endodontist will clean it and carefully place it back into the socket. A stabilizing splint will be applied for a period of time to help support healing.

Depending on the stage of root development, root canal treatment may be started one to two weeks after the injury. Because outcomes with dental trauma can be unpredictable—even with the best care—ongoing follow-up and close monitoring are essential to give the tooth the best chance of long-term survival.

Root Fractures

A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture may help determine the long-term health of the tooth. If the fracture is close to the root tip or apex, the chances for success are much better. The closer the fracture is to the gum line, the poorer the long-term success rate. Sometimes, stabilization with a splint is required for a period of time.

Summary: Traumatic Dental Injuries in Children

Chipped primary (baby) teeth can be esthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a knocked-out primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.

Children’s permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your endodontist to stimulate continued root growth.

With any traumatic dental injury, time is of the essence. Contact your dentist or endodontist immediately.