While most traumatic dental injuries occur in children, people of all ages can be affected. Whether it be a sports injury, blunt force trauma, or a seemingly minor "bump" to the dentition it is a good idea to have the situation examined. The type and severity of the injury will determine the treatment necessary. Correct first aid significantly reduces the risk of tooth loss or subsequent infection. Dental injuries may affect the inner soft tissue of the tooth known as the dental pulp. This is the root forming organ of each tooth, and when the injured pulp becomes inflamed or infected, root treatment may be needed.

Chipped teeth account for the majority of all dental injuries. Dislodged or knocked out teeth are examples of more serious injuries. Treatment if needed depends on the type, location & severity of each injury. And dental injury should be examined by a dentist or an endodontist immediately. If one tooth is hit we also check adjacent teeth during our examination. Chipped teeth are frequently repaired with a bonded filling in severe cases with a full coverage crown. It is important to cover exposed dentin as quickly as possible. If the damaged area exposes the canal space then root canal treatment may be necessary.

During an injury a tooth may be pushed sideways, out of, or into the socket. Root canal treatment is usually needed for teeth that were dislodged, especially if intruded into the socket. Research shows the best time to initiate endodontic treatment is about 14 days after the injury. Teeth that are knocked loose need to be stabilized via a splint which usually consists of a flexible wire and bonded filling material. Children between 7 and 12 years old may not need root canal treatment since their teeth are still developing. Multiple follow up visits are most time recommended so that any unfavorable changes can be caught. New research indicates that stem cells present in the pulp of young people can be stimulated to complete root growth and heal the pulp following an infection of a tooth that has an incompletely formed apex or root tip.

Knocked out or avulsed teeth present a special problem. If the root is sufficiently developed these teeth need endodontic treatment. The critical factor is "time out of the mouth". Replantation success of avulsed teeth decreases when out of the mouth times exceed 45 minutes. You should avoid touching the root surface of an avulsed tooth. Gently wash off any dirt with water or milk. Do not use soap or any other cleaning agent. Never scrape or brush the root of an exfoliated tooth. The best storage place for knocked out tooth is its socket. If you can't replant the tooth it should be ideally stored in a special solution called "Save-A-Tooth" found ar many drug stores. The next best option is to sore it in milk, cold if possible. If no milk, store it in the cheek or vestibule between cheek and gum. The tooth can then be replaced, splinted, and endodontically treated. Avulsed teeth are somewhat unpredictable regarding long term success rates. Root resorption is the worst change that can occur, and if severe, can result in tooth loss later. This occurs when your body's immune system attacks the root surface and begins to dissolve or resorb the root. Even in these cases keeping the natural tooth until the patient gets older is a good option because a dental implant may then be possible.

Traumatic injuries may also result in root fractures. The location of the fracture determines the long term health of the tooth. If the fracture is close to the root tip then the chances for success are greater. The worst fracture occurs near the crestal bone.

Chipped primary or baby teeth can be restored. Severely dislodged or avulsed baby teeth should left extracted. Attempts at repositioning or replanting these teeth could do injury to the underlying permanent tooth bud.

Endodontists have the knowledge and skill to treat incompletely formed roots in children so that in some instance the roots can continue to develop. Endodontists will do all that is possible to save the natural tooth.