Sometimes trauma may result in a tooth to be moved in the socket. The degree of tooth movement will determine if root canal therapy is required. Generally, tooth movement greater than 5mm in any direction will result in injury that will require root canal therapy. Your endodontist or general dentist will be able to restore the original position of the moved tooth and it will likely be splinted to adjacent teeth.
If an injury causes a tooth to be completely knocked out of the mouth, it is important that treatment occurs immediately. Most importantly, the tooth must remain moist and should not be handled excessively or cleaned at all. It is crucial to maintain the integrity of the delicate ligaments on the root surface. If possible, place the avulsed tooth back into the socket. An avulsed tooth can be saved if it remains moist and is replaced into the socket within twenty-five minutes. After this time frame, the chance of success drops dramatically. Endodontic therapy will be required if the tooth is deemed worthy.
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 following injury. Soft pulp tissue is covered with medication to maintain pulp vitality and continue root development. Root development is dependent on healthy pulp tissue. If successful, tooth development will continue and root canal therapy may never be required.
In this case, the unhealthy pulp is remove. Dr. Elliott will 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.