EVEN WHEN WE’RE doing everything we’re supposed to do to keep our teeth healthy and strong, accidents sometimes happen. A bad fall, a sports injury, or biting down on something the wrong way are just a few things that could lead to a damaged or knocked-out tooth. In cases like these, the best person to see (after getting emergency treatment for any dangerous injuries) is the endodontist.
What Makes the Endodontist the Better Choice?
Dental school doesn’t offer the same kind of training for treating dental injuries as what endodontists learn. Endodontists get all the techniques, equipment, and experience to achieve the best possible outcome for an injured tooth, and they’re also equipped to ensure there isn’t additional damage that isn’t as obvious to the naked eye. For instance, a neighboring tooth could also be damaged or there could be a crack hiding beneath the gum line.
For Injuries That Result in Cracking or Chipping
The most effective treatment for an injured tooth depends on the severity of the crack or chip in it (as well as how quickly the patient gets to us for treatment). If the tooth only has a fractured crown, it can usually be repaired, whether by reattaching the piece that broke off or by cementing a tooth-colored filling into the damaged spot.
If too large a piece has broken off the crown, we might need to place an artificial crown or cap, sometimes paired with root canal treatment to save the tooth if the pulp was exposed or damaged. Sometimes, it will take root canal treatment and a crown to restore the function of a broken molar. In some cases, the damage is too extensive to be saved even by root canal treatment, particularly when the tooth splits down to the root.
For a Dislodged or Knocked-Out Tooth
A tooth that has been knocked out of place or pushed deeper into its socket (but not completely knocked out) may require root canal treatment, but it is often possible to reposition and restabilize it. For teeth that are knocked out completely, it’s a race against the clock. Get to the endodontist with the tooth immediately, because the faster we can treat it after the accident, the better the chances are that the tooth can be successfully replanted.
It’s very important that you do not touch the root of a knocked-out tooth or attempt to clean it, because this will kill the root and make replanting impossible. Store it in the socket or a glass of milk if that’s not possible. To replant it, the endodontist will use a stabilizing splint (think of a bonded retainer) to keep the tooth steady throughout the healing period. Root canal therapy is sometimes necessary too, depending on the health of the tooth.
How to Manage a Dental Injury Prior to Treatment
The ideal dental injury situation is that you can get to the endodontist or an emergency dentist within minutes after the injury occurs. In the meantime, you can manage the discomfort and protect the damaged tooth in a few ways. Biting down on clean, moist cloth or gauze can help if it hurts to breathe through your mouth or drink cold fluids. Avoid topical painkillers (including putting aspirin directly on the affected area), but it’s fine to take over-the-counter pain medication.
Prepare an Emergency Dental Injury Plan
Even though it’s impossible to prevent all accidents, we can prepare for them in advance by making an emergency plan. Any injuries that impact more than the teeth should be treated at an emergency room first, but make a plan for how to get to the endodontist quickly in the event of an oral injury.