Traumatic Dental Injuries


Traumatic Dental Injuries - nsbendo

Traumatic dental injuries can often occur as a result of an accident or sports-related trauma.  These injuries can be minor, such as chipped or cracked teeth, or severe, such as dislodged or knocked out teeth.  Whether the injury is minor or severe, it is important to see a dentist as soon as possible for examination.  Treatment of traumatic dental injuries depend on the type and severity of the injury, which will be determined during the initial or follow-up examinations.

Fractured or Chipped Teeth

If you’ve chipped or fractured your tooth, it’s likely it can be repaired with a variety of dental restorations. If a significant part of your tooth is broken off, a crown may be required to restore it. If the pulp is exposed or damaged due to a trauma, root canal treatment will be required. Sometimes, traumatic dental injuries can even affect multiple teeth. Click here to learn more about cracked teeth and fractures.

Dislodged (Luxated) Teeth

During an injury, a tooth may be pushed sideways, out of or into its socket. Your endodontist or general dentist will reposition and stabilize your tooth. If it is determined that there is permanent damage to the root, nerve or blood vessels, they will likely recommend a root canal treatment to prevent the tooth’s discoloration or abscess. This should be started within several days following the injury.

Children ages 12 and under may require special management and treatment since their permanent teeth are still developing.

Your endodontist will monitor the healing carefully and intervene immediately if any unfavorable changes appear.  Several follow-up appointments may be needed.

Knocked Out (Avulsed) Tooth                                                                                                                   

If one of your teeth is completely knocked out of your mouth, see an endodontist or dentist immediately! Time is of the essence and if you receive treatment quickly, there is a chance to save your tooth.

Following a few important steps will help increase the likelihood of saving your tooth. Your endodontist or dentist will evaluate the tooth, place it back in its socket and examine you for another dental and facial injuries. A stabilizing splint may be placed for the next few weeks. Depending on the stage of root development, your dentist or endodontist may start root canal treatment a week or two later.

Important:  If a tooth is ever dislodged or knocked-out, immediately reposition the tooth in its original socket and contact an endodontist immediately.  If you cannot reposition the tooth, place the tooth in milk and bring it to the examination. Do not attempt to scrub the tooth or wipe it clean.  Avoid touching the root surface to prevent further damage to the tooth.  In both cases, the tooth can often be saved with proper pre-operative care and endodontic treatment.

At North Shore & Brookline Endodontic, we take the time to thoroughly assess the risk factors in every case.  When needed, we use 3D imaging CBCT scans and clinical microscopic examinations to evaluate the case.  

For more information regarding traumatic injuries, please visit the American Association of Endodontists.


Frequently Asked Questions


Is it easier to just extract a tooth that has suffered dental trauma?


It may be easier, but endodontists know that there is no replacement as great as a natural tooth. By using the most advanced procedures imaginable they make every effort to save a tooth that has suffered dental trauma rather than just extracting it.


Which teeth are most affected by dental trauma?


Depending on the type of trauma, any tooth can be impacted. However, the most commonly impacted teeth are the maxillary central incisors – or, in other words, the two upper front teeth.


Are dental splints usually successful for avulsed teeth?


Yes, dental splints are highly successful. When used for a couple of weeks with teeth that have been knocked out, patients usually yield positive results. For avulsed teeth that were not immediately placed in milk or another moist solution, sprinting may take a little longer.


What happens if the knocked-out tooth cannot be found?


Finding a tooth that has been knocked out is not always a possibility. Thankfully there are many different artificial replacements available that can help, such as dental implants.


Is a chipped tooth always a dental emergency?


No, a chipped tooth is not always a dental emergency – but it always requires the attention of your endodontist whether it feels like a big deal or not. An exposed root or a crack that gives bacteria easy access to your inner tooth can lead to bigger dental concerns. Sometimes the chipped tooth may not cause you any pain and can be easily repaired with restorative dentistry procedures.

Is endodontic treatment considered an emergency?

Yes, endodontic treatment can be considered a dental emergency. In trauma situations, a tooth can be damaged enough that it leaves the pulp exposed. Another need for endodontic treatment occurs when tooth decay reaches the pulp of the tooth, resulting in intense pain. An abscess may also occur which needs to be addressed, too.

What if I don’t have milk for my avulsed tooth?

While placing your tooth back in the socket is the most ideal way to preserve a tooth after it is knocked out, soaking it in milk is the next best thing. The reason for this is that the protein in the milk helps keep the tooth balanced and alive. 

If you don’t have milk, you can place the tooth in a cup with your saliva to keep it moist. Tap water should always be used as an absolute last resort.

How long will a tooth survive once it is knocked out?

Even if you place your tooth in its socket, in milk, or in your saliva, it needs to be addressed by your dentist right away. On average, you will have about 2 hours to seek treatment and successfully save your tooth.

Is a crown a permanent solution for a chipped tooth?

No, dental crowns are not permanent. On average they last about 10 to 15 years, but can last upwards of 20 years with exceptional dental care. When it needs to be replaced, it will continue to protect the chipped tooth.

What is a tooth intrusion injury?

Tooth intrusion can be described similarly to a luxated tooth, except that the impact of the trauma drives the tooth deeper into its socket. There are different methods of treatment involved in saving the tooth, such as repositioning and the use of orthodontic appliances. The chosen treatment option will depend on the injury.