A dislodged tooth is a tooth that has been pushed further in or out of its original socket. This may occur because of a traumatic injury in the mouth caused by an accident.
If the tooth is pushed partially out but the pulp remains healthy, repositioning of the tooth and proper stabilization is necessary. In case the pulp is damaged, a root canal is necessary before or sometimes after stabilization.
If the tooth is pushed further into the socket, your endodontist or general dentist can reposition it or recommend a root canal a few weeks after the injury and some medication will be placed inside the tooth. Eventually, a permanent root canal treatment is completed to increase the likelihood of healthy repair.
An avulsed tooth is a tooth that is completely knocked out of the mouth due to injury; this situation needs to be treated immediately. If this happens to you, keep the tooth moist and immediately visit your dentist. You should gently rinse the tooth and transporting to under your tongue; or, in milk or very diluted salt water before you see the dentist. The length of time it takes to replant the tooth and how the tooth was stored can influence likelihood of saving your tooth.
Injuries in Children
When an injury occurs on an immature tooth, a different approach is followed to improve chances of saving the tooth. An immature tooth is a newly erupted permanent tooth with an incomplete root formation. Sometimes no treatment is necessary; but, if the sterile pulps of the roots have been involved the endodontist may recommend either an Apexification or Apexogenesis.
Apexogenesis is a conservative procedure that preserves healthy vital pulp tissues to encourage the root to continue development. As the child gets older, the root continues to mature and the walls of the root canal will thicken. Most of the time the pulp heals and no further treatment is required. Sometimes root canal treatment is still necessary later in life if contamination occurs or if the pulp degenerates.
Apexification uses a different approach and is usually necessary if a deeper injury has happened or if infection has set it. In this procedure, the endodontist removes all of the infected tissues in the roots and places medication in the immature root canals to stimulate hard tissue formation at the apex. This procedure may be done in steps and may requires a few months of healing. Once the hard tissue barrier is formed and the infection heals, the root canal is completed as necessary. Since the root can’t mature and normal root thickness can’t be achieved, the tooth remains susceptible to fractures. It is therefore important to follow up with your dentist to properly restore the tooth.