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As the result of a dental injury a tooth can be partially pushed into its socket. When this happens immediate dental care is required to reposition and stabilize the tooth. If a permanent tooth has been dislodged, a root canal treatment is usually needed and should be initiated within a few days of the injury. As part of the treatment a special medication called Calcium Hydroxide is placed inside of the tooth.
In situations where a tooth is partially pushed out of its socket, immediate dental care to reposition and stabilize the tooth is also required. If the pulp of the tooth remains healthy, no other treatment is necessary. However, if the pulp becomes damaged or infected, a root canal therapy is necessary.
When a tooth has been completely knocked out of the mouth, it is important to get to the endodontist as quickly as possible. It is important to handle the tooth carefully to avoid further damage. The main thing is to keep the tooth moist. You can place the tooth in milk or a glass of water (add a pinch of salt). Saving the tooth in large part depends upon the length of time the tooth was out of the mouth and the way the tooth was handled and stored. Keep in mind that only permanent teeth should be re-implanted.
Since the nerve and blood supply of the tooth is damaged when the tooth is avulsed, a root canal will be needed. Your endodontist will determine the appropriate time for this.
A permanent tooth in a child might not be fully developed at the time of injury. There are special considerations in terms of root development that are taken into account in these cases. An immature tooth may require one of the following procedures to improve the chances of retaining the tooth:
The intent of apexogenesis in injured immature teeth is to preserve vital pulp tissue so that continued root development with apical closure (root tip closure) may occur. During this procedure a special medication to encourage normal development and maturation of the root is placed inside of the tooth. The injured tooth is then closely followed to determine if successful root formation is taking place. In cases where the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance of saving the tooth.
If the vital tissue inside an immature tooth is irreversibly damaged a procedure known as a apexification may be performed. The intent of this procedure is to induce the formation of hard tissue near the root tip that will provide closure and allow a root canal filling to be placed. Since the structural integrity of the tooth may be compromised, it is important that the tooth have a proper final restoration placed by your endodontist.