Immature permanent teeth have a greater likelihood of survival than mature permanent teeth. The chance of a successful replantation depends to a large degree on the length of time the tooth has been out of the socket and how it was stored. It’s important to handle a knocked-out tooth gently, rinse it quickly in cold water and avoid touching the root surface. Placing an avulsed tooth in milk at room temperature can preserve the cell viability for up to six hours. Although detrimental to periodontal cells, saliva and saline can maintain cell viability for up to two hours.
An avulsed tooth is a painful condition, resulting in complications which we can help our patients resolve. One of these is ankylosis which occurs in 57-80% of teeth replanted after avulsion. Ankylosis is solid fixation of a tooth, resulting from fusion of the cementum to the alveolar bone (bone that supports your teeth), with destruction of the periodontal ligament. Cementum is a hard layer of tissue that helps the periodontal ligament attach firmly to a tooth. Although ankylosis in adults can be successfully managed with prosthodontic therapy or implantation, ankylosis in immature teeth interferes with normal development and can lead to continued root replacement resorption and disturbed alveolar ridge growth. Other complications include pulp necrosis which is the death of the soft tissue inside the tooth. Infection of the root can also occur, as well as pulp canal obliteration, a condition that involves hard tissue depositing along the walls of the root canal, leaving it narrowed and restricted. Treatment in our office can relieve the symptoms of these and other tooth root aliments.
Most studies show a reduction in dental injuries when mouth guards are worn. In intercollegiate athletes, the risk for dental trauma in basketball was five times that of football, likely due to mouth guard protection worn by football players. One study showed the overall risk of an orofacial injury was 1.6 to 1.9 times higher when a mouth guard wasn’t worn. In addition to preventing avulsed teeth, mouth guards reduce the chance of tooth fractures, tooth dislocations and soft tissue lacerations. Although other protective materials such as goggles, helmets, shoulder pads and shin guards are required for participation in sports, mouth guards are not always mandatory. An American Association of Orthodontists survey found that 84% of children didn’t wear mouth guards while playing organized sports because they weren’t required.
If you or your child are involved in sports activities with a risk of dental injuries, we’ll help you select the most optimal mouth guard based on your dental history, the sport and position played, and a thorough exam of your oral structures. As a parent, you can reinforce the importance of your child wearing a mouth guard, even if their league or coach doesn’t require it.
Endodontic management of tooth avulsion includes dental splinting, endodontic therapy and restorative techniques to re-establish function and esthetics. When you visit us for emergency care, our endodontists will carefully evaluate the avulsed tooth in New York, NY, place it back in its socket, and examine you for any other dental and/or facial injuries. A stabilizing splint may be placed for a few weeks. Depending on the stage of root development, we may start root canal treatment a week or two later. Medication may be placed inside the tooth, followed by a permanent root canal filling at a later date. If the bone around the tooth wasn’t fractured, the tooth should firmly attach to the bone in about three to four weeks. When damage is more significant, it can take six to eight weeks to heal.
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