Traumatic Dental Injuries


While most traumatic dental injuries occur in children and teenagers, people of all ages can be affected, usually as a result of sports mishaps, automobile accidents, or bad falls. If you've experienced a traumatic dental injury it is important to visit your endodontist in order to determine any necessary treatment. Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.

Chipped or Fractured Teeth

Chipped teeth account for the majority of dental injuries. Most chipped or fractured tooth crowns can be repaired either by reattaching the broken piece or by placing a tooth-colored filling. If a significant portion of the tooth crown is broken off, an artificial crown or "cap" may be needed to restore the tooth.

Injuries in the back teeth often include fractured cusps, cracked teeth, or a more serious split tooth. If cracks extend into the root, root canal treatment and a full coverage crown may be needed to restore function to the tooth. Split teeth may require extraction.

Dislodged (Luxated) Teeth

During an injury, a tooth may be pushed sideways out of or into its socket. Your endodontist will reposition and stabilize your tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started a few days following the injury.

Children between seven and 12 years old may not need root canal treatment, since teeth are still developing. For those patients, your endodontist will monitor the healing carefully and intervene immediately if any unfavorable changes appear.

Split Teeth May Require Extraction

Knocked-Out (Avulsed) Teeth

If a tooth is completely knocked out of your mouth, time is of the essence. The tooth should be handled very gently, avoiding touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If possible, the tooth should be placed back into its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it.

Once the tooth has been put back in its socket, your endodontist will evaluate it and will check for any other dental or facial injuries. If the tooth has not been placed back into its socket, your endodontist will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks. Depending on the stage of root development, your endodontist may start root canal treatment a week or two later.

Root Fractures

A traumatic injury to the tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of the tooth. If the fracture is close to the root tip, the chances for success are much better. The closer the fracture is to the gum line, the poorer the long-term success rate. Stabilization with a splint is sometimes required for a period of time.

Traumatic Dental Injuries in Children

Chipped primary (baby) teeth can be aesthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.

Children's permanent teeth that are not fully developed at the time of the injury need special attention and careful follow-up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your endodontist to stimulate continued root growth.

Root Resorption

Resorption occurs when your body, through its own defense mechanisms, begins to reject your own tooth in response to the traumatic injury. Following the injury, you should return to your endodontist to have the tooth examined or treated at regular intervals to ensure that root resorption is not occurring and that surrounding tissues continue to heal.

With any traumatic dental injury, time is of the essence. Contact your endodontist immediately. Call our expert team at (212) 371-1414 or contact us online for more information.

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Frequently Asked Questions

  • The American Academy of Pediatric Dentistry (AAPD) recommends that children first see a dentist as early as six months of age and no later than one year of age. During this time, your child's baby teeth will be coming in and your dentist can examine the health of your child's first few teeth. After the first visit, be sure to schedule regular checkups every six months.
  • Your toothbrush will eventually wear out, especially if you are brushing your teeth twice a day for two to three minutes each time. Your dentist recommends that adults and children change their toothbrush every three months. If you are using an electric toothbrush, be sure to read the directions because you may not need to change toothbrush heads as frequently. Patients with gum disease are encouraged to change their toothbrush every four to six weeks to keep any bacteria from spreading. After brushing, rinse your toothbrush with hot water to kill germs and keep the bristles clean. If you've been sick, be sure to change your toothbrush as soon as possible.
  • A cavity is a small hole that forms inside the tooth because of tooth decay. Cavities are formed when plaque buildup on the outside of the tooth combines with sugars and starches in the food you eat. This produces an acid that can eat away the enamel on your tooth. If a cavity is left untreated, it can lead to more serious oral health problems. Cavities can be prevented by remembering to brush your teeth at least two times a day and floss between teeth at least once.
  • According to your dentist and the American Dental Association, you should brush your teeth at least two times a day. Brushing keeps your teeth, gums, and mouth clean and healthy by removing bacteria-causing plaque. It is also recommended that you use a soft-bristled toothbrush and toothpaste that contains fluoride when you brush your teeth. You should spend at least a minute on the top teeth and a minute on the bottom teeth, and remember to brush your tongue; it will help keep your breath smelling fresh!
  • A dentist is a specialist who works to diagnose, treat, and prevent oral health problems. Your dentist has completed at least eight years of schooling, and received either a DDS (Doctor of Dental Surgery) degree, or a DMD (Doctor of Dental Medicine) degree. If your doctor is a pediatric dentist, this means that he or she specializes in caring for children from infancy through their teen years. A pediatric dentist has received the proper education and training needed to work with young kids. Other specializations include:

    • Endodontics (root canals)
    • Oral and maxillofacial (including pathology, radiology, and surgery)
    • Orthodontics and dentofacial orthopedics
    • Periodontics (gum disease)
    • Prosthodontics (implants)
  • Visiting the dentist regularly will not only help keep your teeth and mouth healthy but will also help keep the rest of your body healthy. Dental care is important because it:

    • Helps prevent tooth decay
    • Protects against periodontal (gum) disease, which can lead to tooth and bone loss
    • Prevents bad breath – brushing, flossing, and seeing the dentist regularly will help reduce the number of bacteria in your mouth that causes bad breath
    • Gives you a more attractive smile and increases your self-confidence
    • Helps keep teeth looking bright by preventing them from becoming stained by food, drinks, and tobacco
    • Strengthens your teeth so that you can enjoy healthy, beautiful smiles for the rest of your life!

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