If a tooth has been knocked clean out of the mouth, it is essential to see a dentist immediately.  When a tooth exits the mouth, tissues, nerves and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

1. Call the dentist.
2. Pick up the tooth by the crown and rinse it under warm water.  DO NOT touch the root.
3. If possible, place it back into its socket – if not tuck it into the cheek pouch.
4. If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort.  It is important to keep the tooth from drying out.
5. Get to the dentist, quickly and safely.

The dentist will try to replace the tooth in its natural socket.  In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy may be necessary.

It is common to have a severe toothache and your dentist has told you that you need root canal treatment.  You’re not alone. Millions of teeth are treated and saved each year with root canal, or endodontic, treatment. This page explains root canal treatment in detail and how it can relieve your tooth pain and save your smile.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.

The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

What are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gum tissues. Sometimes, however, there are no symptoms.

How does endodontic treatment save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.

Will I feel pain during or after the procedure?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When the dentist is not immediately accessible, here are the steps to take:

1. Apply clove oil to the tooth to alleviate pain.
2. Clean the crown and affix it onto the tooth with dental cement.  This can be purchased at the local pharmacy.
3. If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
4. DO NOT use any kind of glue to affix the crown.

The dentist will check the crown to see if it still fits.  If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

The teeth are strong, but they are still prone to fractures, cracks and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme.  Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting.  If a tooth has been fractured or cracked, there is no alternative but to see the dentist as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

1. Call the dentist.
2. Rinse the tooth fragment and the mouth with lukewarm water.
3. Apply gauze to the area for ten minutes if there is bleeding.
4. Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
5. Cover the affected area with over-the-counter dental cement if there is no way to see the dentist immediately.
6. Take a topical pain reliever.

The nature of the break or fracture will limit what the dentist is able to do.  If a fracture or crack extends into the root, root canal therapy may be the only effective way to retain the tooth.  In the case of a complete break, the dentist will usually affix the fragment back onto the tooth as a temporary measure.

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it.  If the tooth remains in the mouth and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call the dentist immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain.  The dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy may be required.

If you have questions or concerns about dental emergencies, please contact give us a call.