As a leading Martha’s Vineyard endodontist, Dr. Karen Gear treats patients with cracked or decayed teeth every day. In fact, these are the primary reasons that patients will visit an endodontist. An endodontist has extensive training to treat the disease of the pulp (tooth nerve). When a patient exhibits symptoms that involve the nerve or dental pulp and needs a root canal, they are referred to an endodontist for evaluation and treatment.
These symptoms are:
- Thermal sensitivity: Pain to hot and cold solutions or food.
- Spontaneous pain that lingers for more than a few seconds to several minutes or hours.
- Radiating pain to opposite jaw, for example, pain which starts in the upper molars and radiates to the lower jaw.
- Pain that starts in your tooth and radiates to your ear or causes a headache, or causes a sore throat.
When left untreated, decay tooth symptoms can cause infection in the pulp of the tooth. This is also referred to as an abscess. When a tooth becomes cracked or fractured, bacteria is able to enter into the pulp chamber and cause infection. The infection will slowly attack the roots and nerves without leaving any obvious decay tooth symptoms. Without treatment, the infection will continue to grow until the supporting bone structure is damaged. When this happens, severe jaw pain or swelling can occur. Treatment is urgent at this point. As soon as you notice any decay tooth symptoms, such as a split or cracked tooth, you should visit Dr. Gear to get a dental second opinion in the Martha’s Vineyard area.
Chipped or Fractured Teeth
Chipped teeth account for the majority of all 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, and the 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 their teeth are still developing. For those patients, your endodontist will monitor the healing carefully and intervene immediately if any unfavorable changes appear.
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 and 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.
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. Sometimes, stabilization with a splint is required for a period of time.
Traumatic Dental Injuries in Children
Chipped primary (baby) teeth can be esthetically 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 knocked-out 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.
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 and/or treated at regular intervals for up to five years to ensure that root resorption is not occurring and that surrounding tissues continue to heal.
If you notice any of the above decay tooth symptoms and would like to get a dental second opinion, contact the office of Dr. Gear to schedule a consultation today!