As the Boy Scouts say, it's best to be prepared. You may never have a traumatic injury to your teeth. But what if you do? Here are four questions and answers about such injuries and their treatment that may be helpful some day.

What are traumatic injuries?
We are talking about physical damage caused by a fall, an accident, or a blow to the face. The word trauma comes from the Greek root meaning “wound.”

A traumatic injury can also cause broken, cracked, or split teeth, or a fracture to the root of the tooth. A tooth may be dislodged from its proper position, pushed sideways, out of or deeper into its socket. It may even be completely knocked out of your mouth.

What should you do if your tooth is knocked out?
With proper treatment, the tooth can be restored to its original place. You must handle the tooth gently and seek professional help as soon as possible. Rinse the tooth in cold water if it is dirty, but do not use any cleaning agent. Avoid touching the root. While hurrying to your dentist, keep the tooth from drying out by keeping it in a container of milk or of your saliva, or by holding it in your mouth between gum and cheek. It is vital to keep the tooth's living tissues moist until it can be professionally assessed and replanted in its socket. If a tooth has been dislodged but not knocked out, it must be repositioned in its socket and may be stabilized with a splint.

Who can treat a tooth that is damaged by a traumatic injury?
A general dentist, an oral surgeon or an endodontist is trained to treat such injuries. An endodontist is trained to treat the root canal(s) inside a tooth. The word comes from “endo” the Greek word for “inside,” and “odont,” the word for “tooth.” After a tooth is replaced in its socket and stabilized, root canal treatment is often needed.

What is root canal treatment?
A tooth is composed mostly of dentin, a living tissue. The top part or crown is covered by hard mineralized enamel. The soft tissue inside the tooth, the pulp, contains blood vessels, nerves and connective tissues. It extends from the crown to the tip of the roots. Treatment of dental pulp injuries is called root canal or endodontic treatment and is usually needed to treat teeth that have been dislodged or fractured.

Contact us today to schedule an appointment to discuss your questions about injuries to teeth and related nerve damage. You can also learn more by reading the Dear Doctor magazine article “Trauma & Nerve Damage to Teeth.”

We pride ourselves on educating our patients regarding oral health and dental treatment. This is why we are providing you with these frequently asked questions (FAQs) regarding root canals. Our belief is that by being informed about this important dental treatment, you will be more comfortable should you ever require a root canal.

Exactly what is root canal treatment?

A root canal treatment is an endodontic procedure (“endo” – inside: “dont” – tooth) in which the living pulp tissues are housed, including the nerves. When a severely decayed or damaged tooth begins to hurt, it is because the pulpal tissues are inflamed or infected, and the response of the nerves is varying degrees of pain — letting you know something is wrong. If the pulp is dead or dying it must be removed and the root canal of the tooth is filled and sealed to stop infection and to save the tooth.

Who typically performs them?

Endodontics is a specialty within dentistry that specifically deals with the diagnosis and treatment of diseases and disorders of root canal issues affecting a tooth's root or nerve. While endodontists are dentists who specialize in root canal treatment, general dentists may also perform root canal treatment and are usually the dentists you will consult with when you first have tooth pain and who will refer you to an endodontist if necessary.

What are the symptoms of a root canal infection?

Root canal symptoms and the character of the pain may vary depending on the cause. For example, symptoms may be:

• Sharp, acute pain that is difficult to pinpoint
• Intense pain that occurs when biting down on the tooth or food
• Lingering pain after eating either hot or cold foods
• Dull ache and pressure
• Tenderness accompanied by swelling in the nearby gums

Does root canal treatment hurt?

A common misconception is that a root canal treatment is painful when, in actuality, it is quite the opposite. The pain associated with a root canal occurs prior to treatment and is relieved by it — not visa versa.

If you have tooth pain, you may or may not need a root canal treatment. Contact us today (before your symptoms get worse) and schedule an appointment to find out what's causing the problem. And to learn more about the signs, symptoms, and treatments for a root canal, read the article “Common Concerns About Root Canal Treatment.”

If you are pleased with your smile except for that one front tooth that appears darker, then we have good news for you. Often a tooth appears darker as a result of trauma that may have occurred years ago. Your tooth may need root canal treatment or may have already had root canal treatment in the past. Regardless, you can whiten this tooth via a process called internal bleaching. And as the name suggests, the tooth can be bleached from the inside out. Here's a brief summary of how this entire process works:

1. Performing an x-ray exam: The first step is to take a radiograph (x-ray) to make sure that your root canal filling is intact adequately sealing the root canal and the surrounding bone is healthy.
2. Making an access hole: To apply the bleaching agent, a small hole will need to be made in the back of your tooth to apply the bleach. However, before doing that, the area must be thoroughly cleaned and irrigated.
3. Sealing above the root canal filling: This step is critical to prevent the bleach from leaking into the root canal space.
4. Applying the bleach: To obtain the whitening needed, it typically requires between one and four office visits for additional bleaching.
5. Applying a permanent restoration: Once your tooth has lightened to the desired color, a permanent filling will be placed over the small hole to seal your tooth's dentin. This is then covered with tooth-colored composite resin (filling material) so that the access hole is undetectable to the naked eye.

To learn more about this procedure and see amazing before and after images, continue reading the Dear Doctor article, “Whitening Traumatized Teeth.” Or, you can contact us to discuss your questions or to schedule an appointment.