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Root Canals

Traumatized tooth and root canal

08/16/2007

Question:

Two weeks ago I fell and traumatized my tooth. The tooth was slightly moved and in a lot of pain. Per the hot/cold test my tooth did not hurt and my dentist told me to wait a week to see if the pain went away. Due to night grinding my tooth was moved back into place in my sleep but the pain did not go away although it has gone down significantly.

My dentist is pushing me toward getting a root canal next Friday because she says that my tooth root may die. Can I just wait a few more weeks for the root canal on this tooth? I feel a lot of pressure to get it done now and I`m not certain that the tooth has had enough time to heal on its own yet or if a root canal is even necessary. Any thoughts on if the root canal is needed?

Answer:

When a tooth is traumatized to the point of where it is moved, shifted or even partially knocked out, there is trauma to the blood vessels and nerves that enter the tooth from the deep end of the root. Once the blood supply to the tissue inside the tooth is lost, this tissue dies off. This will happen in about 7-10 days after the trauma. It is also the reason it is recommended to have the root canal started at about this time. The dead tissue will release a number of cellular toxins that can cause inflammation in the bone around the tooth. They can also cause the body to start to resorb or eat the root of the tooth.

The accepted protocol for treating displaced teeth is to move them back, get them stabilized in position and then, in most cases, start the root canal. The exception would be if you were about 8-9 years old and the root of the tooth had not fully developed. Delaying the start of the root canal may put your tooth at risk. These teeth normally do not respond to any thermal or electrical stimulus because the nerve inside the tooth is dead.

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Response by:

John M Nusstein, DDS John M Nusstein, DDS
Associate Professor of Endodontics
College of Dentistry
The Ohio State University