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Healthy Mouth, Healthy Kids

Horizontal root fracture in 4yr old



Does my 4yr old have to get his tooth extracted because he has a horizontal root fracture. Can it heal by itself? Can it be splinted? It is his upper left primary tooth in the very front, F. Thank you.


A horizontal root fracture can heal in one of three ways (with a tooth-tooth, tooth-bone, or tooth-inflammatory tissue junction). The healing pattern observed can determine the overall prognosis of the tooth. Studies on permanent teeth found that the higher (towards bone) section often retains vitality (90%+ of the time), while the section towards the crown retains vitality 60% of the time in some studies. However, the location of the fracture can also affect the prognosis (the closer to root tip, the better usually). Other factors include the child's overbite, any history of grinding, thumbsucking, etc. In many cases the lower section is extracted and the other piece is left in bone. This definitely needs to be followed closely by a dentist experienced in treatment of dental trauma.

Hope this helps.

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Response by:

Sarath  Thikkurissy, DDS, MS Sarath Thikkurissy, DDS, MS
Director, Residency Program, Division of Pediatric Dentistry and Orthodontics
College of Medicine
University of Cincinnati