NEW YORK, New York – Children who suffer dental injuries, ranging from chips and cracks to teeth knocked out of the socket, often can have their teeth repaired and keep them for a lifetime thanks to a variety of new treatments. Most dental injuries occur in boys and girls between the ages of 7 and 15, the result of mishaps involving in-line skates, bicycles, skateboards and a variety of sports activities, according to Peter M. DiFiore, DDS, MS, speaking at the American Association of Endodontists' (AAE) 55th Annual Session. Dr. DiFiore is director of endodontics at Northwestern University School of Dentistry in Chicago.

"These are all part of children's play culture and, as skillful and agile as they are, they occasionally lose control, collide and fall," Dr. DiFiore said. "When dental injuries occur, it is an extremely trying time for both child and parent. However, now more than ever, we're able to provide effective treatment for teeth that have been fractured, loosened or knocked out."

The treatments include new, stronger bonding materials that look and function like natural teeth to repair the crown of a tooth, and medications and growth factors to repair the damaged root of the tooth and enhance root reattachment.

"When a child sustains a traumatic dental injury, it's easy for a parent to think it's the end of the tooth," Dr. DiFiore said. "But much research is being done to improve the success of treatments for traumatic dental injuries, and even a tooth that's knocked out of the socket can often be reimplanted and last for a lifetime."

Often a tooth that has sustained a traumatic injury requires endodontic treatment because the blow to the tooth has damaged the tooth's soft inner tissue called the pulp. The endodontic procedure removes the damaged tissue and replaces it with biocompatible filling and sealing materials.

In younger children with permanent teeth, a conventional endodontic procedure often cannot be performed because the root of the tooth is not fully mature and the blow to the tooth may stop the root from completing its growth. In a procedure called apexification, the dentist places a medication inside the tooth that allows the root to continue to grow. After the root fully matures - in up to several months - the dentist can perform the endodontic procedure that will save the tooth.

"The new medications will allow us to complete this treatment more quickly and more successfully because they speed the rate of root regrowth," Dr. DiFiore said

Successful treatment often depends on quick action.

"The parent or caregiver should immediately call the dentist and take the child and the tooth or tooth fragments to the dental office," Dr. DiFiore said. "If a knocked-out tooth is reimplanted within 30 minutes, the chance of retaining the tooth is excellent."

If your family dentist is unable to see your child right away, ask about a referral to an endodontist. As dentists who specialize in root canal procedures, endodontists are experts in treating dental emergencies, including severe toothaches and traumatic injuries.

Dr. DiFiore had these additional tips for parents concerned about traumatic dental injuries.

• Have your child wear a mouth guard during sports and other physical activities.
• If a tooth is knocked out, the child should be taken to the dentist right away. If possible, the tooth should be repositioned in the socket immediately. If this is not possible, it should be placed in a cup of fresh, cold milk or placed in the mouth between the gum and the cheek. Always handle the tooth by the crown, not the root. If it gets dirty, gently rinse it with water.
• If a blow to a tooth does not cause a crack or chip, but the child complains of pain, or the tooth becomes discolored, this may be a sign that the pulp has been damaged. Take the child to the dentist as soon as possible. An endodontic procedure may be able to save the tooth.

The American Association of Endodontists is the recognized specialty organization of 5,000 endodontists and other dental professionals worldwide. The Association was founded in 1943 to promote the interchange of ideas, to stimulate research and to encourage the highest standard of quality care in the practice of endodontics. The AAE is headquartered in Chicago.

SOURCE: American Association of Endodontists

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