Dentistry focuses on diagnosing, preventing, and treating conditions of the teeth, gums, and oral structures, supporting oral health and overall well-being.
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Treating dental injuries needs to happen quickly and is based on how the body heals. At Liv Hospital, we follow the International Association of Dental Traumatology’s guidelines. The main goals are to keep the tooth’s nerve alive, protect the ligament, and restore how the tooth looks and works. Treatments can be as simple as bonding a broken piece or as complex as procedures to help a dead tooth recover. Care usually happens in stages: emergency treatment, stabilization, main repair, and long-term follow-up.
Treating a knocked-out tooth is the most urgent and important part of dental injury care.
Immediate reimplantation: The best place for a tooth is its own socket. If the tooth is clean, it should be replanted immediately at the accident site.
Storage media: If you can’t put the tooth back in right away, keep it in a suitable liquid to protect the ligament cells. The best options are Hank’s Balanced Salt Solution, cold milk, or the patient’s saliva (inside the cheek). Don’t use water, as it can harm the cells.
Surface treatment: If the tooth has been dry for over an hour, the ligament cells are no longer alive. The root can be treated with fluoride before putting it back to slow down the process where bone replaces the root.
Antibiotic coverage: Systemic antibiotics (typically doxycycline or penicillin) are prescribed to prevent infection during the initial healing phase.
Stabilization of Injured Teeth
Splinting is used to immobilize luxated, avulsed, or root-fractured teeth to allow the PDL and bone to heal.
Flexible splinting: Current advice is to use flexible splints, like fishing line or thin wire, attached with dental material. Hard splints are not used because they stop normal movement and can cause the tooth to fuse to the bone.
Duration: For most knocked-out or displaced teeth, the splint stays on for only about 2 weeks. Leaving it on too long can be harmful.
Root fractures: Fractures in the middle or cervical third of the root require longer stabilization, typically 4 weeks to 4 months, to allow a calcified callus to form between the fragments.
Hygiene access: The splint is placed so it doesn’t touch the gums, making it easier to keep the area clean and prevent gum problems.
Preserving the Nerve
If a tooth is badly broken and the nerve is exposed, it’s better to keep the nerve alive instead of doing a root canal, especially in children.
Cvek Pulpotomy: A partial removal of the superficial, inflamed pulp tissue. The remaining healthy pulp is covered with a biocompatible material.
Pulp capping: For small exposures, a direct cap with MTA (Mineral Trioxide Aggregate) or bioceramic putty is placed to induce a dentin bridge formation.
Apexogenesis: In immature teeth, keeping the pulp alive allows the root to continue growing and the walls to thicken, preventing future fractures.
Bioceramics: These modern materials seal the area and release calcium, which helps the tooth form new protective tissue.
When the pulp dies in an immature tooth, traditional root canals leave the tooth weak. Regenerative procedures aim to regrow tissue.
Revascularization: The canal is disinfected with antibiotic paste (triple antibiotic paste) or calcium hydroxide. Bleeding is then induced from the apical tissues to fill the canal.
Stem cell migration: The blood clot acts as a scaffold for Stem Cells of the Apical Papilla (SCAP) to migrate into the canal.
Outcome: If regeneration works, the infection at the root tip heals, the root keeps growing, and the tooth walls get stronger.
Biocompatible seal: The blood clot is sealed with a bioceramic material to prevent bacterial re-entry while supporting cellular differentiation.
Trauma can trigger the body to attack the tooth root. Managing this requires aggressive intervention.
Inflammatory resorption: Caused by bacteria in the canal and damage to the root surface. Treatment involves thorough root canal disinfection and long-term placement of calcium hydroxide to alter the pH and inhibit osteoclast activity.
Replacement resorption (Ankylosis): Sometimes, the bone starts to replace the tooth root. There’s no way to stop this once it begins. The usual treatment is to remove the crown but leave the root to keep the bone ready for a future implant.
Internal resorption: The pulp transforms into granulomatous tissue that eats the tooth from the inside. Immediate root canal therapy is curative because it removes the blood supply that fuels the resorptive cells.
Cervical resorption: An invasive resorption starting at the neck of the tooth. Treatment involves surgical exposure, removal of the resorptive tissue, and restoration with Geristore or bioceramics.
The last step is to rebuild the tooth’s shape and appearance.
Fragment reattachment: If the patient brings the broken tooth fragment, it can be bonded back to the tooth with high strength and excellent esthetics.
Composite bonding: High-performance composites are used to build up fractured edges, mimicking the optical properties of natural enamel.
Veneers and Crowns: If a lot of the tooth is missing, ceramic veneers or crowns might be needed, but these are only done after making sure the nerve is healthy.
Send us all your questions or requests, and our expert team will assist you.
Find the tooth, hold it by the crown (white part), rinse it gently with milk if it’s dirty, and try to put it back in the socket immediately; if not, store it in milk and go to the dentist instantly.
For most knocked-out or displaced teeth, a flexible splint is kept on for only 2 weeks to allow healing without causing the root to fuse to the bone.
If the trauma damages the nerve inside the tooth, a root canal is necessary to remove the dead tissue and bacteria, prevent infection, and prevent root resorption.
Yes, if you have the fragment, keep it moist (in water or milk); the dentist can often bond it back to the tooth with excellent strength and aesthetics.
It is a modern procedure used on young teeth to stimulate stem cells to grow new tissue inside the root, allowing the tooth to continue developing even after the nerve has died.
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