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Question
my 8 yr old daughter broke her right front tooth down to the gum line two days ago...we took her to the dentist yesterday, and they want her to go to an endodontist...because of her apex?  They said that they  might need to do some procedure on her first if her apex wasn't closed, and then come back months later to do a root canal, if they can't do the root canal first.  Is this correct?  Can't they just cap her tooth, or bond the tooth back?  I am kind of amazed that she needs all this work done..I have read other posts where teeth were just bonded back..any info would be helpful...thank you

Answer
Hi Karleen,

WOW...I am SO sorry to hear your daughter is going through all this at such a young age. Trauma to young permanent teeth is one of the most difficult things we deal with. Your dentist is right on referring you to an endodontist for evaluation and treatment. If things are not done correctly the first time, there is a high likelihood your daughter will lose her tooth. Let me explain.

When a tooth is traumatized, the nerve in the tooth may die and if that happens, the root will stop forming in young children. That will make a root canal very difficult to do and also will make the tooth very weak long term. In addition, trauma can also stimulate a process called resorption which is where the body identifies the tooth as a foreign body and starts to actually "eat" it up and the entire root can be lost if the process is not treated. Your daughter is probably in for a long period of observation at the least since this resorption can start months after the actual trauma. If the pulp is already affected, she will probably need 6-12 months of treatments to make sure the process doesn't start. It is VERY important that things are done right. You only get one chance to save the tooth. After you see the endodontist, you will have a much better idea of what is needed. Unfortunately, just bonding the tooth back on is not an option in your daughter's situation. For more info, including diagrams, you might want to check out our website...www.aae.org....which has a lot of info on it for patients and does a real nice job explaining trauma and the problems associated with it.

Hope this helps. I know it's not what you want to hear, but it's a true picture of what you are up against.

Gary Backlund DMD, MSD

Dentistry

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Gary Backlund, DMD, MSD

Expertise

I am an Endodontist ( root canal specialist ) and can answer questions about root canals and their treatment. I cannot diagnose or treat online, but can answer general questions. I have been a specialist for 25 years and am Past President of the Washington State Association of Endodontists.

Experience

25 years practicing as a specialist

Organizations
American Association of Endodonists, Past President Washington State Association of Endodontists.

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