Previously Traumatised Teeth

An accidental knock or blow to front teeth, either before or during orthodontic treatment, can cause the teeth to become predisposed to certain conditions. Regardless of how much damage is sustained or when the incident happened, traumatised need to be monitored very carefully for any undesirable consequences.

Although uncommon, there are certain consequences that might ensue:

• Loss of vitality. This is when the tooth essentially dies with a progressive degeneration of the nerve inside the tooth. This can happen in teeth with pre-existing deep large fillings/crowns or those teeth which have severe gum problems. The trauma simply exacerbates the pre-existing condition. The affected tooth may discolour, and become painful. Dental work such as root canal treatment or deep periodontal (root and gum) cleaning may become necessary to save the tooth from extraction. In many cases cosmetic dentistry may also be required if the top part of the tooth discolours or darkens.
• Root Resorption. This is when special cells called “osteoclasts”, break down the outer mineralised surface of the root inside the bone. The tooth appears on radiographs (x-rays) as having shorter roots. The outcome and possible treatment depends on the degree of resorption. However, the longevity of the affected tooth could seriously be affected.
• Ankylosis. This is the fusion or attachment of the tooth root to its surrounding bone. Normally a fibrous layer separates the root from jawbone called the periodontal ligament. An ankylosed tooth cannot be moved with orthodontic braces, and it may require removal, or more complex treatment like surgery to move it into position.