What are the long term complications?

Adult Teeth and Dental Trauma

The long term consequences of dental trauma are unpredictable. You should monitor your/your child's teeth for any signs of infection. You can see here for signs and symptoms of an infection after dental trauma.

If an adult tooth has been injured, possible long term complications include:

1) Nerve damage

• A) Nerve dies causing pain and infection.
  The tooth may look grey/brown and be tender to bite on. This can be managed with root canal treatment. Once the tooth has been treated, it can be whitened to improve the appearance. You can find about more about tooth whitening here.
  
  
• B) Root canal constricts as more dentine is formed (find out more about tooth anatomy here).
  This is called "pulp canal obliteration". The tooth may look more yellow or brown but you won't have any pain from the tooth. This doesn't need any treatment unless the nerve dies. If the nerve dies, you may need to see a specialist endodontist for root canal treatment. If you are unhappy with the colour of the tooth, you can consider a course of tooth whitening.
  
  
• C) Tooth starts to "dissolve" from the inside out.
  This is called "internal inflammatory resorption". The tooth may have a pink-ish tinge to it. In most cases, you won't have any pain from the tooth unless the resorption has extended to the outer surface of the root. If detected very early, this condition can usually be managed with root canal treatment. Sometimes, the tooth will have to be removed (see dental extraction).
  

2) Damage to outer surface of root

• A) Outer surface of the root starts to "dissolve" away due to infection.
  This is called "external inflammatory root resorption". Root canal treatment should be started immediately to try to stop it progressing. Your dentist may refer you to a specialist children's dentist (paediatric dentist) or root canal specialist (endodontist) to continue treatment.
  
  
• B) Outer surface of the root is replaced by, and fuses to, the surrounding bone.
  This is called "external replacement resorption" or "ankylosis" and is most common when the tooth has been completely knocked out of the mouth. In a growing child, the damaged tooth will start to look shorter than the surrounding teeth. This is called infraocclusion (i.e. below the line of bite). You can find out more about it here - LINK avulsion.

3) Abnormal root development

• This is more relevant if the injured tooth has erupted in the last 3 years, as the root is still growing.
  
  
• A) The root may start to grow at a funny angle.
  No treatment is needed but if the tooth needs root canal treatment or extraction in the future, you may need to see a specialist.
  
  
• B) If the nerve dies, the root stops growing.
  This means the tip of the root is left wide open. It can be managed with root canal treatment and a special material called "MTA", which is a bit like a cement. MTA is used to "plug" the hole at the tip of the root during root canal treatment. This is a treatment which is usually only carried out by a specialist children's dentist (paediatric dentist) or endodontist (root canal specialist).

4) Loss of bony support along the gumline around the tooth

• This may cause the gum to shrink away from the tooth, making the tooth look longer.
• If you don't like how this looks, you can see a gum specialist (periodontist) who can discuss the option of a gingival graft - LINK. This is a small surgical procedure which can recontour your gum line.