15 years old son knocked out front tooth

[Bee1216]

It was reinserted after being held in socket and milk for maybe about hour or 90 min. It looks good and it's splinted. No pain anymore. Problem now is I have two wildly different opinions on when to do root canal.

Treating dentist said there was a small fracture and don't touch it! He's adamant said it could loosen tooth , wants bone to heal and is happy with how it's healing. He said 6-8 weeks and his dental partner said 3 months.

I went to an endo and he said it's fine- he will drill through splint (that dentist wants on for 8 weeks) and suggested root canal next week. The tooth is dead - he doesn't feel cold. All guidelines say root canal soon but the dentist is so emphatic and scaring me we will mess up tooth.

I was thinking I would compromise and do it in 2 weeks when we are back in town (4 weeks post injury) but I have a second opinion w endo tomorrow

An oral surgeon and another dentist said fine to wait but online keep saying root canal 14 days. Thanks for any insight.

 

[honestdoc]

In my opinion, there is a fine balance between not disturbing the tooth reintegrating into bone and completing the root canal to remove contamination and nonvital tissue. The Endodontist is the root canal specialist with training in all aspects including managing traumatic dental injuries. I believe the endodontist will be the best source for care.

 

[Bee1216]

Ok thanks so much. 3 endodontists said fine to do now, so I am most likely going to next week. (2.5 weeks post injury)
The one I saw today offered to call the dentist and discuss beforehand which I appreciated. I am going to follow up Monday. He said barring anything we would plant to do the root canal. He also x-ray the teeth today and there was a dark shadow by the apex (haha I am basically a dentist now) which he said could be the start of an infection. He still didn't seem to indicate it was anything worrisome, but to me, it made me think better to do the root canal sooner..

I just feel bad the dentist did a great job splinting the tooth and saving it (for now) and i feel like I am messing up his work but having a root canal and if the tooth has an issue I will freak! But it must be common if all guidelines say to do it soon. The first endo I saw said it's not even a gray area.

Let me know you have any thoughts on the shadow.. just curious!

 

[Bee1216]

Sorry meant to clarify the first endodontist said doing a timely root canal isn't even a gray area and was confused why he would suggest delaying. I wasn't sure if endodontists just do the root canal and then have no idea if the tooth falls out weeks later haha as opposed to the dentist who maybe follows up long term. Thanks again for any other feedback and appreciate the reply very much!

 

[honestdoc]

Endodontists do follow up on root canals. It is on them if it fails and it is to everyone's best interest for cases to succeed. They have the most experience with cases like these and will take the best care.

 

[Bee1216]

Thanks- wasn't sure who deals with tooth avulsions more. Fingers crossed!

 

[MattKW]

Root canal therapy underway within 2 weeks of damage. The apex (tip of tooth) for your son is closed, and the tooth has been out of the socket for a long time. Read the attached guidelines, print them up, and take to your endodontist for a discussion. I've highlighted relevant parts for you. It is quite likely that over time the tooth will be treated as a foreign object and the root will get eaten away (resorbed) and/or become fused to the bone (ankylosed). The last statistics I remember are that the lifetime of this tooth is probably about 5 years. However, this buys time for your son to keep growing and keeping a good bone level for a probable dental implant at a later date.

 

[Bee1216]

Thank you! Yes then endodontist follows this and agrees - it's the dentist who was saying wait. I think I have read this but will read over again. He's getting root canal Tuesday I think

 

[Bee1216]

Sorry was only out of socket like 5 minutes. Meant got to dentist for reimplantation 90 minutes

 

[Bee1216]

Root canal therapy underway within 2 weeks of damage. The apex (tip of tooth) for your son is closed, and the tooth has been out of the socket for a long time. Read the attached guidelines, print them up, and take to your endodontist for a discussion. I've highlighted relevant parts for you. It is quite likely that over time the tooth will be treated as a foreign object and the root will get eaten away (resorbed) and/or become fused to the bone (ankylosed). The last statistics I remember are that the lifetime of this tooth is probably about 5 years. However, this buys time for your son to keep growing and keeping a good bone level for a probable dental implant at a later date.

Thank you for the detailed reply. Yes I had read that and similar guidelines which is why the treating dentists advice stressed me out! We did reinsert tooth within 5 minutes until appt but regardless, seems like root canal is standard procedure within a few weeks. Fingers crossed it happens tomorrow