Attached is an x-ray that was taken 2 weeks ago of the cracks in my 10 year old sons roots. Another x-ray taken 2 days ago (I do not have a copy) shows more seperation in the right tooth crack. My son is not in pain and has no sensitivity to hot or cold. No tests were done on the teeth. The right front tooth was displaced inwards. The tooth was straightened and splinted across the 4 front teeth 23 hours after accident. What treatment do you suggest? Thank you so much.
What Are Options for 10 Year Olds Cracked Roots? (photo)
Doctor Answers (4)
Kids do the darnest things.....
Well, not in pain is great news! Having two boys myself i understand. Yes, I believe the other dentist is also correct in saying rct's on those two teeth and possibly post. Then later in life possibly swao those tow teeth out for implants and beautiful cosmetic teeth.
Douglas Hauck DDS.
10 year old with cracked roots
I would suggest root-canal therapy on both teeth and hope they stay asymptomatic for as long as possible. When he is an adult, he will have to have them both extracted and implants placed.
Get board certified endodontist consultations for fractured roots on a 10yo
If this was my son, I would go to at least two Board Certified Endodontists to get opinions. Maybe also a local dental school endodontic faculty. No disrespect to other comments, but we are restorative/cosmetic dentists and may not be up to date with the latest endodontic protocols.
I remember reading about the potential for this type of root fractures to heal (like bones heal), particularly when it is a very young patient who has good blood supply in those teeth. The two fragments must be well aligned (may need a CT scan). Infection is a small concern, but if there was no open wound into the gums to contaminate the pulps, then it is most likely a sterile environment with some inflammation, not infection. If they heal on their own, then great, follow up the teeth.
If they don't heal on their own, then a process using CaOH (calcium hydroxide) can be used to promote root/bone healing (also called apexification but in this case would be for healing the fracture). Once the fracture heals, then the root canal therapy would have to be completed.
Again, I'm just relaying some information I have come across in journals or CE courses. You should seek a couple of Endodontists to get all your options. I would also go the college of dentistry and see a faculty (not residents) if its an option for you.
Testing the teeth for pulp vitality should be done at various intervals, but be aware that soon after trauma the teeth may give false or conflicting results. They may test as dead, but as you do follow up tests, they may regain some vitality. If they never regain vitality then Root canals will be recomended, regardes if the fractures healed or not.
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Splinting the teeth would help more if the teeth weren't cracked, because now there is no way to repair it predictably.
The teeth are now a likely source of infection, and as Dr. Neuhaus said so well, will need to be extracted. We usually make retainers with false teeth in them for teenagers waiting to get implants on the front teeth, so they won't feel as self-conscious or need to go 'toothless.'
It's not all bad. I know a man who did the same thing when he was younger skateboarding, only to be inspired by all of the work the doctors had done to fix his smile and go on to be a dentist himself.