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Trauma is the most common cause of loss of permanent incisors in childhood. Dental trauma often leads to complications such as pulpal necrosis, and it is nearly impossible to predict the long-term prognosis of the injured tooth; the injury often results in long-term restorative problems. [51] [52] [53]
Pulp necrosis is a clinical diagnostic category indicating the death of cells and tissues in the pulp chamber of a tooth with or without bacterial invasion. [1] It is often the result of many cases of dental trauma, caries and irreversible pulpitis.
Teeth may turn grey following trauma-induced pulp necrosis (death of the pulp). [2] This discoloration typically develops weeks or months after the injury and is caused by incorporation of pigments released during the breakdown of the pulpal tissue and blood into the dentin. [2]
Usually, trauma—like a direct blow to the tooth—or stress from too much pressure—like bruxism—causes these infractions. Enamel infractions, as opposed to cavities, may not need bacterial decay or tooth structure loss, although they may still result in sensitivity or cosmetic issues.
Failure to re-plant the avulsed tooth within the first 40 minutes after the injury may result in a less favorable prognosis for the tooth. [15] If the tooth cannot be immediately replaced in its socket, follow the directions for any knocked-out (avulsed) teeth kit, or place it in cold milk or saliva and take it to an emergency room or a dentist.
After having patients describe in painful detail what caused their moral injury, therapists asked them to choose someone they saw as a compassionate moral authority and hold an imaginary conversation with that person, describing what happened and the shame they feel. They were then asked to verbalize the response, using their imagination.
The exact causes of pulp obliteration are unclear [2] but it typically occurs in response to dental trauma, [1] especially following luxation injuries involving displacement, particularly if a tooth is replanted after being completely avulsed (knocked out) [3] This response is common in this scenario and typically starts to occur several months ...
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