Trauma to a tooth can sometimes create a fracture or crack through the tooth's root system. Vertical cracks are difficult to treat in adult teeth, which need more permanent solutions than baby teeth that are going to fall out anyway, and often require extraction. A horizontal fracture is more treatable because there is healthy root material on either side of the crack and the dentist is usually able to save the tooth.

What are some of the ways your dentist can help an adult tooth with a horizontal root fracture?

Root Canal Therapy

A horizontal root fracture that passes through the root canal is fairly easy to treat using standard root canal therapy. The procedure involves removing all of the pulp from the root canal, which also removes the significant damage associated with the fracture.

Your dentist will drill a hole into the crown and then insert a special narrow tool that is used to scrape out all of the pulp. The canal is then washed with an antibacterial rinse in case any bacterial was knocked into the canal with the fracture. A type of bio-cement is then inserted into the canal as a filling so that no new pulp material can enter the tooth from the lower part of the roots.

The tooth is still alive because there is pulp present in the roots. The procedure simply strips out the damage and keeps pulp from reentering the area of the damage.  

Your dentist will then close the tooth's drill hole by bonding an artificial dental crown onto the exterior of your natural crown. The artificial crown offers more stability to the dentin of your natural tooth and minimizes the risk of further damage.

Apicoectomy

In rare cases, the horizontal fracture occurs near the bottom of the roots rather than through the top of the root canal. Depending on the location and nature of the damage, your dentist might be able to treat the tooth using a surgical procedure called apicoectomy.

An apicoectomy removes the lowermost tips of the roots, which are called the apexes. The dentist will need to cut into your gum tissue to access the apexes. Once the tips are removed, the remaining opening in the roots is sealed shut with a similar bio-cement as to what is used in root canal therapy.

The apicoectomy can also be paired with a root canal procedure aimed at getting the damaged material out of the top of the roots, but this isn't always necessary depending on the level or severity of the crack. For more information, contact a dentist at Discovery Dental.