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The Endodontics Program at Boston Children’s Hospital is dedicated to providing therapeutic and preventative dental care in a safe and comfortable environment. We understand that children, especially those with special medical, physical, and emotional limitations that need to be respected.

Anxiety and nervousness are common issues that we address. We take the time to explain exactly what we will be doing during the procedure. We go through each dental technique and demonstrate them before performing it on the child.

Treatment

Treating tooth decay (cavities) that affects the nerve and avulsions (knocked-out teeth) remain a top priority for endodontists. 

  • Root canals: A root canal treatment is a procedure in which the diseased nerves are removed from the tooth by making a hole in the back of the tooth, locating the diseased part and removing it. We insert gutta-percha, a type of rubber that seals the tooth from the bone. Once the rubber is put in, the bone heals the majority of the time.
  • Caps and crowns: After root canal therapy, a crown (cap) is done to reinforce a weakened tooth in adult teeth.
  • Bonding: For children whose teeth haven’t reached their adult level, we usually bond the teeth. When the child reaches adulthood the tooth is crowned.
  • Avulsions: Knocked-out teeth (avulsions) are routinely treated in our clinic, especially on weekends during the summer when swimming and diving accidents occur. Pediatric dentistry residents are on-call at the emergency room to handle these situations. However, there are important steps parents can follow before they reach the ER that will make the treatment process easier. 

What to do if your child’s tooth is knocked out

Remember: an avulsed (knocked-out) tooth is a dental emergency. When a permanent tooth gets knocked out of a child’s mouth, the sooner you replace it in the socket the better the prognosis. If the tooth is left out of the mouth (dry) there is a high risk that the body will reject it. Quickly putting the tooth back into its socket is the key to preserving it.

Boston Children's dental specialists have compiled this list of tips to help you preserve your child’s knocked out tooth:

  • Find the knocked-out tooth and pick it up by the crown, not by the root. If possible, rinse with milk.
  • Insert the tooth back in your child’s mouth and go to your dentist.
  • If you are unable to get the tooth back in your child’s mouth place the tooth in milk and get to your dentist so it can be replanted within 15 to 30 minutes of being avulsed.