Apexification for Sports-Related Dental Injuries: Getting Back in the Game Safely

Apexification for Sports-Related Dental Injuries: Getting Back in the Game Safely

Regardless of the season, on any given Saturday across the United States tens of millions of families gather at the local ball field to watch practice or root for their sons, daughters, or grandchildren. 

Despite wearing helmets, shin guards and other safety gear like mouth guards, young athletes can inevitably get hurt. Dental injuries are, unfortunately, common.

In fact, trauma from sports activities represents about a third of all orofacial injuries. More than half of these injuries are traumatic dental injuries. Not surprising, many of these dental injuries happen before the apex, or base of the tooth root, has had a chance to fully form and close. 

In this blog, our own Robert Scott Nance, DDS, MS, PA, in Statesville and Hickory, North Carolina, takes a look at apexification for sports-related dental injuries. 

Apex and sports dental injuries

You may be more familiar with such parts of the teeth as enamel, dentin, and pulp, but you might not have heard about a tooth’s apex, which is the bottom or base of a tooth’s root. 

The opening at the apex of the root is the pathway to the soft tissue. That’s where blood vessels and nerves are located that supply the dental pulp that ultimately nourishes a tooth and keeps it viable.

So why is this significant in the context of sports-related dental injuries? Typically, an apex remains in an open position until the tooth fully develops and then takes about three years to close once the permanent tooth has fully erupted. 

Most permanent teeth come in by age 13, with wisdom teeth arriving between ages 17 and 21. The rub is that about 90% of all dental injuries occur before the age of 19.

Sports-related dental injuries threaten tooth viability

The problem with trauma or dental injuries happening before the apex closes is twofold. First, with the apex in an open position, bacteria can easily gain access to the tooth’s inner pulp and the soft tissue where the nerves are, which sets up a perfect storm for infection.

The second issue is that in the event the patient needs a root canal treatment due to an untreated cavity, gum disease, or a cracked or trauma-damaged tooth, the opening makes it challenging at best to complete a root canal procedure. 

For the final step of a root canal, we must use a compound and sealing paste to fill the tooth, and finish the process by applying a dental filling to create a tight seal. With the apex in an open position, there’s no way to contain the dental filling.

Apexification explained

For the most part, apexification procedures typically take place in a regular dentist’s or endodontist’s office. The procedure is much like a conventional root canal treatment. We administer an anesthetic, then prepare the treatment area by placing a rubber dam over the affected tooth to keep it dry.


Dr. Nance then drills an access hole in your affected tooth and cleans out the pulp layer of the tooth. He then seals the end of the root canal with a chemical solution. After the apexification procedure, we send you home with a list of recovery instructions. 

Over the course of the next six months or so, you return to the office every few weeks for checkups. Dr. Nance checks on the progress of the hardened plug, as well as how the tooth reacts to sensations like temperature and pressure. 

Once Dr. Nance is confident that the root apex has successfully sealed, he performs a root canal and seals the tooth with a permanent filling or crown.

If you experience a sports-related dental injury and want to know if you’re a candidate for apexification, make an appointment at our Statesville or Hickory, North Carolina, location. Call our office or send us a message online today.

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