Dental Trauma Management in Wollongong

Wollongong Endodontics is the only specialist endodontic clinic in the Illawarra. For dental trauma in the Wollongong region, specialist care is now available locally — patients and referring dentists no longer need to send trauma cases to Sydney.

Types of dental trauma we manage

We follow the IADT (International Association of Dental Traumatology) guidelines for the assessment, treatment and long-term follow-up of all dental trauma cases:

• Avulsion — tooth knocked completely out of the socket
• Luxation injuries — concussion, subluxation, lateral luxation, intrusion and extrusion (tooth displaced but still in the socket)
• Crown fractures — enamel-only, enamel–dentine, and complicated (pulp exposure)
• Crown-root fractures — where the fracture extends below the gum line
• Root fractures — horizontal and oblique fractures of the root
• Alveolar bone fractures
• Soft tissue injuries of the gums and lips (referred on where required)

Avulsion (knocked-out tooth) — emergency protocol

Time is the single biggest factor in outcome. Every minute a permanent tooth is out of the socket reduces the chance of long-term success. The first 30 to 60 minutes are critical.

1. Pick the tooth up by the crown — never touch the root. The delicate cells on the root surface are essential for successful reattachment.
2. Rinse briefly in cold running water if dirty (no more than 10 seconds). Do not scrub.
3. Replant immediately if possible — push the tooth back into the socket, hold it in place, and seek urgent care. This is the best storage medium by far.
4. If replantation is not possible, store in milk or saliva — never water. Milk is the preferred transport medium; saliva (in the mouth, between cheek and gum) is acceptable in older children and adults.
5. Call us on (02) 4208 0155 en route.

Once you arrive, the tooth is carefully assessed, replanted if necessary, splinted in position, and the long-term treatment plan begins.

Crown fractures

Treatment depends on the depth of the fracture:

• Enamel-only — smoothing or composite restoration; long-term review.
• Enamel–dentine (no pulp exposure) — composite restoration to seal dentine tubules; pulp vitality monitoring.
• Complicated (pulp exposure) — vital pulp therapy (pulp cap or partial pulpotomy) in recent, small exposures; full pulpotomy or root canal treatment in older or larger exposures.
• Crown-root fractures — assessment of restorability; combination of restorative, orthodontic extrusion, or extraction depending on the fracture line.

Luxation injuries

Luxation injuries range in severity from mild (concussion — tooth is tender but not displaced) to severe (intrusion — tooth is pushed into the bone, or extrusion — tooth is partially pulled out). Treatment typically involves repositioning the tooth, splinting where needed, and carefully monitoring the pulp and periodontal ligament. Root canal treatment may be required weeks to months later if the pulp becomes necrotic.

Root fractures

Root fractures often require CBCT 3D imaging for accurate diagnosis — they are frequently invisible on 2D X-rays. Treatment depends on the level of the fracture:

• Apical or middle-third fractures — often saveable with splinting and pulp monitoring.
• Coronal-third fractures — guarded prognosis; may require extraction of the coronal fragment and root canal of the remaining root.
• Vertical root fractures — generally not saveable; extraction is the usual outcome.

Long-term follow-up

Trauma follow-up is a long-term process. Complications can develop weeks to years after the initial injury — pulp necrosis, inflammatory resorption, replacement resorption (ankylosis) and periapical pathology. IADT guidelines recommend review at 2 weeks, 4 weeks, 3 months, 6 months, 12 months, and then yearly for at least 5 years.

Where root canal treatment is required following trauma, we use the Fotona SkyPulse laser (SWEEPS technology) for deeper disinfection — particularly valuable for traumatised teeth with complex root anatomy or where infection has developed within the root canal system.

IADT trauma guidelines

For the complete clinical guidelines — useful for general dentists managing trauma in the chair:

Download IADT trauma guidelines from our Dentist Resources page →

For referring dentists

For all trauma referrals, time is critical. Call (02) 4208 0155 directly — do not use the online form for acute trauma. We will arrange same-day assessment where clinically indicated. A full consultation report and follow-up schedule is sent to your practice after the initial appointment.

Call (02) 4208 0155 Refer a Patient

Frequently Asked Questions