What is the initial decision for a child with a fracture at the apical third of a tooth root?

In the case of a child with a fracture at the apical third of a tooth root, the initial approach often involves a period of observation. This is because fractures in the apical third can sometimes heal naturally, especially in primary teeth, without the immediate need for invasive procedures. Waiting and recalling the child after one month allows the dentist to monitor the tooth’s health and ensure that the fracture is not leading to further complications, such as infection or dental pulp necrosis.

During this observation period, the dentist can assess the vitality of the tooth, take necessary X-rays, and determine if any further treatment is required based on the child’s symptoms and radiographic findings. In many cases, if the tooth remains asymptomatic and shows signs of healing, extraction or other invasive treatments might be avoided altogether.

Other treatment options, such as root canal treatment, extraction, or apicoectomy, are generally considered if significant complications arise or if the tooth shows signs of pulp involvement, which would necessitate immediate intervention. Thus, careful monitoring initially helps ensure that only necessary treatments are pursued, thereby preserving the child's tooth structure and promoting better long-term outcomes.