Dental emergencies happen when we least expect them. Quick thinking and proper action can make the difference between saving and losing an avulsed tooth. Understanding the correct steps during these critical moments is essential for increasing the chances of successful reimplantation.
If you or someone you know experiences a knocked-out tooth, don’t panic. Follow the steps outlined in this guide, and contact North Atlanta Family Dentistry immediately for emergency dental care.
What is an Avulsed Tooth?
An avulsed tooth is a tooth that has been completely knocked out of its socket due to trauma or injury. When this happens, blood vessels, nerves, and supporting tissues are severely damaged. This creates a time-sensitive situation where proper and immediate care is crucial for potential tooth preservation and reimplantation.
5 Common Causes of an Avulsed Tooth
- Sports Injuries: Contact sports like hockey, football, basketball, and martial arts account for a significant percentage of avulsed teeth. It’s usually more prevalent when participants don’t wear proper protective gear, such as mouthguards.
- Falls and Accidents: Unexpected falls, especially on hard surfaces, can result in facial impact that knocks teeth out completely. This is particularly common in children learning to walk, ride bikes, or during playground activities.
- Vehicle Accidents: Car, motorcycle, and bicycle accidents often involve sudden impacts that can cause dental avulsion. This is because of the force involved when a person strikes the steering wheel, dashboard, or ground.
- Physical Altercations: Fights and physical confrontations where blows are directed at the face can easily result in knocked-out teeth, especially front teeth that are more vulnerable to direct impact.
- Workplace Accidents: Certain occupations carry higher risks of facial trauma, particularly construction, manufacturing, and other settings where proper safety equipment isn’t consistently used.
What to Do When You Have an Avulsed Tooth
Proper handling is crucial for the successful reimplantation of an avulsed tooth. The tooth contains delicate cells on its root surface that are essential for reattachment to the socket. Improper handling can damage these cells and significantly reduce the chances of saving the tooth. Ideally, reimplantation should occur within 30 minutes of the injury.
- Stay calm and locate the tooth – Search the area carefully and pick up the avulsed tooth by the crown (the white part visible in the mouth) only. Avoid touching the root portion as this contains sensitive fibers necessary for reattachment.
- Gently rinse the tooth if dirty – If the avulsed tooth has fallen on the ground or is dirty, rinse it gently with milk, saline solution, or cold running water for no more than 10 seconds. Do not scrub, use soap, or dry the tooth as this can damage the root surface cells.
- Attempt to reinsert the tooth. If possible, gently place the tooth back into its socket, ensuring it’s facing the correct way. Once inserted, bite down gently on a clean piece of cloth or gauze to hold it in position while seeking emergency dental care.
- Seek immediate professional help – Even if you’ve successfully reinserted the tooth, visit an emergency dentist immediately, as the tooth will need to be properly stabilized and assessed for damage to ensure the best long-term outcome.
How to Store a Knocked-Out Tooth If You Can’t Reinsert It
If reimplantation isn’t immediately possible, proper storage is critical to preserve the living cells on the root surface. The storage medium can significantly impact the survival rate of these cells and the eventual success of professional reimplantation. Here’s how to properly store a knocked-out tooth until you can reach a dentist.
- Use a tooth preservation solution – These solutions are specifically designed to maintain cell viability and should be included in first aid kits for schools, sports teams, and homes.
- Cold milk is an excellent alternative – If a tooth preservation solution isn’t available, place the tooth in cold, whole milk. The proteins and sugar in milk help preserve the root cells for up to six hours.
- Consider saline solution or saliva – If milk isn’t available, sterile saline solution or even having the person place the tooth in their mouth between the cheek and gums can work as temporary measures. However, this latter option isn’t recommended for young children who might swallow the tooth.
- Avoid water and dry storage – Never store the tooth in regular water, as its chemical composition can damage the root surface cells. Similarly, wrapping the tooth in tissue or cloth will quickly dry out the cells, significantly reducing the chances of successful reimplantation.
When Should You NOT Put an Avulsed Tooth Back In
Baby Teeth
Attempting to reinsert a baby tooth can potentially damage the developing permanent tooth underneath. When a baby tooth is avulsed, the permanent tooth bud lies directly beneath it in the jawbone. Reimplanting the baby tooth could push it into an incorrect position, potentially causing the permanent tooth to erupt abnormally or become impacted.
Severely Fractured or Damaged Teeth
An avulsed tooth that has been severely damaged beyond just being knocked out should not be reimplanted. This includes teeth with significant fractures, especially those extending below the gumline or into the root structure. It could lead to infection, continued pain, or complications. In these cases, consider alternative restorative options like dental implants or bridges.
Medically Compromised Patients
Individuals with certain medical conditions should not have avulsed teeth reimplanted without careful consideration by both dental and medical professionals. This includes patients with severe immunosuppression, serious heart conditions requiring antibiotic prophylaxis, or those undergoing chemotherapy or radiation therapy. The reimplantation process creates a risk of infection that could spread throughout the body, potentially causing serious complications in medically vulnerable patients.
What Happens During Professional Dental Treatment for Avulsed Teeth
When you arrive at the dental office with an avulsed tooth, you’ll undergo a specific treatment protocol designed to maximize the chances of successful reimplantation. The dentist will work quickly but thoroughly to assess the situation and provide appropriate care. The treatment process involves several key steps that work together to stabilize the tooth and promote healing of the supporting structures.
- Assessment and examination – The dentist will examine the tooth socket, the avulsed tooth, and the surrounding teeth for additional damage. X-rays will likely be taken to check for fractures in the socket and to help determine the prognosis for successful reimplantation based on the extent of the injury.
- Cleaning and preparation – If you haven’t already reinserted the tooth, the dentist will gently clean both the tooth and the socket. The socket may be rinsed with saline solution to remove any blood clots that could prevent proper positioning of the tooth back into place.
- Reimplantation and splinting – The dentist will carefully reposition the tooth in its socket and check your bite to ensure proper alignment. Once correctly positioned, the tooth will be splinted (connected to adjacent teeth) using specialized dental materials or wire to hold it stable during the healing process.
- Medication and follow-up care – You’ll likely be prescribed antibiotics to prevent infection and may receive a tetanus shot if needed. The dentist will also likely perform or recommend root canal therapy, as the nerve tissue in an avulsed tooth rarely survives the trauma.
Conclusion
When faced with an avulsed tooth, remember that time is of the essence. Proper handling and quick action within the first 30 minutes offer the best chance for successfully saving an avulsed permanent tooth. Following the steps outlined in this guide can make a significant difference in the outcome of this dental emergency.
Don’t hesitate to contact North Atlanta Family Dentistry immediately if you experience a dental avulsion or any other dental emergency. Our experienced team is ready to provide the prompt, expert care you need. For more helpful dental tips and information, follow us on Facebook, Instagram, and YouTube, and schedule your regular check-ups to help prevent dental emergencies before they happen.
