Dental Health Articles
Saving a Knocked Out Tooth
By Nick K. Nguyen, DDS, APC
Having an active lifestyle can unfortunately result in accidents involving teeth. Whether the cause is from a tumble over the handle bars of a bicycle, a skateboard accident, or due to horseplay, understanding how to handle a dental trauma emergency is very important since time is the key factor in saving teeth. This is especially true in situations where the whole tooth is completely knocked out (avulsed). In these cases, the best chance for a tooth to be saved is if it is replanted within 15 minutes of the trauma.
If it is impossible to immediately see your dentist, replanting the tooth on-site can be attempted. First of all, try to be calm. Then, handle the tooth by the crown (top portion), trying not to touch the roots of the tooth. This will prevent damaging the tissue tag fibers attached to the root of the tooth, which would greatly decrease the chances of saving the tooth long term. Rinse the tooth under cold water but make sure the drain is closed in case you drop it. Then replant the tooth back into the socket in the correct orientation. Immediately see your dentist for further treatment.
If replanting the tooth on-site cannot be done, carefully place the tooth in a glass of milk and transport it to the dentist, making sure not to touch the roots. Milk is an excellent liquid to transport an avulsed tooth because it helps to preserve the vitality of the root tissue tag fibers. If milk is unavailable, saliva is the next best substitute. The avulsed tooth can be transported to the dentist in the mouth.
What follows next at the dental office depends on the condition of the tooth and whether or not the root is fully developed. In general, if the tooth was replanted by the patient prior to seeing the dentist, the dentist will check to see if the tooth is correctly replanted. If done correctly, the dentist will likely splint the teeth together and within the next couple weeks, perform root canal therapy. If the patient did not replant the tooth, but presents it instead, the dentist will need to determine if the root tissue tag fibers have not been damaged. If undamaged, the dentist will likely replant the tooth, splint the teeth together, and perform root canal therapy within two weeks. If the tooth is still immature, there is a possibility that root canal therapy may not be needed.
In the future, remember that time is of the essence when dealing with an avulsed tooth. Try to take action and immediately contact your dentist.