Losing a permanent tooth is a dental emergency requiring immediate action. When a tooth is dislodged (avulsion), a swift response impacts its chances of successful reattachment. This injury can result from various incidents, including sports injuries, falls, or accidents. Knowing the correct immediate steps is crucial for preserving dental health.
Immediate First Aid
If a permanent tooth is knocked out, first locate it. Pick up the tooth carefully by its crown (the white chewing surface), avoiding the root. Touching the root can damage delicate periodontal ligament (PDL) cells, vital for reattachment.
If the tooth is dirty, gently rinse it with milk or saline solution for a few seconds. Do not scrub the tooth, use soap, or chemicals, as these harm root cells. Avoid tap water, which root cells cannot tolerate.
Immediate re-insertion into its socket offers the best outcome. If possible and the person is conscious, gently guide the tooth back into the gum, root first. Once the tooth is in place, gently bite down on a clean cloth or gauze to hold it steady.
If immediate re-insertion is not possible, keeping the tooth moist preserves the PDL cells. The tooth should be stored in a suitable medium, with pasteurized milk being a recommended option due to its physiological compatibility and availability. Saliva, by holding the tooth inside the cheek, or a tooth preservation kit can also be used. Avoiding dry storage is important because desiccation is a risk to the vitality of the PDL cells.
Seeking Professional Dental Care
After performing immediate first aid, seeking professional dental care without delay is a subsequent step. The best chance for successful reattachment, or replantation, of an avulsed tooth occurs within 30 to 60 minutes of the injury. While a shorter time out of the mouth is generally better, teeth can sometimes be saved even if they have been outside the mouth for an hour or more.
Upon arrival, the dentist will assess the tooth’s condition and determine the best course of action. This often involves reinserting the tooth into its socket, if not already done, and stabilizing it with a dental splint. The splint remains in place for about two weeks, allowing the tooth’s roots to reattach to the socket.
A root canal treatment is often necessary after successful replantation to address the dental pulp, the inner living tissue of the tooth. This procedure removes the pulp, which dies once separated from the body, preventing infection and preserving the tooth. If replantation is not possible or ultimately fails, the dentist will discuss alternative long-term solutions, such as dental implants or bridges, to replace the lost tooth.