It can be unsettling when a permanent tooth is knocked out, but acting quickly and correctly can greatly improve the chances of saving it. This type of injury, known as an avulsion, is a dental emergency that requires immediate attention.
Immediate Actions and Tooth Preservation
The moments immediately following a tooth being knocked out are crucial for its survival. Begin by locating the tooth, handling it carefully by the crown, avoiding contact with the root. The delicate cells on the root surface are essential for successful reattachment. If the tooth is dirty, gently rinse it with water or milk, but do not scrub it or use soap. Avoid wrapping the tooth in tissue or cloth, as this can cause the root cells to dry out rapidly.
After rinsing, attempt to re-insert the tooth into its socket if possible. Gently push the tooth back into place, ensuring it is facing the correct way. If you successfully re-insert it, bite down gently on a clean piece of gauze or a soft cloth to help hold it in position. This immediate re-implantation is the most effective way to preserve the tooth, as it maintains the viability of the periodontal ligament cells.
If re-insertion is not possible, the tooth must be kept moist in an appropriate storage medium. The most recommended options are milk or a tooth preservation kit. Milk provides a suitable environment, helping to maintain the chemical balance of the root surface cells. Saliva can also serve as a temporary storage medium, though it is less ideal due to potential damage to cells over longer periods. Do not store the tooth in plain tap water, as its osmotic pressure can cause damage to the root cells.
Bleeding from the empty socket can be controlled by applying gentle pressure with clean gauze. Additionally, a cold compress applied to the outside of the mouth can help reduce any swelling and pain. The chances of successful reattachment are highest if the tooth is re-implanted or properly stored and brought to a dentist within 30 minutes to an hour of the injury. The viability of the root cells significantly decreases after this initial period.
When to Seek Dental Care
A knocked-out permanent tooth is considered a dental emergency requiring prompt professional attention. After taking the immediate steps to preserve the tooth, contact a dentist or emergency dental service. Even if the tooth has been successfully re-implanted, a dentist needs to assess the situation and provide further care.
There is a limited time frame for successful re-implantation by a dental professional, ideally within 30 minutes to one hour of the injury. The longer the tooth remains outside its socket and dry, the lower the chances of long-term survival. Even if the tooth cannot be found or was not preserved, a dental visit is necessary to evaluate the mouth for other injuries, such as fractures, and to discuss replacement options.
What to Expect at the Dentist
Upon arrival at the dental office, the dentist will assess the tooth and the surrounding oral structures for any damage. X-rays may be taken to check the condition of the root and surrounding bone. If the tooth is viable, the dentist will clean it and the socket before re-implanting it into its proper position.
Once re-implanted, the tooth will be stabilized with a splint. This involves temporarily attaching the injured tooth to the adjacent teeth using a flexible material. The splint helps immobilize the tooth, allowing the periodontal ligament to heal. Follow-up appointments are needed to monitor the tooth’s healing and to determine if further treatments are needed.
When a Baby Tooth Comes Out
The protocol for a knocked-out baby tooth differs significantly from that of a permanent tooth. A knocked-out baby tooth should not be re-implanted. Re-inserting a baby tooth can damage the developing permanent tooth underneath, leading to issues with its eruption, alignment, or even enamel formation.
Instead, the primary focus should be on controlling any bleeding from the child’s mouth by applying gentle pressure with a clean cloth. While re-implantation is not recommended, it is still advisable to contact a pediatric dentist. They can assess the situation, ensure there are no other injuries, and determine if the tooth loss will impact the spacing for the permanent tooth.