It’s not uncommon for a tooth to be knocked out because of an accident, fight, sports injury, or rough play. A hard blow to the tooth is enough to dislodge it or shear it off. This happens to as many as three million Americans annually. Failing to take immediate action can result in the loss of the tooth.
Immediate care for a knocked-out tooth
If you have a tooth knocked out, call your dentist right away and try to get to the office ASAP. You have a 50 percent chance of a successful replantation if you get to the dentist within 30 minutes. Accomplishing this may not sound difficult, but don’t underestimate the trauma of the situation: blood and confusion may delay you. Try to remain calm and rational—saving a tooth is definitely worth the effort. Even if more than 30 minutes elapse, take the tooth to the dentist anyway and let him or her decide what to do. (Note that this advice applies to adult teeth; baby teeth can rarely be saved, and replanting them may damage the underlying tooth bud. Contact your dentist for advice.)
In the meantime, follow this step-by-step post-accident procedure:
- Rinse the tooth. The primary reason adult teeth cannot be replanted is that the cells on the root have been allowed to dry out. After finding the tooth, rinse it gently in tepid tap water, holding it by the crown (nonroot) surface. Don’t scrub the tooth—this could injure the surface root tissue needed for successful replantation.
- Try to insert the tooth. Call the dentist to inform him or her of your imminent visit. Unless the dentist tells you not to, gently insert the tooth in the socket. To seat the tooth properly, bite down gently but firmly on a clean handkerchief or piece of cloth for at least five minutes; keep biting down with moderate pressure until you get to the dentist’s office.
- Keep the tooth moist. If reinsertion at the scene of the accident isn’t possible, place the tooth, bathed in saliva, under your tongue or inside your cheek until you get to the dentist’s office. Or place the tooth in a glass of milk, which will prevent dehydration and infection. Placing it in water, however, may cause the roots toabsorb too much and lead to damage.
Your dentist will assess the situation and re-adjust the tooth in the socket. The tooth will then be fastened with wire or bonding material. It may take up to eight weeks to determine whether the tooth will reattach itself. Once the tooth does reattach, a root canal procedure may be in order because the nerve often dies as a result of the trauma.
According to the American Dental Association, wearing a sport mouthguard can prevent a great number of tooth injuries by cushioning the teeth and providing a buffer between teeth and lips. Sports where mouthguards should be worn include soccer, volleyball, basketball, baseball, football, softball, in-line skating, skateboarding, martial arts, boxing, hockey, and mountain biking. Local sporting goods stores carry a wide variety of models. You can also talk to your dentist about a custom-made model.
When to seek medical help
If the accident victim shows any sign of head injury, unconsciousness, nausea, or persistent head pain, he or she first needs to be evaluated for head injury by a physician. Once a head injury has been ruled out, contact your dentist immediately concerning tooth replantation or else go directly to a local hospital emergency room for treatment.
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Reviewed by Robert Peri, DDS.
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