By the faculty of Columbia University College of Dental Medicine
Dentists refer to a knocked-out tooth as an "avulsed" tooth. This is one of the most serious dental emergencies for permanent teeth. However, the damage can be fixed. If you act quickly, there's a good chance the tooth can be saved.
What You Can Do
When a tooth has been knocked out, the nerves, blood vessels and supporting tissues are damaged, too. The nerves and blood vessels can't be repaired. That is why all avulsed teeth will need a root canal. However, the bone can reattach to the root of the tooth once it's put back into place.
The odds of saving a tooth are highest in young children, but adult teeth can be saved as well. Only permanent teeth should be re-implanted.
It is important to get to the dentist as quickly as possible after a tooth has been knocked out.
It is also important to avoid damaging the tooth even more.
Follow these suggestions to improve the chances of saving your tooth:
Handle the tooth carefully. Try not to touch the root (the part of the tooth that was under the gum). It can be damaged easily.
If the tooth is dirty, hold it by the upper part (the crown) and rinse it with milk. If you don't have any milk, rinse it with water. Don't wipe it off with a washcloth, shirt or other fabric. This could damage the tooth.
Keep the tooth moist. Drop it into a glass of milk. If you can't do this, place the tooth in your mouth, between the cheek and gum. A young child may not be able to safely "store" the tooth in his or her mouth without swallowing it. Instead, have the child spit into a cup. Place the tooth in the cup with the saliva. If nothing else is available, place the tooth in a cup of water. The most important thing is to keep the tooth moist.
Try slipping the tooth back into its socket. In many cases, it will slip right in. Make sure it's facing the right way. Don't try to force it into the socket. If it doesn't go back into place easily and without pressure, then just keep it moist (in milk, saliva or water) and get to the dentist as soon as you can. If the tooth is intact (not broken in pieces), it is always a good idea to try to save it.
What Your Dentist Will Do
Putting the tooth back in place sometimes can be simple. Other times it can be complicated, such as when the tooth or bone is broken. Your dentist will use water to flush debris from the socket. Then he or she will slip the tooth back into place.
It is most important to re-implant the tooth as soon as possible. Ideally, this should occur within the hour of the accident.
The dentist may perform a root canal right away, or may wait. The best course to take will depend upon how long the tooth was out of the mouth and other factors. In any case, the dentist will splint the avulsed tooth to the teeth on either side with a soft wire and/or composite material. This will be used to hold the tooth in place for several days. Your dentist will decide how long the splint should remain.
If the bone around the tooth was not fractured, the root usually will reattach firmly to the bone in about three to four weeks. More damage to the area may require six to eight weeks of repair time. Your dentist should examine the tooth again in three to six months. Unless there are signs of infection, the next visit will occur at your yearly checkup. The dentist will follow up for the next two to three years to ensure that the tooth re-implanted successfully.
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This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.