Over the summer one of our patients had a bicycle accident and knocked out her front teeth. Due to quick thinking on the scene, the teeth were re-implanted and are still in the healing process, the outcome is still unknown. Unfortunately accidents happen, but it brought up the question, would you know what to do if this happened to you?
Dentists refer to a knocked-out tooth as an “avulsed” tooth. 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 which is why all avulsed teeth will need a root canal treatment. If you act quickly after an accident, being careful not to damage the tooth further, the bone can reattach to the root of the tooth once it’s put back into place and the tooth can be saved. An avulsed tooth is fragile and needs to be handled delicately to give it the best chance at survival. Try not to touch the root (the part of the tooth that was under the gum). If the tooth is dirty, hold it by the upper part (the crown) and rinse it. Don’t wipe it off with a washcloth, shirt or other fabric. This could damage the tooth. Keep the tooth moist. Many people have heard they should store it in a glass of milk. While this is a better option than water it is best if you keep the tooth moist with your saliva, by either placing the tooth in your mouth between the cheek and gum or placing it in a cup or container with your saliva. If nothing else is available it is ok to place the tooth in a cup of water, the most important thing is to keep the tooth moist. If you feel comfortable, try slipping the tooth back into its socket. In many cases, if the accident just happened it will slip right in. Make sure it’s facing the right way and that it is in straight. 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 saliva, milk or water) and get to the dentist as soon as you can.
It is very important to re-implant the tooth as soon as possible, ideally within the hour of the accident. After slipping your tooth back into the socket, your dentist will decide if a root canal treatment needs to be done immediately or at a later date. The tooth will then be splinted with a wire to the teeth on either side of it for stability. 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.