Wednesday, March 11, 2015


In the case of an adult tooth being knocked out, the sooner a tooth is put back the greater chance of success.  Two actions are critical:  that it be put back into its socket as soon as possible and that you see a dentist as soon as possible to secure the tooth.

If there is a competent person who is able to place the tooth back into its socket, place it back into the socket without delay.  Don't wait to see a dentist.  If the tooth is clean, do it immediately.  Hold the tooth by the crown (the white shiny part normally seen in the mouth) and not the root (the tapered, yellowish part).  The root has delicate cells needed to reattach the tooth so try not to touch this part.  Pay attention to get the tooth placed correctly.  Look at the shape of the adjacent tooth.  Push the tooth gently back into position.  Once the tooth is back in place, get the injured person to bite gently on a cloth until they can see a dentist.

If the tooth is dirty, rinse the tooth in cold water or milk.  Do not scrub the tooth or try to disinfect it.  This will damage the delicate cells on the root needed to reattach the tooth to the gum.  The tooth must be kept moist.  Milk is the ideal liquid to keep the tooth in.  Do not store the tooth in anything except milk (ideal) or water (next best).  Do not wrap the tooth in anything.  If there's no milk or water available, put the tooth in the injured person's mouth between their cheek and gum (unless of course it's a child).  If the tooth is kept moist until it's replaced in the socket, there is a greater chance of permanent recovery.  It may still be successful up to 24 hours after the accident.

A dentist will then bond a splint to the reattached tooth and the adjacent teeth to prevent any movement.  The splint should stay in place for two to three weeks.  The tooth will then be evaluated to see if root canal therapy will be necessary.  It is also recommended a tetanus shot be administered if it's been a while since you've had one.

In the case of a recent patient's front permanent tooth being knocked out, fortunately, her tooth was saved and healed nicely.  I was able to put the tooth back in its socket in perfect alignment with her adjacent teeth.  This scenario can have a happy ending if you know how to handle it!!!