Accidental Permanent Tooth Loss (Tooth Avulsion)

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 as there's a good chance the tooth can be saved, if you act quickly.

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 i.e. 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. Do not wipe it off with a washcloth, shirt or other fabric as 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 a risk of swallowing it. Instead, have the child spit sufficiently into a cup before placing the tooth in 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.

As mentioned earlier, milk can be used to store the tooth till you see your dentist. Other alternatives are water, saliva, coconut water, egg white or commercially available Save-a-Tooth preserving media - least preferred is water and most preferred is ‘Save-a-Tooth’ or other commercially available preserving media.

Putting the tooth back in place is usually simple. However, complications can arise, such as when the tooth or bone is broken. Your dentist will first use water to flush debris from the socket before he/she slips 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 has re-implanted successfully.

Last updated on 26 November, 2018.

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