Dental Emergency: What To Do With A Knocked Out Tooth (Avulsed Tooth)

cropped 20211105 piara ro1 5941 scaled 1.jpg By Dr. Ram Nair

Dental Emergency: What To Do With A Knocked Out Tooth (Avulsed Tooth)

We will never know when a dental emergency will occur which is why it is important to be prepared in case it happens. One such emergency is tooth avulsion or knocked-out tooth. Tooth avulsion can result from a fall, accident, or sports injury. If you experience losing your tooth, keep calm and maintain a clear head. Some measures can be taken at home while contacting an emergency dentist. You can learn what these measures are in this blog post.

What Is an Avulsed Tooth?

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Tooth avulsion, also called knocked-out tooth, happens when a tooth is completely dislodged or forced out of its socket. It often happens during contact sports, accidents, fights, or other incidents that can cause a hard blow or impact on the cheeks and mouth area. Tooth avulsion may result in damage to the periodontal ligament and tooth socket.

In some cases, an avulsed tooth can be replanted or put back by the dentist in the socket. Periodontal ligaments or PDL are the fibres that connect the tooth’s root to the tooth socket. When the cells in the periodontal ligament die, replanting an avulsed tooth may be unlikely. Hence, the success of treating a knocked-out tooth depends on the PDL cells’ survival. You must seek immediate care from an emergency dentist if you have a knocked-out tooth.

What Are the Common Causes of Tooth Avulsion?

Tooth avulsion often happens when a significant amount of force is exerted on the mouth. The most common reasons are the following:

  • Sudden falls
  • Vehicle accidents
  • Bicycle accidents
  • Sports injuries such as martial arts, football, skating, etc.
  • Assault

While not all sports pose a significant risk of tooth avulsion, contact sports appear to be one of them. Athletes and people participating in such strenuous activities may be more prone to experiencing an avulsed tooth. The most common reason is an increased risk of high impact collisions during sports. Also, people with problems with balance may tend to have this dental problem, as falling and slipping can also cause a hard blow in the face, resulting in dental trauma.

Signs and Symptoms of An Avulsed Tooth

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An avulsed tooth is a tooth that is forced out of the tooth socket. When this happens, the tooth is completely removed from your mouth. Other signs of tooth avulsion may include:

  • Severe mouth pain
  • Bleeding
  • A space in your mouth where the tooth once was.
  • Swelling of your mouth.
  • Skin laceration on the lip and chin as a result of trauma.

What is the Treatment for An Avulsed Tooth?

A patient with a tooth that has been knocked out must seek dental treatment immediately. How dentists handle an avulsed tooth will depend on whether you have reinserted it or kept it moist in a clean container and how long the tooth was outside the mouth. Generally, your dentist may perform the following process:

  • To remove any impurities or contaminants, the dentist will gently rinse the tooth with a saline solution and then flush the tooth socket with saline.
  • Once the tooth and alveolar socket are clean, they will check if there’s any fracture in the socket wall.
  • Depending on how long the tooth was outside the mouth, the dentist will soak the tooth in specific solutions to condition its surface for replantation.
  • The area around the empty tooth socket will be anesthetised.
  • If the tooth socket has fractures preventing the replantation of the tooth, your dentist will use an instrument to reposition the bone.
  • The tooth will be replanted by gently putting it back into place while holding the crown.
  • Afterwards, your dentist will splint your replanted tooth to the nearby teeth for 7 to 10 days. If bone fractures are involved, a longer splinting period of 2 to 8 weeks is needed.
  • Finally, your dentist will give you aftercare instructions and a schedule for a checkup since close monitoring of your case is very important. During these appointments, your dentist may begin root canal treatment of the tooth as needed.

What Should I Do if I Have an Avulsed Tooth?

If a tooth avulsion following an accident occurs, ensure that the dental issue is your most pressing concern. Ensure that medical attention is not needed over dental treatment. If it isn’t, call your dentist immediately for assistance.

When dealing with an avulsed tooth, it is crucial to avoid damaging the tooth until you receive emergency treatment from a healthcare provider. It would help if you also tried not to move the other teeth around while waiting for treatment because this could cause injury or more damage. You can perform first aid and follow these steps:

  • Locate the avulsed tooth. To avoid damaging your tooth’s roots, hold it by the crown or the upper part of the tooth. It’s crucial to avoid touching the root to increase the chances of preserving the PDL cells.
  • Rinse the tooth with water. If the tooth is dirty, rinse it briefly with cold running water or milk. Do not use any cleanser or fluoride toothpaste. Do not brush or scrape the root area. After rinsing, do not dry the tooth with tissue paper or wrap it with a cloth, as these can damage the roots.
  • Gently put the tooth back into its socket. Insert the tooth with the root first. If you can put it back in the socket successfully, bite on a gauze or a clean handkerchief to hold your tooth in place. If you find it hard to insert the tooth in place, do not force it. There may be a bone fracture preventing you from inserting the tooth correctly.
  • Keep the tooth moist. If you find it difficult to put the avulsed tooth back in its socket, keep it moist until you see a dental professional. Avoid putting it in a cup of water, as it may only harm the cells. You can place it in a clean glass with milk or a saline solution to preserve the avulsed teeth. You may also keep the tooth in your cheek so your saliva can keep it wet. Be careful not to swallow it.

If a child loses a baby tooth, don’t try to reattach it because this may cause injury to the developing permanent teeth underneath. Only adult teeth are recommended for replantation. In both cases, seek help from the nearest dentist as soon as possible.

What Should I Do if I Can't Find My Missing Tooth?

In case you can’t locate your knocked-out tooth, there’s a chance that you may have swallowed or aspirated it. Although this may only happen rarely, such incidents may result from traumatic injuries from traffic accidents. Inform your dentist immediately so they can refer you to a healthcare provider who will take a chest x-ray to ensure your tooth hasn’t gone into your lungs.

When Should an Avulsed Tooth Be Reimplanted?

An avulsed tooth should be replanted as soon as possible. Time management and appropriate storage of the knocked-out tooth are important factors that may guarantee the success of saving the tooth.

Replanting avulsed teeth out of the mouth for less than 30 minutes has a greater chance of success. The periodontal ligament cells can be irreversibly damaged after 30 to 60 minutes, and replanting teeth like this may have a less ideal result.

Aftercare Following Reimplantation of an Avulsed Tooth

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After tooth replantation, it is important to follow your dentist’s advice to avoid serious complications. Here are some aftercare tips.

  • Do not bite on the splinted teeth to avoid disrupting the affected area.
  • Avoid consuming food and drinks that are too hot or too cold. The extreme temperature may irritate your wound.
  • Once you brush your teeth, use only a soft-bristled toothbrush and gently clean your mouth after eating.
  • Stick with a soft diet and eat only nutritious food that requires little to no chewing for at least two weeks.
  • Keep yourself hydrated by drinking enough water.
  • Rinse your mouth with an antibacterial mouthwash or chlorhexidine twice a day for two weeks.
  • Avoid engaging in any contact sports until you are permitted to do so. It’s best not to immediately get involved with any sporting events or vigorous activities.
  • Your dentist will prescribe antibiotics and pain relievers. Follow the prescription religiously.
  • Your dentist may refer you for a tetanus shot. Make sure to have it within 48 hours.

It is best to visit the dentist to check your reattached tooth regularly. Studies have shown that keeping up with follow-up treatment and dental checkups can result in the long-term survival of reattached avulsed teeth.

How Can I Prevent Tooth Avulsion?

Wearing a mouth guard when you play sports can help prevent tooth avulsion. While some individuals find it uncomfortable, it is very useful in protecting your mouth to preserve your natural teeth. You may still feel the pressure of impact, but protective dental appliances can be a physical barrier between your upper and lower teeth and protect your oral structures.

Final Thoughts

While you never know when dental injuries may occur to you or your loved one, it is essential to take precautions when engaging in any sport. You can invest in a high-quality mouth guard to protect the teeth and soft tissues in the mouth.

If you experience having a knocked-out tooth, knowing the proper steps to take can save you from losing permanent teeth. You can treat your knocked-out tooth by reinserting it gently into its socket. Before doing this, ensure the tooth is clean to avoid dental infection. If this is impossible, store the tooth with milk, saliva, or saline until you receive dental treatment. Make sure that you receive dental attention as soon as possible.

For more information on managing other dental emergencies, visit our website or call our office at (08) 6196 4661. Piara Waters Dental is here to help you in any way we can!

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