Dental trauma can occur at any time and when you least expect it. Trips, falls and blows to the face are all common causes of a knocked out tooth.
There are a number of other issues that can arise due to a traumatic injury to the body of a tooth, with avulsion (completely knocked out) being the most extreme. These include concussion (a knock), subluxation( a minor loosening), extrusion(the tooth has moved out of the socket and looks longer), lateral luxation(the tooth has been pushed backwards or forwards but is still in the socket), intrusion(the tooth has been pushed further into the socket and may look shorter than before).
What can you do to help a knocked out tooth?
There are a few things that you can do to help maximize the chances of your tooth being replanted, and minimizing the risk of complications.
1. Assess other injuries. If the person who has sustained the injury requires further medical attention then this must be sought first. In the meantime you need to try keep the tooth clean and moist.
2. Keep the tooth moist. You can ask the patient to insert the tooth into the socket (if it is clean) or hold it in their cheek fold. Do not attempt to scrub the surface of the root-it contains very sensitive cells and fibers that are important for the healing process. Alternatively, you can keep the tooth moist in contact lens solution or milk. Allowing the tooth to dry out plays a big role in complications arising.
3. The highest chances of a successful replantation is to have the tooth professionally replanted within 1-2 hours. This minimizes the risk of complications and failure of replantation.
4. Arrange an appointment with the emergency dentist or 24 hour dentist, time is of the essence.
What will happen at the dental emergency clinic?
The emergency dentist will do a thorough examination. This may include x-rays and clinical photographs. They will also assess soft tissue injuries and injuries to adjacent teeth. You may also have an examination performed to ensure you have not broken or fractured your jaw.
An assessment will also be made of the likelihood of a successful replantation. This is dependent upon how long it has been since the injury, whether the root of the tooth has been damaged in any way, whether the tooth has been kept in a moist medium, how old the patient is and the stage of root development, and whether there are any further injuries to the supporting tissue of the root in the jaw.
Replantation of a knocked out tooth
1. You will be numbed using local anaesthetic
2. The socket will be gently flushed out with saline to ensure there is no foreign debris inside
3. The tooth may be allowed to soak in some special solution for 20 minutes to help its success at replantation
4. The tooth will be very gently replanted and an x-ray will be taken to confirm it’s correct positioning
5. The emergency dentist will place a flexible splint, it may look like a brace. This needs to be kept for 4 weeks to allow the tooth to replant with the bone and to keep it in position
6. You may be given antibiotics
7. You will be required to reassess the tooth regularly in order to make sure that no complications are arising. Complications can occur at any stage, even many years after the injury, so it is important that your regular dentist is routinely examining the tooth.
You will need to follow some basic instructions:
1. Avoid participation in contact sports.
2. Soft diet for up to 2 weeks. Thereafter normal function
as soon as possible.
3. Brush teeth with a soft toothbrush after each meal.
4. Use a chlorhexidine (0.1%) mouth rinse twice a day for