| Act quickly and a knocked-out tooth may be able to be reimplanted in the jaw. Plants that are pulled up by the roots may survive if they're put back into soil right away. The same is true of teeth. They may seem bony and lifeless, but teeth are alive and can often be saved as long as you act quickly. The blood vessels and nerves in knocked-out teeth (also called "avulsed" teeth) are usually damaged beyond repair. But microscopic ligaments in the jaw may reattach to the root of the tooth once it's put back into place. "After a tooth is avulsed, time is of the essence and the quicker you get it back in the mouth, the better," says Donald Sadowsky, D.D.S., M.P.H., Ph.D., professor of dentistry at Columbia University School of Dental and Oral Surgery in New York. The odds of saving a tooth are highest in young children, but adult teeth can be saved as well. Even if the tooth reattaches, however, you most likely will need root canal treatment to clean out the damaged nerve. How the tooth is handled right after the accident will largely determine whether it can be saved. To improve the chances of the tooth being saved, Dr. Sadowsky suggests doing the following: - Handle the tooth carefully. Avoid touching the root of the tooth (the part of the tooth that was embedded in the gum) because it can be damaged easily.
- If the tooth is dirty, hold it by the upper part (the crown) and rinse it off with milk until most of the dirt is washed away. If you don't have any milk available, then it is best to leave the tooth alone. Wiping it off with a handkerchief or shirttail may cause additional damage.
- It is important to keep the tooth moist. If possible, drop it into a glass of milk. If no milk is available, then place the tooth in the mouth between the cheek and gum.
- A young child who has had a tooth knocked out may not be able to safely "store" the tooth in his or her mouth without swallowing it, so don't give the tooth to a young child for safe-keeping in his or her mouth. Place the tooth in milk or have the child spit into a container and place the tooth in the cup with the saliva. The most important thing is to keep the tooth moist. Use a cup of water if nothing else is available.
- Get to a dentist as quickly as possible. If getting to a dentist immediately after a tooth has been knocked out is impossible, then you may want to 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 it's better just to hold it between the cheek and gum or to keep it in milk, saliva or water.
Even if the odds of success seem poor, Dr. Sadowsky recommends that you try to save the tooth. "I can remember seeing a youngster who appeared in the office with a knocked-out tooth after a three-hour trip from summer camp," Dr. Sadowsky recalls. "I reimplanted the tooth, hoping for the best. The front tooth remained in place for five years until she reached her late teens, at which time a permanent solution was feasible." The Next Step
It usually takes about two weeks for ligaments in the jaw to firmly reattach to the tooth. Because soft tissues inside the tooth probably are damaged, you'll most likely need a root canal at some point, which will prevent the tooth from darkening or becoming infected. ©2002-2005 Aetna, Inc. All rights reserved Reviewed by the faculty of Columbia University College of Dental Medicine |
