Dental Injuries (cont.)
What if I get my teeth knocked out?
The upper front permanent teeth are the most common teeth to be
completely knocked out. Children with forward-protruding front
teeth that
have not had orthodontic treatment to bring them into alignment
are at
increased risk. Knocked out baby or primary teeth are usually
not
reimplanted in the mouth, since they will be naturally replaced
by
permanent teeth later. However, knocked out permanent teeth
should be
retrieved, kept moist, and placed back into their sockets
(reimplanted) as
soon as possible. The most important variable affecting the
success of
reimplantation is the amount of time that the tooth is
out of its
socket. Teeth reimplanted within one hour of the accident
frequently
reattach to their teeth sockets.
The knocked out tooth is rinsed in clean water or milk, and
placed back
(reimplanted) into the socket from which it came. This can be
done by the
patient or parent and then checked by the dentist. Care should
be taken to
handle the tooth only by its crown and not by its root. If the
parent or
patient is unsure about reimplanting the tooth, then the tooth
should be
stored in milk (if available) or in water and brought to the
dentist as
soon as possible. Alternatively, in older children and adults
who are
calm, the tooth may be held within the cheeks inside of the
mouth while
traveling to the dental office.
After reimplanting the tooth into its original socket, the
dentist can
then splint this tooth to adjacent teeth for 2-8 weeks.
Splinting helps to
stabilize it while the bone around it heals. During the
splinting period,
the patient eats soft foods, avoids biting on the splinted
teeth, and
brushes all the other teeth diligently to keep the mouth as
clean as
possible.
In adults, the reimplanted tooth should have a root canal
procedure
within 1-4 weeks. On the other hand, reimplanted permanent
teeth in
children (where the tooth root has not yet completely formed)
may not need
a root canal procedure. These teeth are observed for at least
five years
for symptoms of dying pulp, such as pain, discoloration, gum
abscesses, or
abscesses seen on an x-ray.
In most patients who have had tooth reimplantation, over-the-
counter
medications like acetaminophen (Tylenol) or ibuprofen (Advil)
are
sufficient for pain relief. Chlorhexidine (Peridex) mouth rinse
may be
prescribed to prevent and control gum inflammation
(gingivitis), since the
splinted teeth cannot be brushed normally and the splint
usually collects
extra dental plaque and food debris. Oral antibiotics and
tetanus toxoid
injections are considered for patients with accompanying
significant soft
tissue cuts (lacerations).
Next: What is a displaced tooth? »
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