Knocked-out Tooth Treatment: Everything You Need to Know

Understanding Knocked-out Teeth

A knocked-out tooth, also known as a dental avulsion, is a serious dental emergency. It occurs when a tooth is forcefully knocked out of its socket and often out of the mouth. This can happen due to various reasons such as falls, bicycle accidents, contact sports injuries, traffic accidents, or assaults. The most common teeth affected are the incisors at the front of the mouth.

Symptoms and Causes

The symptoms of a knocked-out tooth include a gap in the mouth where the tooth used to be, mouth pain, and bleeding. The force required to cause a tooth avulsion is significant, and common causes include falls, sports-related injuries, and accidents.

Diagnosis and Tests

The diagnosis of a knocked-out tooth depends on the specific situation. If the tooth can be placed back in the socket, a healthcare provider will check it and begin treatment. If the tooth is brought to the provider, they will examine the mouth for other injuries before reinserting it. They will also ask about the incident, especially if it involved a hard fall, to check for possible head injuries like a concussion.

Emergency Actions

When a tooth is avulsed, immediate action is crucial. Try to reinsert the tooth right away. The best chance of success is within 30 minutes to one hour. To do this, pick up the tooth by the crown (white chewing surface), rinse it with water or milk to remove dirt (avoid using soap and scrubbing or drying the tooth), gently place it back into the socket root first, bite on a napkin, gauze, or handkerchief to anchor it, and contact a dentist for an emergency appointment. If reinsertion is not possible, store the tooth in milk (not water) until you can see a dentist. Milk provides the best protection. You can also keep the tooth in your cheek, tucked against your gum, or under your tongue.

Dentist's Treatment

If you reinserted the tooth into its socket, your dentist will ensure it's in the correct position and place a splint to anchor it to the surrounding teeth. If they need to reinsert the tooth, they will follow the same process and may schedule a root canal if there's an infection in the tooth pulp.

Post-treatment Care

After the tooth is put back in the socket, it's important to follow certain care instructions. Consume only soft food and liquids for two weeks, avoid extreme temperatures of food, brush gently with a soft toothbrush after each meal, rinse with an antibacterial chlorhexidine mouthwash twice a day for two weeks, take nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief, and avoid contact sports.

Complications and Alternatives

Some possible complications of tooth replantation include ankylosis (fusion of the tooth to the alveolar bone), apical periodontitis (inflammation of the tissue around the tooth), inflammatory issues, pulp complications, and pulp necrosis. If the tooth can't be replaced in the socket, your dentist may recommend treatments such as a partial denture, dental bridge, or dental implant.

Prevention

While it may not be possible to prevent all causes of tooth avulsion, especially accidents or fights, wearing a mouth guard during contact sports like football, basketball, or hockey can significantly reduce the risk.

Outlook and Prognosis

If the avulsed tooth is reinserted, you'll have regular follow-up appointments with your dentist. A reinserted tooth may stay in place for 10 to 20 years but may eventually loosen or fall out, requiring replacement treatment like a partial denture, dental bridge, or dental implant.

Living With a Reinserted Tooth

The most important thing is to protect the replanted tooth during the healing process. Don't poke at the splint with your finger or tongue, eat soft foods for at least two weeks, use a soft-bristled toothbrush, follow up with your dentist as scheduled, and wear a mouth guard when playing contact sports. See your dentist if you experience bleeding, continued tooth pain, swelling, or tooth discoloration.

Common Questions and Answers

Some common questions include why it's necessary to put an avulsed tooth in milk (milk provides the best combination of proteins and antibacterial protection), whether you can put only part of a tooth back in the socket (never do this; see a dentist immediately), if an avulsed baby tooth should be replanted (no, as it may cause issues with the permanent tooth), and what to do if you can't find your knocked-out tooth (tell your provider if you think you may have swallowed or aspirated it).

In conclusion, a knocked-out tooth is a serious dental emergency, but with prompt and appropriate action, there is a good chance of saving the tooth and maintaining oral health. Always be prepared and know what to do in such situations to ensure the best outcome for your teeth.