by Aliyeus J

Created on: February 13, 2011

A tooth avulsion or “knocked-out-tooth” can occur in the event of any traumatic injury to the face and mouth area. With the blow of a traumatic force, a tooth can be knocked out of socket, pushed deeper into the socket, or left partially unhinged and crooked in an angle that could cause even more trauma to the jaw, gums, and other teeth.  Tooth avulsions are not that uncommon, as approximately five million victims, both children and adults, lose a tooth or more, each year. These people are made victims as a result of car accidents, falls, sports-related injuries, and biting down on hard foods or objects.

A tooth avulsion should never be taken lightly as it is considered to be a serious dental injury. Victims are advised to take quick action, receiving emergency medical and/or dental attention immediately. Depending upon the source of a tooth avulsion, victims could end up in a hospital emergency facility, where some specific dental equipment is not available. Hospital staff may garner outside dentistry assistance, but with a tooth out of socket, the victim should seek emergency dental attention at a dental facility if at all possible.

Following a tooth avulsion, quick emergency care is key, but if the victim can save the knocked out tooth, re-implantation may be feasible. When saving the avulsed tooth, only the crown (top) should be handled, and rinsed (not scrubbed) with milk or water. The root of the tooth (the part that was embedded in the gums) should be left completely untouched, as this could cause damage to sensitive ligaments. After rinsing the tooth, avoid the natural instinct to wipe it off. In fact, the tooth should be kept moist.

The best way to keep the tooth moist is to place it back into socket, if possible. This needs to be done carefully, and should not be forced. If the tooth doesn’t glide easily into place, use alternative ways to keep the tooth moist. For adults, the tooth may be placed between the cheek and gums for safe-keeping, retaining moisture, until a dental professional is able to take over. Never leave children holding an avulsed tooth between cheek and gum, as they could mistakenly swallow it. An additional option for keeping the tooth moist would be to place the enameled structure into a small container of milk, or the victims own saliva.

At the dentistry facility, a plain dental x-ray will be taken, as well as a panoramic x-ray, which is able to detect the varied specifics of a dental injury. If a tooth is thought to have been swallowed, neck and chest x-rays may be taken, as a swallowed tooth could cause trauma, ending up in the throat, lungs, or stomach.  

Dental professionals cannot guarantee the re-implantation of an avulsed tooth, even when safely kept moist while on arrival to a dentistry facility. Blood vessels  and nerves within the avulsed tooth are usually damaged beyond repair. But there is still hope, as microscopic ligaments in the jaw may encounter and reattach to the root of an avulsed tooth when it’s set back into socket. If the tooth does successfully re-implant, root canal treatment will likely be needed at some point to clean out damaged nerves.

Successful re-implantation won’t be noticed right away. It usually takes an average of two weeks for microscopic ligaments in the jaw to firmly attach to the root of the tooth. Without root canal treatment some time after re-implantation, the tooth may eventually darken and become infected.

For comfort after incidence of an avulsed tooth, one may apply a cold compress to the mouth, near the area of injury, to help control pain.

To control bleeding, apply direct pressure to the injured area, while using clean gauze.  

Learn more about this author, Aliyeus J.
Click here to send this author comments or questions.