New Guidelines for Knocked-Out Teeth

As fall sports in Winston-Salem swing into full gear for kids and teens, it’s important to look at what to do if a tooth (or teeth) gets knocked out.

We dentists refer to a knocked-out tooth as an “avulsed” tooth. If a tooth gets knocked out, the blood vessels and supporting tissues are damaged too. Unfortunately, these cannot be repaired and will need a root canal. However, the bone can reattach to the root of the tooth once it has been put back into place, and the tooth can be saved. It is important to act quickly and to know what steps to take that will best save the tooth or teeth.

With advances in knowledge and technology, the thinking on avulsed teeth has evolved. Many past recommendations suggest placing the tooth in milk until you can get to the dentist. While milk is preferable to water or saliva (which can cause periodontal ligament cells on the tooth’s root surface to die), it is not ideal. The ideal fluid that shows beneficial effects in preserving the root cell viability is a pH-balanced cell-reconstituting solution, such as Hank’s Balanced Salt Solution from Life Technologies.

If an avulsed tooth is placed in the correct fluid prior to being reimplanted, the success rate can be increased from 10 percen to 90 percent. Save-a-Tooth® is one tooth-saving system that has received Food and Drug Administration approval and the seal of acceptance from the American Dental Association. This is a kit we would recommend that parents, athletic trainers, coaches and school nurses have on hand.

Be prepared for accidents that involve teeth by having the proper storage solution on hand. If a tooth is knocked out, take the following steps:

If you or your child’s tooth is knocked out, take the following steps to improve your chances of saving the tooth:

  1. Handle the tooth carefully only touching the white enamel. Don’t touch the root because it can be easily damaged.
  2. Place the tooth into the appropriate fluid, such as the Save-a-Tooth® system. If you do not have the proper storage solution, place the tooth in milk.
  3. Get to the dentist within 24 hours if you have the tooth in a scientifically tested avulsed tooth-preserving system.
  4. The dentist will clean the tooth, reimplant the tooth back in its socket and splint it within guidelines based on the individual’s situation and how long the tooth has been out of the mouth.

The takeaway? The prognosis for avulsed teeth has dramatically improved with new dental protocols for re-implanting the tooth. If your tooth is knocked out, time is of the essence for teeth that are out of the mouth, but you can buy time if the tooth is in the correct holding solution.

If you have an avulsed tooth, call Enlighten Dental immediately at 336-765-0904. 

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