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To all of those who read this newsletter, thank you. I hope you find this monthly newsletter educational and interesting; perhaps it may even answer some questions about oral health that you may have been pondering. This month I will teach you what steps to take if you or your child have a tooth knocked out from a traumatic accident. I will break this topic down further by covering what to do if a baby tooth is knocked out versus a permanent tooth.

Baby Teeth

It can be a scary event if your child has an accident which results in a baby tooth being knocked out. If this ever happens to your child, first remain as calm as possible and keep your child as calm and relaxed as possible. Try to locate the avulsed tooth but DO NOT TRY TO REINSERT THE TOOTH IN THE SOCKET. Trying to reinsert a baby tooth can result in permanent damage to the underlying permanent tooth and surrounding tissue. Apply a cold compress to your child’s face to reduce swelling and call me, Dr. Krist, or your pediatric dentist so that we can set up an emergency exam.

Understand that the baby tooth was going to fall out eventually and often the only treatment indicated in this scenario is monitoring the permanent tooth forming underneath the avulsed baby tooth with x-rays. Routine follow ups and check ups in the subsequent months/years following the event will be necessary to monitor the development of the underlying permanent tooth.

Permanent Teeth

If you ever knock out a permanent tooth, immediately try to find the tooth. Do not pick the tooth up by the root, pick the tooth up by the crown. The crown is the top of the tooth which is normally visible above the gumline. The root is the long slender section of the tooth embedded in the gums which anchors it in your jaw. If you pick the tooth up by the root/roots, you can damage the attachment tissue which coats the roots and it can negatively impact the prognosis of the tooth moving forward.

If the root of the tooth is dirty, grasp the tooth by the crown and gently rinse the tooth off with cold water. Do not try to brush or scrub any dirt or debris off the tooth. Once the tooth is clean, try to reinsert the tooth into the socket as quickly as possible.

The longer a tooth is out of the mouth, the worse the prognosis is. Studies show that an avulsed tooth typically has one hour to be reinserted into the mouth or preserved in a solution or it will die. If the tooth cannot be reinserted into the socket, it needs to be preserved in one of the following solutions which are listed in order of how effective they are: 1) Hank’s Balanced Salt Solution 2) Save-A-Tooth 3) cold milk 4) saliva. Do NOT store the tooth in water.

Once the tooth has been cleaned, reinserted, or preserved in one of these solutions, apply a cold compress to the area to reduce the swelling. Please call me or Dr. Krist immediately so we can examine the area, splint the tooth, prescribe any medication if necessary, and advise you on what further steps need to be taken. Understand that the tooth will need to be monitored extensively in the upcoming months/years to assess its prognosis. Avulsed teeth often need to be treated with a root canal in the months/years following the accident.

Please do not hesitate to call me or Dr. Krist if you ever experience an accident resulting in tooth related trauma. We will do everything we can to make sure that your needs are compassionately addressed as soon as possible.

John Obeck, DDS