KNOCKED-OUT (AVULSED) TEETH TREATMENT

Many statistics are presented to the public as it related to sports-related injuries. One of these statistics is that 5 million teeth will be knocked out of U.S. Youth while they play sports. These teeth can be either primary (baby) or permanent (adult) teeth. The most commonly affected age range is 8 to 12 years of age.

It is estimated by the time students complete high school, one out of three boys and one out of four girls will have suffered a dental injury. What treatment should be done if this occurs to your child? According to Drs. John B. Roberson, Chad Stanley and Drew Middleton who see this type of injury on a regular basis, here are the steps you should take if this occurs to your child.

Note that the following treatments are for teeth that have been avulsed (knocked out) completely from the socket.

PERMANENT (ADULT) TEETH

• Locate and identify the tooth
• Once located, hold the tooth by the crown (the part you chew with) and gently rinse with water or normal saline
• Do NOT hold, touch or scrape the root surface
• Attempt to re-implant or reposition the tooth back into the socket
• If not able to re-implant the tooth, place in container of milk. If milk is not available, as a last resort, place inside your cheek (be careful to not swallow tooth!)
• Apply pressure to socket with moistened gauze or towel to control bleeding
• Contact your General Dentist, Oral Surgeon, Endodontist or Pediatric Dentist as soon as possible for radiographs (x-rays), re-implantation and splinting . The sooner the tooth is placed back in the socket, the higher the success rate. Within 30 minutes from time of avulsion to re-implantation is best.
• The splint will be used to hold the tooth in place for approximately 2 weeks.
• Endodontic (root canal treatment) therapy will be needed for the tooth approximately 2 weeks after the injury
• Antibiotics and analgesic will be started
• Regular follow-up is necessary to make sure everything is healing properly
• If unable to locate your dentist, you should go to the Emergency Room
• Missing teeth or fragments of teeth must be accounted for at time of examination. If unable to do so, they must be considered to have been aspirated, swallowed or displaced into soft tissues of the lip, cheek, floor of mouth, neck, nasal cavity or maxillary sinus. A radiographic examination (x-ray) of the head & neck, chest, and abdomen must be done to rule out the presence of teeth or fragments within these tissues or organs.

 

PRIMARY (BABY) TEETH

• Locate and identify the tooth
• Apply pressure to socket with moistened gauze or towel to control bleeding
• Do NOT attempt to re-implant a baby tooth if it has been totally avulsed (knocked out). The reasons for this include:
  
  1. Increased chance of ankylosis (fusing to the jawbone)
  2. Internal or External resorption (erosion of the tooth)
  3. Abscess formation
  4. Alteration of eruption pattern of the adult tooth
     
• If a primary (baby) tooth appears to be avulsed and can not be found, it could possibly be intruded into the gums. It can be located by radiographs (x-rays) and will be allowed to re-erupt naturally if no damage to the permanent tooth bud exists.
• Contact your General Dentist, Pediatric Dentist, Oral Surgeon or Endodontist as soon as possible
• If unable to locate your dentist and bleeding persists along with suspicion of other oral injuries, go to Emergency Room
• Missing teeth or fragments of teeth must be accounted for at time of examination. If unable to do so, they must be considered to have been aspirated, swallowed or displaced into the soft tissues of the lip, cheek, floor of mouth, neck, nasal cavity or maxillary sinus. A radiographic examination (x-ray) of the head & neck, chest and abdomen must be done to rule out the presence of teeth or fragments within these tissues or organs.

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