Emergency Treatment For Avulsed Tooth

The incidence of knocked-out teeth (avulsion) is high. Many of these teeth are knocked-out during school activities or sporting events such as football, basketball and hockey. The use of protective mouth guards has been encouraged and even mandated by some sports governing bodies but, even when penalized for not wearing a protective mouth guard, many athletes disregard the recommendation. Most of these teeth can be saved if they are treated correctly. Immediate reimplantation insures the best possible prognosis but this isn’t always possible since more serious injuries may be present and studies have shown that most people will not do it. Studies have shown that teeth that are protected in a physiologically ideal media can be replanted twenty-four hours after the accident with good prognosis. The success of delayed reimplantation depends on the vitality of the cells remaining on the root surface.

In normal conditions, a tooth is connected to the socket by means of a ligament, the periodontal ligament. When a tooth is knocked-out, that ligament stretches and splits in half. Maintaining the vitality of the cells that remain attached to the root surface is the key to success following reimplantation. Years ago, it was thought that the key to maintaining root cell vitality was keeping the knocked-out tooth wet thus giving rise to storage media recommendations such as water, the mouth and milk. Recent research has shown that one of the key elements for maintaining vitality is storing the tooth in an environment that closely resembles the original socket environment. This environment is one that has the proper cell pressure (osmolality), pH, nutritional metabolites and glucose. There are scientifically designed storage media that provide this environment. These storage media are now available to the consumer in retail products. Use of devices that incorporate the ideal storage media and protective apparatuses have increased the success rate of replanted knocked-out teeth to over 90% when used within sixty minutes of the accident.

There are many storage media available for knocked-out tooth storage. The most often recommended are: Water, Ice, Saliva, Physiologic saline, Milk, pH balanced cell preserving fluids etc. The most optimum storage media that are available have been shown to be pH balanced cell preserving solutions. The best known and most extensively tested is called Hank’s Balanced Salt Solution (HBSS). It has all of the metabolites such as Ca, P04, K+ and glucose that are necessary to maintain normal cell metabolism for long periods of time.

As with most accidents, prevention is always better than cure, so dentists always advise using the necessary protective devices.When physically demanding sports are concerned, this means always wearing a mouth guard. These can be uncomfortable and make talking to your team mates a real pain but that’s nothing compared to the pain and lifetime of embarrassment and dental complications a knocked out tooth can cause. It is advisable to visit a your dentist to have a mouth guard fitted to ensure the maximum level of protection. Other preventative measures include always wearing a seatbelt and steering clear of eating any hard foods.Whatever the circumstances, it is essential that you see a dentist immediately. A knocked tooth can be a serious trauma that can cause a lifetime of dental complications, even if the tooth has successfully slotted back in. If the tooth is not replaceable, a  dentist can talk you through the alternatives, which may involve dental implants or bonding.