If a tooth is lost due to trauma, there are a few guidelines to follow, which will depend on whether or not the tooth is a baby tooth or permanent tooth:
- If a child’s tooth is knocked out, it is important to determine whether the tooth is an adult/permanent tooth, or a baby/primary tooth. If the tooth is a baby tooth, do NOT try to place it back in the socket (if it is an adult tooth, see below). Placing a baby tooth back in its socket can damage the permanent tooth that is still forming behind the baby tooth. Call your dentist for an evaluation of the bone around the site and to determine if a space maintainer is necessary to prevent the other teeth from drifting into the empty space. If teeth drift into the space, they can cause serious problems with the eruption of the permanent tooth. One of the important functions of baby teeth is to hold space for the permanent teeth.
- If an adult’s tooth is knocked out, do not touch the root of the tooth. Rinse the tooth with Hanks Balanced Salt Solution (such as from a first aid kit), sterile saline, or whole milk, or saliva--not water. Gently replace the tooth in the socket, have the person close gently on gauze or a paper towel to hold the tooth in place. Call a dentist immediately--timing is crucial to saving the tooth. If the tooth is coated with dirt or sand and rinsing does not clean it, place the tooth in Hanks Solution, saline, milk, or saliva--not water, keep it cool, and get to a dentist’s office immediately. The root of the tooth has cells that can allow it to re-integrate into the socket. Touching the root or cleaning it with anything abrasive can destroy these cells and decrease the chance of integration.
- The dentist will take multiple radiographs and evaluate the tooth and the surrounding bone for fractures and numb the area. If the tooth is not in the socket, they will clean the tooth, reinsert it into the socket, and place a splint made from wire or filling material. If the tooth is already in the socket, they will place a splint. In either case, the dentist will take additional radiographs to confirm the tooth is properly seated.
- The dentist may place you on antibiotics and advise a tetanus booster.
- The tooth will remain splinted for 1-2 weeks and the dentist will have to re-evaluate the condition of the tooth periodically. The tooth may eventually need root canal treatment even if it does successfully re-integrate into its socket.