What to do if a Tooth is Knocked Out

Sometimes things happen… whether it’s a ball to the head, a knee to the mouth, or tripping over your own shoelaces. Would you know what to do if a tooth is knocked out??

Firstly, it is important to understand the difference between exfoliation and avulsion.
Exfoliation is when the tooth is lost due to natural circumstances – the most common cause of exfoliation is loss of a baby tooth due to the impending eruption of the permanent successor.
Avulsion is when the tooth exfoliates forcibly due to unnatural circumstances, such as a knock to the face.

In cases of exfoliation:

– PRIMARY TEETH: Children lose their primary teeth from the ages of about 6-12 years of age; you can usually tell if it is a baby tooth by the size (quite small), colour (very white), and if the tooth was ready to exfoliate there will be no or very little of the remaining roots attached. You may also notice a new permanent tooth already erupting through the gum, or see/feel a bulge where that new tooth is sitting close to the surface of the gum.

– PERMANENT TEETH: If a permanent tooth is lost and there has been no trauma involved, you may wish to seek advice from your dental professional as there may be more complicated underlying issues present.

In cases of trauma and/or avulsion:

– PRIMARY TEETH: If a primary tooth suffers avulsion, never re-implant the tooth due to risk of damage to the underlying permanent tooth. You may wish to keep the tooth and make an emergency appointment with your dental professional to check that the tooth has come out in one piece and if there is any remaining tooth fragments left in the bone.

– PERMANENT TEETH: For permanent teeth that exfoliate before their time due to a knock or trauma, there are a few steps to follow:

1. Find the tooth and pick it up by the crown (avoid touching the root/s).
2. If you feel confident replanting (re-inserting) the tooth you may do so, BUT make sure you place the tooth in the correct position / the right way around because once it is back in it isn’t coming out again for hopefully a very long time!
3. If the tooth has debris on it, clean the tooth under cool running water (max 10 seconds) prior to replantation.
4. If you do not feel confident replanting the tooth yourself, either place the tooth into a cup or glad bag of milk, or if milk is unavailable, you can place the tooth inside the patients mouth between the lower teeth and the cheek BUT DO NOT SWALLOW IT!
5. Make an emergency appointment with your dental professional or closest dental clinic for assessment, replantation, and splinting/stabilisation where appropriate.
6. NOTE: For the best long-term prognosis, the tooth should be replanted immediately, or no later than 1-2 hours after avulsion.

Once a tooth has avulsed and been replanted, there is a significant risk the nerve inside the tooth will not survive the trauma, and it may require further treatment later down the track; this could take days, months, years, or even decades. Regular dental appointments, diagnostic tests, and radiographs (x-rays) will be performed for ongoing assessment of the vitality of the tooth.

If you have any questions or concerns about exfoliation or avulsion, you are more than welcome to call Riverside Dental Spa on 4323-4323 to discuss these with our friendly team!