So today I want to talk about how to manage an avulsed permanent tooth. Obviously kids lose baby teeth all the time, and if those are avulsed, or knocked out, its not likely that we'll reimplant them. Doing so can cause the primary tooth to fuse with the bone, or ankylose, and cause problems for the eruption of the permanent tooth. .
Children most often will have an avulsed tooth at home or at school, and its usually a front tooth on the upper jaw, aka a maxillary anterior tooth. These teeth tend to erupt in an anterior direction towards the lips, and this splayed eruption pattern predisposes these teeth to avulsion. If this ever happens with your child, time is critical, and if you can manage a few of the primary steps at home immediately after the accident then it will considerably help with the outcome.
If you're unable to reimplant the tooth, store it in either milk, or something called Hank's Balanced Salt Solution, or HBSS. I realize you probably don't have this at home, but you can purchase something like this:
You can click here to read more about the product.
Ideally, the tooth should be reimplanted within the first 15 minutes. If the tooth is out of the mouth for 60 minutes it is unlikely that reimplanting the tooth will be successful.
Third - get to a dentist ASAP. He or she will evaluate the tooth, reimplant if necessary, and likely place a splint to hold the tooth in place.
The dentist may elect to do root canal therapy on the tooth at this visit as well. The trauma sustained to the tooth makes in unlikely for the tooth be remain viable, and root canal therapy will prevent necrosis and/or infection of the nerve and blood supply inside of the tooth. Your dentist will follow your child and determine how long the splint should be worn, and when root canal therapy should be initiated.
I should point out that this same protocol is followed for adults, so if you're playing softball with someone and this happens, or you get into a bar room brawl, follow the same steps.
Happy Tuesday everyone!