Accidents are a part of life.  Some accidents involve teeth, so it certainly helps to know what to do if you or a loved one suffers dental trauma.

First and foremost, severe bodily or life-threatening injuries should be addressed.  If the patient is unconscious or seems confused, this may be a sign that the brain has been injured, and emergency medical services should be contacted immediately.  Likewise, if there are any other signs of significant bodily injury, seek urgent medical attention.

If injuries are limited to teeth, promptly call your family dentist.  If your family dentist is unavailable, endodontists and oral surgeons may also be called, because they are dental specialists who have additional training and experience in treating dental trauma.

When a tooth gets knocked out of the mouth, dentists refer to that as an “avulsion”.  These teeth may be saved if you know how to handle the tooth properly.  The main goal is to keep the cells on the root surface alive because these cells are responsible for keeping the root of the tooth healthy:

DO NOT scrub the root of a tooth, DO NOT dry the root, DO NOT keep the tooth in water; doing so can kill the cells on the root surface.  

The best thing you can do for an avulsed adult tooth is to hold it by the crown (the top white part of the tooth), briefly rinse debris off with water (less than 10 sec), and push it firmly back into the socket!  If possible, hold it in position by having the patient bite on something soft like a shirt.  Baby teeth should NOT be placed back in the socket to avoid damaging the adult tooth growing in the gums underneath it.

If you are uncomfortable placing an adult tooth back in the socket (or if you are unsure whether it is an adult tooth), the next best thing is to IMMEDIATELY place the tooth in a special solution sold specifically for temporarily storing avulsed teeth. Many sports teams have such solutions available in their emergency kits. These special solutions are sold as “Save-A-Tooth” and other brands.  Putting the tooth in a jar of milk works almost just as well.  A last resort would be to have the patient spit in a cup and keep the tooth moist in the patient’s saliva (spit).  DO NOT store the tooth in plain water.  Do not delay.  After only 30 minutes of being exposed to air, the chances for a favorable outcome drop precipitously.

Putting the tooth in a storage solution will buy you only a limited amount of time to find someone who is able to put the tooth back in its socket.  Every minute a tooth spends out of its socket decreases the long term prognosis of the tooth, so act quickly!  

Once the tooth has been replaced in its socket, repositioned properly, and stabilized by the dentist, the tooth will require root canal treatment in about one week.  The pulp (or “nerve”) inside that tooth will not survive after avulsion, and the inside of the root will need to be cleaned out before the necrotic tissue becomes another source of inflammation.  Development of severe inflammation or infection from a necrotic pulp can then damage the bony socket and the root which you tried so hard to preserve.

Additional information for dental professionals about treatment of dental trauma can be found by following the links below.

http://dentaltraumaguide.org

http://www.aae.org/uploadedfiles/publications_and_research/guidelines_and_position_statements/2004traumaguidelines.pdf