Alright all my awesome patients, after treating my third avulsed tooth (an avulsed tooth is one that has been traumatically knocked out of the mouth) in the last three months, I felt it necessary to teach all of you First Aid for Tooth Loss due to trauma. The three avulsed tooth patients I have treated lately have experienced premature tooth loss from every day events, and not from sports or high adventure.
In each of these cases, parents and youth had never received training for tooth avulsion. As many of you know, I teach CPR/AED and Remote Wilderness First Aid Courses, as a Red Cross instructor, to Scout Leaders and their older youth. So please read the following and do your best to commit it to memory. You just might save a smile!
Knocked out Tooth (Dental Avulsion)
A knocked out tooth is a real dental emergency in which immediate treatment, within 20–40 minutes of tooth loss, affects the prognosis of the tooth.
First Aid Treatment consists of doing the following:
-Pick up the tooth by the anatomical crown portion, not the root.
-The avulsed permanent tooth should be gently rinsed, not scrubbed, with water to clean any unwanted dirt or debris.
-Care should be taken not to damage the surface of the root, which may have living tissue still present.
-With the tooth and mouth clean, an attempt should be made to re-plant the tooth in its original socket. Care should be taken to place the tooth so that it looks similar to the others, and not placed in backwards.
-If the tooth cannot be replaced immediately, place in milk, saline solution, or spit (held in the mouth with extreme care to prevent swallowing the tooth) to maintain moisture, and seek emergency care at an Emergency Room, or a dental office. If the patient is even slightly dazed, or worse, has an obvious change in level of awareness or consciousness, do not have them hold it in their mouth to prevent aspiration.
-Failure to re-plant the avulsed tooth within the first 40 minutes after the loss may result in a less favorable outcome for the tooth.
-First Aid of injured baby teeth differs from management of permanent teeth; avulsed baby teeth should not be re-planted to avoid damage to the permanent.
-If you are unable to re-plant the tooth due to uncontrolled bleeding, have the patient bite down on gauze or any other substance such as a hand towel or clean rag, thus applying direct pressure to the wound site, and seek an emergency care facility as soon as possible.
The best treatment for an avulsed tooth is immediate replantation. However, this can be difficult for the non-professional person. The teeth are often covered with dirt or other substances. The debris must be ideally washed off with a physiological solution and not scrubbed. Sometimes multiple teeth are knocked-out and it might be difficult for the average person to figure out where each tooth belongs in the mouth. The injured person will often times have other injuries, such as lacerations or fractures, that require more immediate attention. The patient may resist replantation of the teeth due to pain when attempting replantation.
If immediate replantation is not possible, the teeth should be placed in an appropriate storage solution and brought to a dentist who can then replant them. The dentist will clean the socket and tooth/teeth, and replant them into their appropriate sockets. The dentist will splint them to non-knocked-out teeth for a specific period of time to allow stabilization of the teeth. Additional treatment will usually be needed after emergency treatment.
The best way to avoid tooth loss is to wear mouth guards and appropriate gear for specified activities. However, tooth avulsion can occur when least expected.
If you have any additional questions, please do not hesitate to call our office.
Sincerely,
Dr. Rob and Team at Thorup Dental