LDS Emergency Preparedness

Be Prepared, Not Scared!

Tooth Knocked Out?

Posted by Elise on October 11, 2010

 

 

 

kunisawa (sxc.hu)

What to Do

 

An occupational hazard in my line of work is that I’m always primed for terrible health news, so when a friend started to tell me that her mother had fallen in the driveway the day before, I expected to hear that she’d broken her hip. I was happy to learn that she’d merely knocked out her tooth! But “merely” wasn’t how it felt to her… fortunately, my friend knew what to do and where to go, so the tooth is now back in place and looks like it might heal just fine.

The incident motivated me to check in with Michael Apa, DDS, restorative and aesthetic dentist and instructor at NYU College of Dentistry, to learn about the right things to do in such a situation. His advice was surprising and practical. (Who knew dental first aid involved tea bags and cottage cheese?)

 First Aid for Teeth

 According to Dr. Apa, most intact teeth (ones that remain connected, even by just a bit of tissue) and many that have been knocked out altogether can be saved if you follow the right steps. First of all, be aware that this is a dental emergency and that it is important to act fast, because the longer a tooth is out of the socket, the less likely it is to be “re-established.” In that case, you’d need an implant.

 Here’s what to do if you get a tooth knocked out:

If the tooth is loose but hasn’t left the socket...

  • Gently try to move the loose tooth back into place beside the tooth next to it, placing it very close so the edges touch one another smoothly. This doesn’t usually hurt.
  • Do not put anything other than your clean fingers in your mouth… it’s important to avoid introducing additional nonresident bacteria.
  • See your dentist immediately. If it’s after office hours, call the emergency number… or, if that’s not an option, go to the nearest urgent-care clinic or hospital emergency department.

If the tooth is out of the socket…

The goal is to try to put the tooth back into place in the gum, if it can be done. Time is of the essence — you’ll have the best chance of saving the tooth if you get to the dentist (or an urgent-care clinic or the hospital emergency room) within 30 minutes. Meanwhile…

  •  If the tooth fell onto the ground, pick it up and clean it in your own saliva, saline solution, milk (any kind), baby formula or water (in this order of preference). Do not scrape off dirt or clean the tooth with alcohol.
  • Take care to handle the tooth by the crown (the biting end), avoiding contact with the roots and nerve endings so you don’t injure or contaminate them.
  • Try to insert the tooth back into place in your gum. Push it in by gently biting or using your fingers to approximate its normal position. Hold a wet (warm or cool, not hot) tea bag in your mouth, biting down softly on it to keep the tooth in place.
  • If you can’t put the tooth in place yourself (or if it makes you too nervous), tuck the tooth in your mouth firmly against your cheek, your lower lip or under your tongue and keep it there until you can get to the dentist. Saliva protects it and keeps it from drying out. Though it may sound bizarre, another adult (if willing) can hold the tooth for you in this way as well.
  • Another option is to put the tooth in milk (whole is best, but low-fat and skim are fine, too). If that is not available, use any sugarless, soft dairy product, such as yogurt or cottage cheese — the milk proteins will help keep the nerves and blood vessels alive. Do not put the tooth in a plastic bag or tissue even to transport it, as the nerves and blood vessels will dry out and die.
  • If you need to clean your mouth, rinse gently with water — your dentist will clean it more thoroughly.
  • Do not eat or drink anything.

Your dentist will clean your gum and stop the bleeding before trying to permanently reimplant your tooth. This is typically done by inserting and then splinting the tooth (with wires, a metal arch bar or plastic bond) for 10 to 14 days, which is how long it takes to fully reattach. Most people will not need stitches nor antibiotics, though a tetanus booster may be necessary if the tooth fell on the ground.

You’ll need to continue to monitor the tooth for some time afterward, with regular follow-up visits. Sometimes root canal becomes necessary down the road, as the nerves may have suffered irreparable damage.

A suggestion: The American Dental Association has endorsed an FDA-approved emergency kit, Sav-A-Tooth ($15), containing a storage case and special saline solution for one tooth

One final note — this advice is meant for coherent adults, not children or adults who are groggy from injury and likely to swallow or inhale a loose tooth.

Source:  Michael Apa, DDS, a partner in The Rosenthal-Apa Group, a private aesthetic dentistry practice in NYC, and instructor at New York University College of Dentistry.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

 
%d bloggers like this: