Dental avulsion means that the tooth has been completely knocked out of bone socket. This usually happens to the front tooth when the young child endures physical contact in a sport. Generally avulsed tooth can be replanted back with good prognosis. Here is what to do in a dental emergency involving tooth avulsion:
Upon immediate avulsion, try to pick up the tooth by the crown area. Avoid touching the root area where the vital cells are on the surface of the root. We need the vital cells to help the tooth to reattach to the periodonteum after replantation.
Next is to clean the tooth with cold running water for 10 second. Wash off any visible debris but do not scrub the tooth. You can either replant the tooth into the original socket or put the tooth into a bottle of milk. The longer the tooth is dried, the poorer the chance of survival.
Take the child to the dentist for evaluation.
I would take a couple of Xray image to verify the condition of the tooth and the bone socket. I would take xray to verify for proper placement position. I would splint the tooth together with the adjacent tooth and tell the patient to wear the splint for two weeks. I would also put patient on an antibiotic regimen. If tooth is contaminated with soil, I would recommend patient to have medical checkup and evaluate for the risk of titanus.
Sometimes, the tooth would need root canal therapy in the next 7-10 days, followed by periodic checkup and Xray radiograph.
If the tooth has been dried for more than 60 minutes, the prognosis of the replantation goes down. Root ankylosis or root resorption may occur and the tooth may eventually be lost.
Written by Daniel Tee, DDS, MS
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