Avulsed tooth

Avulsed tooth is a medical term for knocked out tooth. Modern emergency departments focus on reimplanting the avulsed tooth as soon as possible, minimizing periodontal damage, and preventing infection of the pulp tissue. A permanent (adult) tooth that is knocked out can sometimes be put back in place (replanted). In most cases, only permanent teeth are replanted into the mouth. Baby teeth are not replanted.

Call your dentist right away when a tooth is broken or knocked out. If you can find the tooth, bring it with you to the dentist. Follow the steps below.

If you cannot close your upper and lower teeth together, your jaw may be broken. This requires medical help right away at a dentist’s office or hospital.

Here is what you need to do for the avulsed tooth:

Save any tooth that has been knocked out. Bring it to your dentist as soon as possible. The longer you wait, the less chance there is for your dentist to fix it. Hold the tooth only by the crown (chewing edge).

Baby or milk teeth

• If one of your child’s first teeth has been knocked out (a ‘baby tooth’), the dentist won’t try to put it back in. Instead they will leave the space until a new, permanent tooth grows.
• If one of your child’s adult teeth has been knocked out, follow the advice for adult teeth below.
• If your child is in pain, get advice from your pharmacist or doctor on pain relief medicines they can take.

Adult teeth

1. If an adult tooth has been knocked out, don’t throw it away.
2. Call a dentist urgently and ask for an emergency appointment (ideally within 30 minutes)
3. Handle the tooth very carefully – it is best to hold it by the crown or white part of the tooth. Don’t touch the root.
4. Don’t scrub the tooth at all or rinse it with water. If the tooth has dirt on it, gently rinse it in milk. If milk is not available use saliva or a sterile saline solution (available from pharmacies).
5. If you are able to, push the tooth back into the socket it came from. Do this gently until you hear a click or the tooth is level with the other teeth. Then bite down gently on a clean cloth while traveling to the dentist for further assessment.
6. If it’s not possible to put your tooth back in, place it in contact lens saline solution or milk immediately and go to the dentist, taking your tooth with you.
7. If milk or sterile saline solution are not available, put the tooth very carefully in your mouth between your cheek and gum and go to the dentist. Be very careful not to swallow your tooth.
8. You can also use plastic wrap to protect the tooth. Spit some saliva into the plastic before wrapping the tooth.
9. Do not place your tooth in water as this can damage the tooth’s delicate cells.
10. If parts of your tooth have broken off, these should be placed in milk or a sterile saline solution and taken to your dentist.
11. If you have swelling, try using a cold compress against the side of your face to relieve pain and reduce the swelling. Wrap an ice pack in a cloth before placing it against your skin.

If you are bleeding after your dental injury:

• Apply pressure over the area with a pad made from a clean, rolled-up, cotton handkerchief (or other clean cloth), which has been slightly dampened with clean water.
• Keep this pad in place for 15 minutes without removing it. Check to see if the bleeding has stopped. If not, repeat the process and keep the pad in place until you are seen by a healthcare professional.
• If you are in pain, get advice on pain relief medicines you can take.

DO NOT

If a tooth breaks or is knocked out:

• DO NOT handle the roots of the tooth. Handle only the chewing edge — the crown (top) portion of the tooth.
• DO NOT scrape or wipe the root of the tooth to remove dirt.
• DO NOT brush or clean the tooth with alcohol or peroxide.
• DO NOT let the tooth dry out.

Avulsed tooth causes

Tooth accidents are commonly caused by:

• Accidental falls
• Sports-related trauma
• Fighting
• Car accidents
• Biting on hard food

Avulsed tooth prevention

Some activities are more likely than others to lead to accidents that cause dental injury. It’s best to wear a fitted mouthguard (one that’s custom-made by your dentist) to protect your teeth when doing activities such as:

• off-road bike riding
• skateboarding
• rock climbing
• white-water rafting
• trampolining
• boxing
• football – soccer, rugby, league or Australian Rules
• basketball
• squash
• hockey.

Follow these guidelines to prevent broken or knocked out teeth:

• Wear a mouth guard when playing any contact sport. Ask your dentist for advice about oral protection for yourself or your child.
• Avoid fights.
• Avoid hard foods, such as bones, stale bread, tough bagels and unpopped popcorn kernels.
• Always wear a seatbelt.

Avulsed tooth treatment

Save any tooth that has been knocked out. Bring it to your dentist as soon as possible. The longer you wait, the less chance there is for your dentist to fix it. Hold the tooth only by the crown (chewing edge).

You can take the tooth to the dentist in one of these ways:

1. Try to place the tooth back in your mouth where it fell out, so it is level with other teeth. Bite down gently on a gauze or a wet tea bag to help keep it in place. Be careful not to swallow the tooth.
2. If you cannot do the above step, place the tooth in a container and cover it with a small amount of cow’s milk or saliva.
3. You can also hold the tooth between your lower lip and gum or under your tongue.
4. A tooth-saving storage device (Save-a-Tooth, EMT Tooth Saver) may be available at your dentist’s office. This type of kit contains a travel case and fluid solution. Consider buying one for your home first aid kit.

Also follow these steps:

• Apply a cold compress on the outside of your mouth and gums to ease pain.
• Apply direct pressure using gauze to control bleeding.

After your tooth has been replanted, you will most likely need a root canal to remove the cut nerve that is inside your tooth.

You may not need an emergency visit for a simple chip or a broken tooth that is not causing you discomfort. You should still have the tooth fixed to avoid sharp edges that can cut your lips or tongue.