Knocking out a tooth can be a painful and distressing experience. It is classified as a dental emergency, but it’s important not to panic. It may be alarming, but it is relatively common. Fast action and making the right choices in the moment can save a tooth and may mean that you won’t be left with a gap or any further complications.
This article will give you a brief overview of what to do in the first instance if you or someone you care about experiences having a tooth knocked out. We hope it will be helpful advice to help you preserve a smile.
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Act Fast: The Importance of Immediate Action
You may have heard of ‘the golden hour’ in relation to traumatic injuries, but did you know that it also applies to teeth that have been knocked out by an injury or impact to the face? The first hour is the ideal timescale in which care and treatment should begin in order to give you the best chance of saving a tooth that has been knocked out.
Time is vital to saving knocked-out teeth because the tooth root cells cannot survive for long periods outside the mouth, and once a tooth has died it cannot be revived and replaced in the mouth.
This is why it is so important to act decisively and rapidly in the event of someone having a tooth knocked out: they are likely to have suffered quite a blow and may be shocked as well as in pain, so may need someone to take charge of the situation for them.
3 Step-by-Step First Aid for a Knocked-Out Tooth
1. Find and Handle the Tooth Correctly
It may sound trivial or unlikely, but even the way that you pick up a knocked-out tooth makes a difference to tooth first-aid. When picking up a tooth that has been knocked out, you must pick it up by the crown, the part you would normally see above the gumline, not the root, the part that normally sits in the gum and jaw.
You must avoid touching the tooth’s root as this part of the tooth is not usually exposed to touch and it can be extremely fragile. The root cells on this part of the tooth can be damaged even by gentle touches.
You should check the tooth carefully for any fractures so that you know if any pieces or fragments are missing. This will be important information for your dentist when you finally reach their care. And whatever you do, don’t be tempted to scrub the tooth clean, even if it fell on the floor.
2. Gently Clean the Tooth
If a tooth is visibly dirty or has debris on it after falling onto an unclean surface such as the floor, you can rinse it gently with either saline or milk as these will not cause further damage to the tooth. Saline can be made at home by adding table salt to cooled boiled water – do not put the tooth into boiling water.
You must avoid chemical products, soaps or abrasive scrubbing to clean the tooth. Teeth that have been knocked out can be fragile and may end up more badly damaged by harsh cleaning. They must be handled and treated with the utmost care.
3. Store or Reinsert the Tooth
The best thing to do with a knocked-out tooth is to reinsert it as soon as possible into its original socket. It can then be held in place by biting down gently on a clean cloth or wad of gauze.
If this is not possible, then the tooth should be stored in either milk or saline for the trip to the dentist. If the person who has lost the tooth has the capacity and understanding not to swallow it, a safe place to transport it can be under the tongue or in the cheek, as this keeps the tooth at its optimum temperature in its usual pH-balanced environment.
You must avoid dry storage for a tooth that has been knocked out. Do not wrap it in a tissue or put it in a pocket, because the delicate periodontal ligaments on the tooth root will die if they are left to dry out in the air. Keeping a tooth moist with a suitable liquid increases the chance of successful reimplantation by a dentist.
What NOT to do in a Dental Emergency
- Don’t Touch the Tooth Root: The root contains periodontal ligament cells that are crucial for the successful reimplantation of the tooth and the healing process. Touching the tooth root can damage these cells, making saving the tooth less likely.
- Don’t Scrub or Sterilise the Tooth: This will prevent proper reattachment if the tooth can be reimplanted as it is likely to damage the surface cells on the root of the tooth and the periodontal ligament cells, preventing their proper functioning that could allow for reimplantation.
- Don’t Delay Seeking Care: The ‘golden hour’ is vital. Ideally, a patient whose tooth has been knocked out should be sitting in a dentist’s chair within the hour of the accident occurring. This will maximise their chances of successfully having the tooth replaced in their mouth and maintaining their smile.
- Don’t Store the Tooth in Water or let it Dry Out: Plain water can cause tooth root cells to swell and burst, leading to cell death which reduces the likelihood of successful reattachment. Drying out a tooth will also damage and kill these cells.
Your Journey to the Dentist: What to Expect Next
When dealing with a knocked-out tooth, a dentist will aim to reimplant the tooth as this is the ideal outcome to preserve a patient’s smile and bite pattern as well as reduce the healing process required.
If a tooth can be reimplanted, the dentist may splint the tooth to support it and stabilise it as it reattaches to the jaw and the periodontal ligament begins to heal. This process often involves dental resin and a wire to bond the reimplanted tooth to adjacent teeth for maximum stability while healing.
Your dentist will advise you on follow-up care and the likelihood of needing root canal treatment in the future to preserve the health of the reimplanted tooth.
Even if in the end your tooth cannot be saved, quick action at the point of a tooth being knocked out will preserve your treatment options for as long as possible.
Closing Thoughts
While it may be distressing to experience a tooth being knocked out, careful action and fast decisions can save a smile and at the very least it can keep your options open while waiting for a dentist to confirm the appropriate treatment.
It’s a good idea to keep the details of an emergency dentist saved at all times, just in case. We hope you never need us in this capacity, but Dental @ Niddrie will be here for you if you need us. Contact us for support and treatment if you or someone you care for has a tooth knocked out.
