As a consequence of a car crash or trauma during games and sport, an intact tooth may literally be knocked-out of its natural place, the alveolus. Swift and precise action will allow this tooth to be re-implanted.
The tooth that has been knocked-out should be immediately located, held delicately by its crown (not by the roots) and then washed with water. It’s essential to avoid using soap or disinfectants, or even worse, to vigorously rub the root while trying to clean it. Each of these actions can irreversibly damage the living cells present on the root’s surface.
When possible the tooth should be immediately replaced in its socket, keeping it in position while going to the dentist as quickly as possible, who should obviously be forewarned by telephone, so that he can appropriately prepare himself to treat the emergency.
An alternative method for transporting the knocked-out tooth to the dentist is to keep it in your mouth, close to your cheeks, or to keep it in a container of water or even better, milk or saline.
The dentist will then be able to put the tooth back into its socket and attach it by splinting to the neighbouring teeth. This treatment won’t guarantee lifelong retention of the traumatized tooth in its socket; it will be able to remain in place for some years and only rarely will it last forever.
Its destiny is in fact root resorption that over 4-5 years will cause its complete substitution by bone. However, even just a few years of permanence in the mouth justifies the correctness of this treatment. It is necessary to underline that the critical factor that determines the success of re-implantation is the amount of time that the tooth has spent out of its socket, together with the manner in which it has been kept following the trauma.
The rapid action of delicate cleansing, conservation in a humid environment and a rapid re-implantation can offer high possibility of success. The tooth shouldn’t stay out of the mouth for more than 30 minutes and should if possible never be kept under dry conditions.
It shouldn’t be forgotten that with less severe trauma than an avulsed tooth, such as a coronal fracture, it is possible to minimize the damage by recovering any fractured fragments.
These fragments can be easily reattached with excellent aesthetic results.