Trauma to the face and mouth from sports or other accidents can cause teeth to fracture, loosen or be knocked completely out of its socket (avulsion). An avulsed tooth can often be saved if it is replanted back into the socket immediately or soon after the injury.
Avulsion of upper left primary central incisors
Avulsion is one of the most serious dental injuries and the outcome for an avulsed permanent tooth is dependent on the actions taken at the place of accident.
If a tooth is avulsed, make sure it is a permanent tooth before replanting it. (You should not replant a baby tooth!)
Note: If you are unable to replant the tooth, keep the tooth moist in a container of plain cold milk and see a dentist immediately. Do not store in water.
If milk is not available, place the tooth in your mouth between the cheeks and the gums.
The most critical factor is time. Teeth that have been replanted within 30 minutes have a better chance of surviving.
If you participate in contact sports, consider wearing a customised mouth guard or a splint to protect your teeth.
Splinting of upper teeth
Splinting of lower teeth
There are a few things that can help to optimize healing of the replanted tooth in the first few weeks. These include:
Replanted teeth should be monitored by your dentist in regular intervals. Root canal treatment will be required in teeth that are fully formed or when the tooth develops pulp necrosis.
When a tooth is avulsed, there is damage to the pulp within the tooth, and the periodontal ligament which surrounds the tooth.
Pulpal death (necrosis) usually occurs after an avulsion injury to a fully formed permanent tooth. Root canal treatment will then be necessary to remove the infected pulp tissue. In a tooth that is incompletely formed, pulpal healing may occur if the conditions are optimal.
During avulsion, the tooth is "separated" from the socket due to the tearing of the periodontal ligament. There may be damage to the root surface due to the crushing or scraping of the tooth against the socket. This results in inflammation of the root surface which may result in ankylosis or root resorption of the tooth. Severe root resorption that cannot be resolved may result in the eventual loss of the tooth. Hence, a replanted tooth should be monitored by your dentist at regular intervals so as to monitor the condition of the tooth and to advise on future treatment options if necessary.
Ankylosis of tooth
Tooth stored incorrectly in tissue paper
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