17. June 2011 06:00
Yesterday we discussed the importance of wearing a mouthpiece during sports. So what happens if no mouthguard was worn, or there is just a case of bad luck. I have had numerous experiences with patients over the years where unforeseen circumstances have created a very unfortunate tooth evulsion (white water rafting, a 10 year old playing tag by throwing rocks!!??, bicycle and skateboard accidents).
So what do you do? The major issue is TIME. The tooth starts to die within 15 minutes of being knocked out. The general school of thought is if the tooth can be reinserted within one hour the odds of success increase significantly. So the first thing is to place the tooth in either milk, water, or even under the lip. Studies have shown this can buy you some time and extend the window of success. Contact your dentist immediately and get to their office. In general hospital emergency rooms are not the best place for this type of treatment.
Ideally the dentist can insert the tooth into the socket and then use some orthodontic splinting to secure the tooth. Usually a prescription for analgesics and antibiotics are recommended. Follow up visits are required to monitor progress. Ideally, the tooth reattaches in the bone and you are as good as new. Sometimes the nerve in the tooth can die from the trauma and a root canal is necessary, but the tooth is still retained.
Remember the white water rafting? I had to reattach four lower front teeth knocked out by a paddle during a flip over of the raft. Fifteen years later all the teeth are in perfect health!
If all goes on schedule there is about a 50% success rate, so hopefully this information will help increase your odds of a good outcome.