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Managing Dental Trauma: A Guide to Handling Tooth Avulsion

Dental trauma is often a distressing experience. Whether it’s a result of a sports injury, an accident, or any other unexpected impact, knowing how to manage dental trauma-related emergencies can make a significant difference in the outcome.

In this first of a series of blog posts offering a comprehensive guide to managing dental trauma, we thought we would look at the most serious –tooth avulsion. This occurs when a tooth is traumatically lost from its socket, i.e., falls out of the gum. It is a serious dental emergency that requires immediate attention for the best possible result. View our next post of this series here.

Speedy and appropriate action increases the chance of the tooth successfully reimplanting, and therefore its long-term viability. The longer a tooth remains out of its socket, the lower the chance will be.

What should you do?
1. Stay Calm and Act Quickly:
The first and most important step is to stay calm. Panic can lead to mishandling of the tooth increase the risk of unwanted complications.

2. Locate the Tooth:
Find the avulsed tooth as soon as possible. Be sure to handle it by the crown (the part of the tooth that is visible in the mouth) and avoid touching the root to prevent damage to the cells necessary for successful reimplantation.

3. Clean the Tooth Carefully:
If the tooth is visibly dirty, rinse it gently with milk or saline solution. Avoid using tap water, scrubbing the tooth or touching the root, as this can damage the delicate root cells. If no other options are available, briefly rinsing with clean (bottled) water is acceptable. If the tooth is not soiled, do not attempt to clean it.

4. Replace the Tooth (If Possible):
Best success rates are found when the tooth is replaced within 30 minutes. Hold it by the crown and gently push it back into its socket. Bite down gently on a piece of cloth or gauze to keep the tooth in position. If you’re unable to reinsert the tooth, proceed to the next step.

5. Keep the Tooth Moist:
If it is not possible to reinsert the tooth, keeping the tooth moist is critical. Place it in a container with milk, or saline solution if available (eyewash would be acceptable). If there is no risk of swallowing the tooth, an alternative option is to keep the tooth in the patient’s mouth between the cheek and the gum.

6. Seek Immediate Dental Care:
Time is of the essence in cases of tooth avulsion. You must go immediately to your dentist or an emergency dental clinic. The best chance for successful reimplantation is within 30 minutes of the injury.

Long-Term Care and Follow-Up
After the initial emergency treatment, follow-up care is essential to monitor the healing process and ensure the tooth remains stable. You will require several visits to assess the tooth’s reattachment and perform necessary treatments over the next few months, which may include root canal therapy to prevent or treat subsequent infection.

Prevention Tips
While accidents are unpredictable, certain precautions can help minimize the risk of tooth avulsion:

1. Wear a Mouthguard:
For those involved in contact sports, wearing mouthguards can significantly reduce the risk of dental injuries. You can buy off-the-shelf mouthguards that are cost-effective and self-mouldable, but for more comfort and best protection, a bespoke custom fit guard can be made by your dentist.

2. Maintain Good Oral Hygiene:
Healthy gums and teeth are more resilient to knocks and minor trauma. Having dental check-ups regularly and keeping up with brushing and flossing are vital in maintaining dental health.

3. Be Cautious with Activities:
Avoid using teeth as tools to open packages or bottles and be mindful of environments where falls or impacts are more likely.

Conclusion
Tooth avulsion is a dental emergency that requires swift and careful action. By knowing the immediate steps to take, you can improve the chances of saving the tooth. Remember, quick response and proper handling are key. For any dental trauma, always seek professional care without delay. Stay safe, take preventive measures, and keep your smile healthy.

References

Trope, M. Avulsion of permanent teeth. Theory to practice. Dent. Traumatol. 27, 281–294, (2011).

Fouad AF, Abbott PV, Tsilingaridis G, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2020; 36: 331–342.

If you have any questions or need further assistance, don’t hesitate to contact us at Bridgeways Dental. We’re always here to help you manage dental emergencies and maintain optimal oral health.

If you are looking for better dental health and a better dental practice in Southampton then please get in touch, simply call 023 8086 8833 or send us a message via our contact page.