Unfortunately, the truth is that we cannot save every knocked-out (avulsed) tooth. Though we have success with many tooth replantations, not every tooth is salvageable.
However, knowing the steps to take after a tooth has been dislodged can significantly improve our chances of successfully saving it.
Here are some guidance points from your emergency dentist in West Allis to keep in mind, along with the steps you should take if you or a loved one experiences a knocked-out tooth.
What Factors Determine Dental Trauma Success Rates?
One of the most important factors in determining the success of saving an avulsed tooth is how quickly the patient responds to their circumstances. The faster we can treat the tooth, the better our chances are of saving it.
The Critical Timeline of a Knocked-Out Tooth
Timing is a key factor in saving an avulsed tooth. The data below is synthesized from the International Association of Dental Traumatology (IADT) peer-reviewed consensus statements, which dictate the global gold standard for treating dental avulsions.
- Replanted Immediately — If our dentists can replant the tooth within five minutes of the injury, there is a high probability of successful periodontal ligament (PDL) healing and root retention.
- Stored in Physiologic Medium — If the tooth is stored in milk, saliva, or saline for safe transport and we see the patient within 60 minutes of the injury, it may still be viable for replantation, and it will require endodontic therapy within 7–10 days.
- Kept Dry — If the tooth is kept dry for 60 minutes, with no moisture for its cells, it will result in severe cell death. Replantation will likely lead to root resorption or ankylosis (cell stiffening), which will likely result in replantation failure.
If you or a loved one experiences a tooth avulsion, it is critical to carefully transport the tooth and visit your emergency dentist as soon as possible. You can contact Urgent Dental Care, your trusted weekend emergency dentist in Milwaukee, at (414) 667-0911, and we will do our best to save your tooth.
The Vital Role of Periodontal Ligament (PDL) Cells
PDL cells are the connective tissues that hold your teeth to the jawbone securely. It's these cells and the tooth root that must be kept moist during transport of an avulsed tooth to achieve successful replantation.
If the socket is clean and accessible, the best way to transport a knocked-out tooth is to place it back into the socket. Never touch the roots of the tooth; only handle it by the crown. If the tooth or its roots are dirty, never scrub them, as this can damage the delicate ligaments needed for replantation. Gently rinse the tooth's roots with milk or a saline solution.
If you can't replace the tooth in its socket, the tooth must be kept moist during transport to your emergency dentist. The best liquids for this are:
- Cow's milk — This is the best option because it has a balanced pH that helps keep cells moist and alive.
- Saliva — You can use your saliva as a liquid for transport if the tooth can't be replaced in its socket.
- Saline solution — A standard contact saline solution is a good option for keeping cells alive.
Use tap water only as a last resort, as it can damage cells and diminish the chances of a successful replantation.
Treatment Options and Long-Term Restorations
If our dentists feel that they can save your tooth, here's what you can expect.
Immediate Stabilization and the Dental Splinting Process
One of our dentists will replant the tooth in its socket and hold it there with a splint for 1 to 2 weeks to allow the PDL to heal and reattach. They may prescribe an antibiotic to combat any infection developing during this critical healing time.
Root canal treatment will also be required around 7-10 days after the replantation to prevent any inflammatory root resorption.
Tooth Replacement Solutions When Replantation Fails
If replantation is a failure, or not an option, our dentists will discuss tooth replacement options with you that would include:
- Dental Implant — The gold standard in tooth replacement because it restores both your tooth and root.
- Dental Bridge — Anchors to two healthy teeth, while supporting a prosthetic tooth in between.
Talk with Our Team
Please contact us at (414) 667-0911 for help with an avulsed tooth. Our team is here to serve the community seven days a week from 9 am to 9 pm.