A knocked out tooth is one of those injuries that are associated with childhood accidents - meanwhile, they often happen to adults as well. It is worth knowing, however, that even a knocked out one does not always have to be a cause for concern: in many cases a knocked out tooth can be saved. What to do after an injury to save a knocked out tooth?

Contents:

  1. Broken tooth - what to do?
  2. Broken tooth - how to save? Important time and transportation
  3. Knocked out tooth - what does a dental visit look like after an injury?
  4. Knocked out tooth - possible complications

Knocked out tooth , whether in children or adults, is usually the result of physical activity and related accidents - hitting a ball in the face, kicks, cycling accidents, falls .

In some cases it can be prevented: for example, if you practice contact sports, martial arts, are exposed to a blow to the head, it is worth investing relatively little in comparison to the cost of treating teeth in a suitable protector.

There are standard, thermoformable protectors on the market as well as individual protectors based on dental arch impressions. The idea is simple, the entire upper arch, sometimes both upper and lower, is covered with a flexible rail, which is to distribute the impact force over a larger area.

Nobody wears such protectors around the clock. It is also difficult to deny yourself (and the child) physical activity or certain entertainment. That is why it is worth knowing what to do in the event of an injury to save a knocked out tooth.

Broken tooth - what to do?

If the accident has already taken place, it is these first moments that determine the further chances of saving the tooth. The most important goal is always general he alth - in serious situations a knocked out or broken tooth is very distant.

Always follow Basic Life Support (BLS) principles in an emergency. Only when it is known that the main ailment is dental trauma, we focus on dental issues.

After each tooth injury, even if it is stuck in the mouth, visit the dentist - not every injury means tooth loss, the tooth may also break inside the alveolus, disrupt the pulp vascularization or dislodge itwithin the bone.

It is worth finding broken fragments and knocked out teeth - first of all, it is evidence that it has not been swallowed, aspirated into the respiratory tract or forced into other tissues. Secondly, the knocked out tooth can be put back into the socket (replantation), and the broken fragment can be used for reconstruction.

However, certain key conditions must be met, the most important of which is the time and method of securing the tooth.

Broken tooth - how to save? Important time and transportation

The length of time between an injury and professional help depends on the method of transporting the tooth (or its fragment) and the stage of tooth development - it is different in immature dentition and different in adults.

A person with a dental trauma must get to the dentist's chair as soon as possible. The way and time in which the lost teeth will be transported to the office is also important. The role of the patient is to see a doctor, follow the dietary and hygienic recommendations adequately to the injury, and observe if something disturbing happens after a dental injury.

The ultimate goal is to create the best possible conditions for the maintenance of living cells in the periodontium and pulp. The transport environment must therefore guarantee moisture, osmotic and microbiological stability.

The tooth can be delivered to the office dry - then we only have an hour to place the tooth in the socket, but the loss of moisture by the tissues reduces the chance of success.

Therefore, for tooth transport, it is worth using fluids such as:

  • saline (we gain an hour and moisture improves the prognosis)
  • pasteurized milk (we gain 6 hours)
  • Hank's solution (24 hours)
  • and even the saliva of a patient who lost a tooth (which gives us two hours)

Tap water should be avoided because of its osmotic properties, which will accelerate the death of valuable periodontium cells.

If the transport time is longer, the chance of preserving a viable periodontium disappears and the failure rate and post-traumatic complications increase.

Traumatic tooth loss in the case of fully developed dentition is often associated with the need for root canal treatment. This is the case when the trauma causes damage to the neurovascular bundle, as a result of which pulp necrosis occurs.

In children, the dentition is in the developmental stage, and thus many permanent teeth still have wide apical openings. The large surface of the opening and the young pulp with a high potential for revascularization (re-formation of the vascular bundle) cause the replantation of immature teethcharacterized by a greater percentage of preserved viable pulp than in adult patients.

Fragments of tooth crowns should be delivered to the office in conditions similar to whole teeth. Dried enamel and dentin in the fracture will have a worse prognosis for long-lasting restoration due to lower adhesion of dental materials and greater brittleness.

Worth knowing

Traumatic injuries of deciduous teeth also require dental attention. The child's age has a significant influence on the doctor's conduct.

Older children, during the period of replacement of the teeth, after the loss of the milk tooth, usually will not require additional treatment of the missing tooth, but only a check for damage to the permanent tooth bud.

In younger children, treatment will be aimed at preserving the milk milk or securing the gap for the duration of the permanent tooth eruption.

Knocked out tooth - what does a dental visit look like after an injury?

In a trauma examination, the dentist will focus on several elements in order to select the best solution to the problem. First: medical history.

Before the visit, therefore, be prepared for questions about the circumstances of the injury, the moment of the incident, and the general condition. This is not about the doctor's curiosity, but about determining whether there has been a concussion and whether more serious general medical complications should be expected.

In addition, in special situations it will also be necessary to prevent tetanus.

The next questions will help the doctor determine the dental history of the patient - whether there were similar situations before, what ailments occurred after the injury, whether the tooth was previously treated for other reasons, etc.

After completing the interview, the doctor will proceed to the physical examination. Check the condition of the damaged tooth (brought in the mouth or in the container), the condition of the socket, tooth vitality, periodontium and gum he alth, assess the general condition of the mouth and surrounding areas.

During the post-traumatic examination, X-rays of the teeth will also be taken to assess the surrounding tissues and the teeth themselves.

After the diagnosis is completed, the doctor will arrange the injury, as appropriate. It will rebuild a damaged crown, replant a prognostic tooth, remove tooth fragments from soft tissues, perform endodontic treatment, remove the tooth from the bite, put in orthodontic components to reposition the tooth or brace the teeth, etc. - all according to the patient's condition.

However, it should be remembered that trauma treatment of teeth is a process that lasts months or even years. This is due to the need for long-term observation and control whether they do not developcomplications of injury.

Unfortunately, conservative treatment will not bring results in every patient - this is something to be taken into account. A tooth may be rejected or serious complications may develop. Then the only alternative may be prosthetic solutions.

Knocked out tooth - possible complications

The injured tooth should be observed for the next several months. During this time, control visits are absolutely necessary, during which the doctor will assess the condition of the restoration, tooth tissue, pulp, periodontium, periodontium and check whether complications develop.

A dentist can handle it, but without the patient's vigilance, prompt intervention may turn out to be impossible. A sign that something disturbing is happening after the injury is a toothache, which, despite previous treatment, does not go away and even gets worse.

You also have to pay attention if the tooth does not change its color from shades of white and yellow to pink (which may indicate resorption) or livid (possibly pulp necrosis). The loss of tooth stability and an increase in its mobility is another sign that you urgently need to see a dentist.

About the authorMateusz Król5th year student of dentistry at the Medical University of K. Marcinkowski in Poznań. An active member of the Scientific Society of Maxillofacial Surgery and the Scientific Society of Conservative Dentistry and Endodontics. Author of conference speeches and scientific publications. He is particularly interested in oral surgery and conservative dentistry.

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Category:

Dentistry and Orthodontics