Tooth Knocked Out!!

Tooth knocked out? What do you do now?

Tooth knocked out, huh? Well first……

Tooth knocked out but need to rule out serious head injury first

So you, or more likely a child, have had a tooth knocked out and you don’t know what to do.  Well time is critical in order to get the tooth back and have it stay.  However, first we need to be rule out more serious injuries.  If someone has sustained a head injury and passed out for any amount of time they must go to the ER first to rule out any serious brain injuries or bleeding.  If no one lost consciousness then the sooner you can get to a dentist the better.  The cells connecting a tooth to the bone will die after 2 hours outside of the body.

Tooth knocked back or tooth knocked loose?

So if the tooth is knocked loose you can try to reposition it yourself.  This will be painful and may not be successful.  It’s much better to get to a dentist quickly without messing with the tooth too much. We can get the area numb and quickly get the tooth back into place.
Tooth knocked loose on a child.

One of our doctors neighbors did this and Dr. Bryan put it back into place in his living room.

Knocked out tooth – like totally knocked out!

If the tooth or teeth are completely knocked out then find the tooth or teeth, but be careful how you handle it.  Please avoid touching the root of the tooth (the part of the tooth that was embedded in the gums) because it is easily damaged.  Do not wipe any dirt or debris off of it; this will only do more damage.  Ensure it is an adult tooth; baby teeth should not be put back in for any reason.

Store a lost tooth or teeth in a either Pedialyte, saliva, or Hank’s Balanced Salt SolutionMilk and saline solution also work as storage solutions but are not as good as the others.  I would prefer that if the tooth is from an adult/older child and none of the liquids above are available for storage, to place it between the cheek and gum and go to the dentist.  You can’t trust a young injured child to do this without possibly swallowing it so have them spit in a cup and store it there.  Some athletic team’s emergency kits have Hank’s Balanced Salt Solution to store a tooth in.  Also, within most crowds someone will have saline solution.

Knocked out tooth STEP by STEP

  1. Rule out more serious head injury (if unconscious go to hospital)
  2. Pick up tooth (or pieces) without touching root (pick up part of tooth you usually see in the mouth)
  3. Do not bother trying to save a baby tooth.  We do not advise replacing baby teeth.
  4. Store in HBSS>Pedialyte>Saliva-Milk-Cheek(if child old enough not be trusted not to swallow it)>Saline solution
  5. Get it back in within 2 hours

Tooth knocked out playing hockey

So here is Ethan after a hockey accident; the ice never loses.
Image of a tooth knocked out.

Another tooth that was knocked back.

Iamge of a tooth knocked out

Knocked back tooth

 Here he is right after Dr. Bryan Bauer repositioned it and Dr. Danielle Bauer (orthodontist) made a custom retaining wire for him.
tooth knocked out before and after
tooth knocked out

How we stabilize a knocked out tooth

Once you see the dentist, he/she will get the area numb and reposition the tooth.  Next, we place a retaining wire, think braces but on the back side of the teeth.  We leave this wire in place for about 6 weeks.  Most of these teeth end up dying and needing root canals, especially in adults.  Replacing the tooth quickly is critical to allowing it to reattach.  Worst case scenario is that you lose it and will need an implant in the future.

These accidents usually happen outside of normal dental hours, but do not hesitate to page or call your dentist’s emergency number.  Every dentist I know will drop just about anything to get to the office and see you in this type of situation, or if they can’t they will find another dentist that can help you.

You can always contact our office at 630-665-5550.  My emergency number is 630-534-0890.

Danielle Bauer DDS, MS

Bryan Bauer, DDS, FAGD

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