One of the most serious emergencies we deal with in our office involves a situation where a patient's tooth has been completely removed from its socket, which is termed tooth avulsion. This type of emergency is typically sports related and involves children who experience facial trauma. For example, during a little league baseball game a boy slides into second base and realizes that his tooth has completely come out of his mouth. What is a parent to do at this point?
The first step in providing treatment is to remain calm by knowing that an avulsed tooth can be successfully replanted if certain steps are followed in a timely fashion. This injury requires immediate attention and the sooner a tooth is replanted the better its prognosis.
Make sure that the tooth involved is a permanent tooth since baby teeth should not be replanted. Handle the tooth by the crown surface (the larger end of the tooth that is more angular and not the cone shaped end).
If the root of the tooth is dirty, gently rinse in cold water, saline or milk for ten seconds and never scrub the root The best immediate treatment is to have the patient or parent replant the tooth into its socket and hold it in a position similar to nearby teeth. If this cannot be done, place the tooth in an appropriate storage medium such as cold milk, saliva, or contact lens solution (saline). Avoid storing the tooth in water.
Furthermore, parents, nurses and coaches can prepare themselves for this situation by having Hanks Balanced Salt Solution, popularly known as "ToothSaver", readily available in a first aid kit. ToothSaver is the ideal tooth medium formulated to keep an avulsed tooth viable for as long as 24 hours.
Once in a suitable storage medium, immediately call your dentist as further treatment will be necessary. Remember to remain calm and attempt to see your dentist within the hour.