Medicines for Knocked-out tooth

What it is

A knocked-out tooth (dental avulsion) is when a whole tooth, including its root, is completely knocked out of its socket, usually as a result of an injury — such as a fall, a blow to the mouth, a sports injury, or an accident. For an adult (permanent) tooth, this is a dental emergency, and quick action gives the best chance of saving the tooth, because the sooner a knocked-out adult tooth is put back into its socket (reimplanted), the better the chance it will survive. The key factor is time — ideally the tooth should be reimplanted within minutes — and how the tooth is handled and stored in the meantime. There is an important difference between adult (permanent) teeth and children’s baby (milk) teeth: a knocked-out adult tooth should be reimplanted if possible and treated as an emergency, whereas a knocked-out baby tooth should NOT be put back in (as this can damage the developing adult tooth underneath) — but a child with a knocked-out tooth should still be seen by a dentist to check. For a knocked-out adult tooth, the recommended steps are to handle the tooth carefully (holding it by the crown, the white part, not the root), and, if it is dirty, to rinse it very briefly with milk or the person’s saliva (or, if unavailable, water) without scrubbing it or removing any attached tissue, and then, ideally, to gently place it back into the socket the right way round and hold it in place (for example by biting gently on a clean cloth); if it cannot be reimplanted, the tooth should be kept moist by storing it in milk (or in the person’s saliva, for example held inside the cheek if they are old enough not to swallow it) — not in water for long, and not allowed to dry out — and taken to a dentist immediately. Urgent dental care is needed either way. The key messages are that a knocked-out adult tooth is a dental emergency where quick action to reimplant or properly store the tooth and get urgent dental care gives the best chance of saving it, and that knocked-out baby teeth should not be put back but should still be checked by a dentist.

How it is treated

A knocked-out adult tooth is a dental emergency, and the priority is quick, correct action to reimplant or properly store the tooth and get urgent dental care — while a knocked-out baby tooth should not be reimplanted but should still be checked. For a knocked-out adult (permanent) tooth, the recommended immediate steps are: find the tooth and pick it up by the crown (the white part), avoiding touching the root; if the tooth is dirty, rinse it briefly (for a few seconds) with milk, or the person’s saliva, or water if neither is available, without scrubbing it, without using soap or chemicals, and without removing any tissue attached to it; then, if possible, gently reinsert the tooth into its socket the right way round, pushing it in gently and holding it in place by biting gently on a clean cloth or tissue — reimplanting it quickly gives the best chance of saving it; and see a dentist immediately (as an emergency). If the tooth cannot be reimplanted (for example if it will not go back in, or the person is unable), it must be kept moist and not allowed to dry out — the best storage is in milk, or held in the person’s mouth against the cheek (only if they are old enough not to swallow it), and it should be taken to the dentist straight away; water is not ideal for prolonged storage. Speed matters, as the chance of saving the tooth decreases with time out of the socket. For a knocked-out baby (milk) tooth, it should NOT be put back in, because this can damage the developing permanent tooth underneath; however, the child should still be seen by a dentist to check for any other damage. In all cases, urgent dental care is needed, and the dentist will assess the tooth and mouth, secure a reimplanted tooth if appropriate (for example splinting it), and advise on follow-up (which may include checks and, sometimes, root canal treatment for a reimplanted adult tooth). Managing any bleeding (biting on a clean cloth) and pain relief help. It is also important to consider whether there is any other injury (such as to the mouth, jaw, or head) needing attention. Preventing dental injuries — such as wearing a mouthguard for relevant sports — is worthwhile. The key messages are: for a knocked-out adult tooth, act fast — handle it by the crown, briefly rinse it if dirty, reimplant it if possible (or store it in milk), and see a dentist immediately, as quick action gives the best chance of saving it; for a knocked-out baby tooth, do not reimplant it, but still see a dentist.