Look Mom...No Teeth....!! Basic Guidelines for Management of Avulsed Tooth

This post purely describes the protocol for immediate management of tooth loss due to trauma. This one is for all you mommies and daddies who have little kids that are highly active and vulnerable to injuries.

Little children are usually curious to explore new things and try new activities i.e. jumping from the sofa, sprinting, riding a bicycle/tricycle, etc.. All these activities possess some uncertainty which could expose your child to injuries. At times the kid may get away by a simple scratch or it could be a sever bump. One of the unexpected sequel is that the kid may fall and have a front tooth knocked out of the jaw.

The site of knocked off tooth appears horrible for the parents and the child is equally terrified at the sit of profuse bleeding. In such situation it is wise not to panic and act wisely. At that moment, the present parent/guardian should maintains a composed temperament. The situation can be well managed and the terrified child can be reassured. 

In my first post, i have displayed an image describing the anatomy of a tooth and the structures supporting it. There is a periodontal ligament that is present between the tooth root and the bone. This ligament is a very important barrier between the tooth root and the bone. If the periodontal ligament is destroyed or absent, the tooth usually undergoes ankylosis or root resorption could occur.
Always keep in mind if a tooth is knocked off, it is mandatory to  hold it by crown portion, preferably with the help of a gauze piece or clean cloth. This will avoid destruction of the periodontal ligament during handling of the knocked off tooth.

Next we will look at the sequence for managing the knocked off tooth situation:

  
.
• Evaluate the extent of injury
• Inspect the site to see if the teeth are intact.
• If a tooth is missing, search the knocked off tooth as soon as possible.
• Simultaneously other person is next to the child for reassurance.

• After the knocked off tooth is found, it is mandatory to know how to handle the tooth.
• The knocked off tooth should always be held by the crown portion of the tooth, and only by the crown portion. 

Replace the tooth in its socket

  

• Rinse the tooth under tap water to remove surface dirt.
• The first thing to do is to place the tooth back in to its socket and have the child hold the tooth in place by placing a gauze piece.

• If the tooth cannot be replaced in the socket our next concern if to keep the tooth and the periodontal ligament hydrated.
• The ideal medium for carrying a knocked off tooth in a house hold set up is a glass of cold milk or if the child is mature enough, with simple instructions the tooth can be kept in the oral cavity of the patient till professional help is available.
• After this stage it is best to follow the instructions and advice given by the dental professional.
• The steps are exclusively for PERMANENT TOOTH ONLY and not for milk tooth. If repositioning of a milk tooth is attempted, there are chances of damaging the developing permanent tooth in the jaw.