Dislodged, Fractured, Chipped & Knocked Out Teeth
Traumatic Injuries and Treatment Options
Chipped teeth account for the majority of all dental injuries. Dislodged or knocked-out teeth are examples of less frequent, but more severe injuries. Treatment depends on the type, location and severity of each injury. Any dental injury, even if apparently mild, requires examination immediately. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.
Chipped or Fractured Teeth
Most chipped or fractured tooth crowns can be repaired by reattaching the broken piece or by placing a tooth-colored filling. If a significant portion of the tooth crown is broken off, an artificial crown or “cap” may be needed to restore the tooth. If the pulp is exposed or damaged after a crown fracture, root canal treatment may be needed. These injuries require special attention.
If breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office.
Dislodged (Luxated) Teeth
During an injury, a tooth may be pushed sideways, out of or into its socket. Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started a few days following the injury.
Knocked-Out (Avulsed) Teeth
If a tooth is completely knocked out of your mouth, time is of the essence. The tooth should be handled very gently, avoiding touching the root surface itself. If it is dirty, quickly and gently rinse it in water. Do not use soap or any other cleaning agent, and never scrape or brush the tooth. If possible, the tooth should be placed back into its socket as soon as possible. The less time the tooth is out of its socket, the better the chance for saving it. Call a dentist immediately!
If you cannot put the tooth back in its socket, it needs to be kept moist in special solutions that are available at many local drugstores (such as Save-A-Tooth). If those solutions are unavailable, you should put the tooth in milk. Doing this will keep the root cells in your tooth moist and alive for a few hours. Another option is to simply put the tooth in your mouth between your gum and cheek. Do not place the tooth in regular tap water because the root surface cells do not tolerate it.
Once the tooth has been put back in its socket, your dentist will evaluate it and will check for any other dental and facial injuries. If the tooth has not been placed back into its socket, your dentist will clean it carefully and replace it. A stabilizing splint will be placed for a few weeks. Depending on the stage of root development, your dentist or endodontist may start root canal treatment a week or two later. A medication may be placed inside the tooth followed by a permanent root canal filling at a later date.
The length of time the tooth was out of the mouth and the way the tooth was stored before reaching the dentist influence the chances of saving the tooth. Again, immediate treatment is essential. Taking all these factors into account, your dentist or endodontist may discuss other treatment options with you.