Last updated: 11/24/2009

When a tooth is dislodged, it is critical to recover the tooth, preserve it under proper conditions, and get the patient to a dentist immediately. The tooth should be handled carefully; it should be picked up or touched by its crown (the top part of...

the tooth), not by its root. The tooth should be rinsed and kept moist, but not cleaned or brushed. The use of toothpaste, soap, mouthwash, or other chemicals can remove the fibroblasts clinging to the root of the tooth. Fibroblasts are connective tissue cells that act as a glue between teeth and the underlying bone.

The avulsed tooth can be placed in milk or a Save-a-Tooth (R) kit, which is a tooth-preserving cup that contains a medium for preserving the fibroblasts around the tooth. The tooth and the patient should go to the dentist within 30 minutes of the accident since fibroblasts begin to die within that time. Rapid treatment improves the chances for successful replantation. In some cases, artificial fibroblasts can be substituted for the patient's own connective tissue cells.

If the tooth is a primary tooth, it should be rinsed and kept moist also. The dentist should be consulted to determine whether the tooth should be replanted by examining the gums and the emergent tooth. The dentist will take a set of x rays to determine how soon the permanent tooth is likely to emerge. Sometimes an artificial spacer is placed where the primary tooth was lost until the permanent tooth comes in.

Any injury to the gum is treated before the tooth is replanted. The dentist may give the patient an antibiotic medication to reduce the risk of infection. Cold compresses can reduce swelling. Stitches may be necessary if the gum is lacerated. The dentist may also take x rays of the mouth to see if there are other injuries to the jawbone or nearby teeth.