How To Save A
Knocked Out Tooth
Every year, there are more than 5 million cases of knocked out teeth in the United States alone. A knocked-out tooth, also known as an avulsed tooth, can be saved if the proper care is applied before treatment. The most effective method of pre-treatment is preserving the tooth so that it can be replanted by a dentist. A knocked-out tooth will only survive 1-2 hours without preservation, with a steep decline in viability after 1 hour out of the socket. No method is 100% effective but taking the proper steps will ensure the best possible chance of success.
Save-A-Tooth is a device that preserves and protects the tooth on the way to the dentist. It uses Hanks Balanced Salt Solution (HBSS) to preserve the tooth for up to 24 hours. With Save-A-Tooth, a patient has the time they need to get proper care with a 91% viability rate.
Find the tooth and pick it up by the enamel, also known as the chewing surface. Be careful to not touch the root! The root is extremely fragile and damaging it will lower the chances of a successful replantation.
Place the tooth carefully into Save-A-Tooth, root side down, and closer the lid.
Carry the Save-A-Tooth to a dentist or emergency room.
Carry The Tooth In
If Save-A-Tooth is not present at the scene of the accident, the next best option is carrying the tooth to the dentist’s office or an emergency room. The rate of survival is lower, but you will not sacrifice your most valuable asset - time.
Check the patient for more serious injuries.
Find the tooth and pick it up by the enamel. Do not place the tooth down on any surface or try to wash it.
Immediately go to your general dentist or to an emergency room and request the nurse calls the on-call dentist.
The dentist will properly prepare and replant the tooth. Ask for Save-A-Tooth storage. The clinic or emergency room might have one and it will improve results.
Using the following methods is risky and does not provide the same level of clinical efficacy that Save-A-Tooth does. Using the following methods may result in the loss of the tooth.
Placing the Knocked-out Tooth in Milk
You may have heard the myth that placing a knocked-out tooth in milk will preserve it long enough to bring the tooth to the dentist for replanting. The truth is that milk has no preservative properties. If you place a tooth in milk after it has been knocked-out, you still only have 1-2 hours before the tooth isn’t viable for replanting.
The only thing milk has to offer as a storage medium for a knocked-out tooth is that is it less damaging than water or saline. However, because milk is opaque, removing the tooth without touching and damaging the root can be tricky.
Using milk that is more than 3 days old or skim milk or a milk alternative like soy, will cause serious damage to the cells on the root.
Placing Knocked-out Tooth in Saline Solution
Like milk, saline solution has no preservative qualities for knocked-out teeth. The same 1-2-hour rule applies with or without saline. You will still need to rush to the dentist to have the tooth replanted.
Saline is not appropriate for tooth storage, but it is an appropriate rinsing solution alternative to water, if you plan to replant in the field.
Saline solution is not an effective way to either preserve or safely transfer a knocked-out tooth to the dentist.
Storing Knocked-out Tooth in Tap Water
Rinsing or storing the tooth in tap water is incredibly harmful to the tooth and should be avoided entirely. The chlorine and pH of water will damage the tooth root cells. This includes rinsing. If saline or HBSS is not available, carrying the tooth in dry is always the better option.
Water is not a preservative. It will not keep your tooth alive. Additionally, water has no container to prevent damage.
For the above reasons, water is not an effective way to preserve or safely transport a knocked-out tooth to the dentist.
Holding Tooth Between the Gums and Cheek
The method of tucking the knocked-out tooth between the gums and the cheek is incredibly damaging to the delicate root cells. There is a high probability of physical damage to the root using this method, as it is right next to your teeth and squeezing against your gums. There is also the risk that the tooth can be swallowed. On top of the potential physical damage, saliva is not a preservative, not sterile, and has poor pH qualities.
Holding the knocked-out tooth in your mouth is not a safe of effective method of transporting your tooth to the dentist.
Replanting the Knocked-out Tooth On-site
The biggest issue with replanting in the field is that no matter how skilled the medical staff is, the tooth will still have to be pulled out again by a dentist to permanently prepare and replant it. This ultimately leads to greater trauma, and greater risk of resorption despite providing more time to get to the dentist. This method should only be used if you are extremely far from care or do not have Save-A-Tooth available.
If you are untrained in this procedure, attempting to re-insert the tooth yourself can cause damage to the tooth socket or the root.
Replanting may not be possible if the patient has more serious injuries that need to be tended to by a trained professional. Therefore, it is safer for both the patient and the tooth to transport the tooth properly and to see a dentist as soon as possible.