Preserving a Knocked-Out Tooth and the Process of Reimplantation

When a tooth is knocked out, immediate action is crucial to the tooth's survival. This guide provides comprehensive information on how to preserve a knocked-out tooth and the subsequent process of replantation. From proper handling to treatment procedures and follow-up care, we delve into the steps dental professionals take to save a tooth from extraction.

Proper Handling Immediately After Knocking-Out a Tooth

The most important factor in saving a knocked-out tooth is the immediate protection of the root. It is imperative to keep the tooth moist, as the surface cells must remain alive to ensure the root can adhere to the bone during the reimplantation process. Here are the best steps you should take:

Keeps the tooth in the mouth: This is the ideal situation, as it keeps the tooth moist and the cells alive. Saline salt water or milk: The next best option is to store the tooth in a container with saline water or milk until you can see a dentist.

Always make sure the tooth is kept moist as the surface cells will continue to survive and contribute to the reattachment process.

Dental Reimplantation Procedure

Once at the dental office, your dentist will begin the process of replanting the tooth. This procedure is carried out under local anesthesia to ensure your comfort. Here's an overview of the steps involved:

Local Anesthesia: The dentist will numb the area to ensure it is pain-free. Cleaning the Tooth Root: The tooth root will be cleaned using a saline solution to remove debris and contaminants. Flushing the Socket: The dentist will flush the socket with saline to remove any blood clots and prepare the bone surface for the tooth's reimplantation. Reimplantation and Splinting the Tooth: The tooth will be repositioned into the socket and splinted to hold it in place during the healing process. Healing Period: It takes about 10 to 14 days for the tooth to stabilize. Once stable, the splint can be removed.

Challenges and Considerations

While the success rate of replanting a knocked-out tooth is high, there are several factors to consider. Here are some challenges and considerations:

Non-Viable Tooth: Most often, the knocked-out tooth will not be fully viable, as indicated by the darkening of the tooth crown. In such cases, a root canal will likely be necessary before reimplantation. Absorption of the Root: Many knocked-out teeth are lost because the root is absorbed over time. This phenomenon allows for the tooth to remain in the socket until the patient is old enough to receive an implant. Ankylosis: In some cases, the tooth may adhere directly to the bone, leading to difficulties in removing it later.

Case Study: Successful Reimplantation

One memorable case involved a young child who knocked a tooth out during an outdoor hockey game. The tooth was left on the ice overnight and retrieved the next morning. The tooth was successfully replanted and remained in the socket for over a decade before it was eventually removed due to age-related changes.

Immediate and Follow-Up Care

After the replantation, several steps should be taken to ensure the success of the procedure:

Washing and Immersion: Wash the tooth under clean water and place it in a container with milk. Immediate Dental Visit: Visit a dentist immediately as this is an emergency. X-rays will be taken before and after the procedure. Root Canal and Resocketing: In some cases, the root canal may be done before reimplantation. The tooth is then shortened by 1 mm and repositioned. Splinting and Bandaging: The tooth may be splinted to adjacent teeth, and sutures may be applied correctly. Antibiotic Treatment: Antibiotics should be taken for at least three days. Removal of Splint: After about 10 days, the splint can be removed, and any necessary sutures.

The success rate of tooth replantation is relatively high when handled correctly. Follow-up X-rays are essential to monitor the healing process and ensure the tooth remains stable.

Remember that a child's front tooth cannot receive an implant before the patient reaches an adult age. Regular follow-up visits and annual X-rays are crucial to maintain the health and stability of the replanted tooth.