Avulsed Tooth (Knocked-Out Tooth) – First Aid in Milk, Treatment, Management, What to do

Key Facts

• An avulsed tooth refers to a tooth that has been completely knocked out of its socket
• It is a dental emergency that requires immediate attention
• The tooth has the best chance of survival if it is replaced within 30 minutes of being knocked out
• Avulsion can happen to anyone but is more common in people involved in contact sports or physical activities
• The long-term prognosis of an avulsed tooth depends on various factors, including the condition of the tooth, how long it was out of the mouth, and the treatment received

What is an Avulsed Tooth?

An avulsed tooth is one that has been completely displaced from its socket in the jawbone, usually due to trauma or injury. Unlike a loose or luxated tooth, which is partially dislodged but still attached, an avulsed tooth is entirely out of its socket. This can occur in both primary (baby) and permanent teeth. The blood vessels, nerves, and supporting tissues are often damaged as well. An avulsed tooth is a dental emergency, and swift action is necessary to improve the chances of saving the tooth.

Who Might Get an Avulsed Tooth?

While an avulsed tooth can occur in anyone, certain groups are at a higher risk:

• Athletes and Sports Enthusiasts: People involved in contact sports such as rugby, football, hockey, and martial arts are at a higher risk due to the physical nature of these activities.
• Children and Adolescents: Kids and adolescents are prone to falls and accidents, which make them more susceptible to tooth avulsion.
• People with Pre-existing Dental Issues: Individuals with dental problems such as periodontal disease might have weakened tooth support, making the teeth more susceptible to avulsion.
• People Involved in Physical Labor: Those involved in physical labor, especially without using protective equipment, are at risk due to the chances of accidental impact to the face.

It is important to recognize that tooth avulsion can be a highly distressing and painful event. Beyond the physical pain, it may also have psychological impacts, especially if the avulsed tooth affects the person’s appearance and ability to chew or speak normally.

What Causes Tooth Avulsion?

Tooth avulsion typically occurs as a result of trauma or injury to the mouth.
Here are some common causes:

• Sports Injuries: Engaging in contact sports such as football, rugby, or martial arts without proper mouth protection can lead to tooth avulsion.
• Falls and Accidents: Falling down or being involved in an accident where there’s an impact to the face or mouth can cause a tooth to be knocked out.
• Physical Altercations: Incidences of violence or physical altercations where a blow to the mouth occurs can lead to tooth avulsion.
• Biting on Hard Objects or Foods: Occasionally, biting down hard on foods or objects, especially if the teeth are already weakened, can cause a tooth to be knocked out.
• Severe Periodontal Disease: In cases where there is severe gum disease, the support structures of the teeth may be weakened, making them more prone to avulsion even with minor trauma.

What Are the Symptoms of an Avulsed Tooth?

The symptoms of an avulsed tooth are usually quite apparent and may include:

• Missing Tooth: The most obvious sign is the physical absence of the tooth in the mouth.
• Pain and Discomfort: There’s usually pain at the site where the tooth was knocked out.
• Bleeding: Bleeding from the socket or surrounding gums is common.
• Swelling: The gums and surrounding area may swell.
• Difficulty Speaking or Eating: Depending on the location of the avulsed tooth, there may be difficulty speaking or eating.
• Sensation of a Gap: The tongue may feel the gap where the tooth was located.

Can I Treat an Avulsed Tooth Myself?

An avulsed tooth is a dental emergency, and while there are steps that can be taken immediately following the incident to improve the chances of saving the tooth, it is crucial to seek professional dental care as soon as possible.
Here are steps to take immediately after a tooth has been knocked out:

• Find the Tooth: Locate the avulsed tooth and pick it up by the crown, not the root, to minimize damage to the root.
• Clean the Tooth if Necessary: If the tooth is dirty, gently rinse it with milk or water. Do not scrub the tooth or use any cleaning agents.
• Reinsert the Tooth if Possible: If you can, try to reinsert the tooth into the socket. Gently push it in with your fingers, by handling the crown, or position it above the socket and close your mouth slowly. Hold the tooth in place with your fingers or by gently biting down on it.
• Keep the Tooth Moist: If it’s not possible to reinsert the tooth, keep it moist by placing it in a small container of milk or a tooth preservation product. Avoid storing it in water.
• Seek Dental Care Immediately: Go to a dentist or emergency room as soon as possible. The sooner the tooth is re-implanted, the higher the chances of saving it.

Remember, while taking these steps can be helpful, it is not a substitute for professional dental care. An avulsed tooth requires the attention of a dentist or oral surgeon for the best chances of saving the tooth.

What Should I Do If I Can’t Find My Tooth?

If you can’t find your tooth after it has been knocked out, it is still important to act quickly and seek emergency dental care.
Follow these steps:

• Remain Calm: Keep calm so that you can think clearly and act efficiently.
• Manage Bleeding: If there is bleeding from the socket where the tooth was knocked out, apply a clean cloth or gauze and bite down gently to stop the bleeding.
• Look Carefully: Sometimes the tooth can be lodged in the mouth or lips, so make sure to check these areas thoroughly.
• Seek Dental Care: Even if you cannot find the tooth, it is important to see a dentist as soon as possible. The dentist can evaluate the injury and discuss options for dealing with the lost tooth, such as dental implants or bridges.

What Should I Do If I Only Find Part of My Tooth?

If only a part of your tooth has been knocked out and you are able to find it, it’s important to take the following steps:

• Handle with Care: Pick up the fragment carefully without touching any exposed roots.
• Rinse if Necessary: Gently rinse the tooth fragment with water or milk if it is dirty. Do not scrub or use any chemicals.
• Store the Fragment: Place the tooth fragment in a small container with milk, or a tooth preservation product to keep it moist.
• Seek Dental Care: See a dentist as soon as possible. Bring the tooth fragment with you. Depending on the situation, the dentist may be able to bond the fragment back to the remaining tooth structure.

How Do Healthcare Providers Treat an Avulsed Tooth?

Treatment for an avulsed tooth depends on several factors including how long the tooth has been out of the mouth, the condition of the tooth, and the patient’s overall oral health.
The general steps for treatment are:

• Cleaning the Tooth and Socket: The dentist will gently clean the avulsed tooth (if it has been found and brought in) and the socket.
• Reimplantation: If the tooth is in a condition that allows for it, the dentist may attempt to reimplant the tooth into its socket.
• Stabilization: The reimplanted tooth will need to be stabilized. This is often done using a splint that attaches the tooth to adjacent teeth.
• Follow-up Care: Antibiotics may be prescribed to prevent infection, and the patient will need to return for follow-up visits to monitor the healing process.
• Root Canal Therapy: In many cases, a tooth that has been avulsed and reimplanted will need root canal therapy to treat or prevent infection in the tooth’s root.
• Alternatives if Reimplantation is Not Possible: If the tooth cannot be reimplanted, the dentist will discuss alternative options for replacing the missing tooth, such as dental implants, bridges, or partial dentures.

It’s important to note that saving an avulsed tooth is not always possible, and outcomes can vary. However, prompt action and immediate dental care can significantly improve the chances of saving the tooth.

How Do I Take Care of Myself After Tooth Reimplantation?

Taking care of yourself after tooth reimplantation is essential for the healing process and for the success of the procedure.
Here are some steps you should take:

• Follow Dentist’s Instructions: Your dentist will provide specific instructions for care after reimplantation. It’s crucial to follow these guidelines.
• Take Prescribed Medications: If your dentist prescribes antibiotics or pain medication, be sure to take them as directed.
• Eat Soft Foods: For the first few days, stick to a diet of soft foods to avoid putting pressure on the reimplanted tooth.
• Avoid Using the Reimplanted Tooth to Chew: Chew on the opposite side of your mouth to minimize stress on the reimplanted tooth.
• Keep the Mouth Clean: Maintain good oral hygiene, but be gentle around the reimplanted tooth. Rinse with a saltwater solution to keep the area clean if advised by your dentist.
• Avoid Smoking and Alcohol: These can inhibit the healing process.
• Attend Follow-up Appointments: It is important to see your dentist for any follow-up appointments to monitor the healing process.

Can I Prevent Tooth Avulsion?

While it’s not always possible to prevent accidents that lead to tooth avulsion, here are some preventive measures:

• Wear Mouth Guards: If you participate in contact sports or activities with a risk of falls, wearing a protective mouthguard can help protect your teeth.
• Address Tripping Hazards: Make your living space safer by ensuring that there are no loose carpets or clutter that could cause a fall.
• Avoid Using Teeth as Tools: Don’t use your teeth to open bottles or packaging, as this can weaken them.
• Maintain Good Oral Health: Strong, healthy teeth are less likely to be avulsed. Regular dental check-ups, brushing, and flossing are essential.

What Is the Outlook for People with an Avulsed Tooth?

The outlook for people with an avulsed tooth varies depending on several factors, including how quickly they receive treatment, the health of the tooth, and the individual’s overall oral health.

• If the tooth is reimplanted successfully and heals properly, it can last for many years. However, ongoing dental care may be needed.
• If reimplantation isn’t successful or possible, there are several prosthetic options such as dental implants, bridges, or dentures that can offer good outcomes for tooth replacement.
• There may be psychological impacts, especially if the avulsed tooth is in a visible location. It’s important to discuss these concerns with a healthcare provider.

In general, the sooner a person with an avulsed tooth receives dental care, the better the outcome. Long-term success often involves a combination of prompt treatment and excellent ongoing oral care.

When Should I See My Healthcare Provider About a Reimplanted Tooth?

After a tooth has been reimplanted, it is essential to closely monitor the area for any signs of complications.
You should see your healthcare provider or dentist in the following situations:

• Immediate Follow-up: Attend any scheduled follow-up appointments after the reimplantation procedure, as your dentist will want to ensure that the tooth is healing properly.
• Pain or Discomfort: If you experience severe pain, increased sensitivity, or discomfort that does not subside after the expected recovery period, it’s important to see your dentist.
• Looseness or Movement: If the reimplanted tooth feels loose or starts to move, this could indicate a problem with the healing process.
• Signs of Infection: If you notice swelling, redness, pus, or if you develop a fever, these could be signs of an infection and require immediate attention.
• Changes in Color: If the reimplanted tooth changes color (turns gray or dark), this could indicate a problem with the tooth’s blood supply.
• Difficulty Eating or Speaking: If you have trouble eating or speaking, or if the tooth interferes with your bite, see your dentist.

Avulsed tooth ICD-10 code

ICD-10 code for an avulsed tooth (a tooth that has been knocked out), is S03.2 (Dislocation of tooth). There are 3 child code categories for specific cases:

• S03.2XXA – Dislocation of tooth, initial encounter
• S03.2XXD – Dislocation of tooth, subsequent encounter
• S03.2XXS – Dislocation of tooth, sequela

Bottom Line

Tooth avulsion is a dental emergency, and the management of an avulsed tooth is critical for its prognosis. Reimplantation, when possible, is often the best option. However, this procedure requires careful post-operative care to ensure the tooth heals properly and functions well. Regular dental check-ups are crucial to monitor the health of the reimplanted tooth. Attention to oral hygiene, following the dentist’s instructions, and being vigilant about potential signs of complications are key factors in the long-term success of a reimplanted tooth. In cases where reimplantation is not feasible or successful, there are alternative dental prosthetics that can restore function and aesthetics. In any case, maintaining good oral health and taking preventive measures can go a long way in avoiding tooth avulsion and ensuring a healthy smile.

This article is complete and was published on July 06, 2023, and last updated on August 25, 2023.