February 3, 2010

Loose Tooth and Other Dental Emergencies

Injury to the teeth, gums, or mouth may occur during the course of normal everyday activities such as eating or exercising. Dental trauma can include the fracturing, chipping, or loose tooth, or the avulsion (knocking out) of a tooth. Consequently, it is important to inform oneself about the proper responses – as well as precautions — to dental emergencies to ensure the successful repair of the damage by a dental professional.

Loose or Avulsed Tooth

If you find a loose tooth due to sudden trauma, gentle pressure should be applied to coax it back to its original position. The injured party should then bite down cautiously to hold the loose tooth in place, then contact his or her dentist immediately or visit an emergency room.

If a tooth is knocked out of place (i.e., avulsed), the tooth should be retrieved by the crown, not the root, since the latter action might damage the cells necessary for bone reattachment. The tooth should be carefully rinsed – not scrubbed – to eliminate dirt without removing any attached gum tissue. If possible, the injured party should gently reinsert the tooth into its socket, or place it between the cheek and gum to prevent drying. Alternatively, the tooth can be immersed in a cup of milk, saliva, or saline solution (used for contacts) preferably after wrapping it in a clean cloth or gauze and then covering the cup with a lid. It is very important to retain the tooth’s moisture and to visit the dentist quickly, within an hour if possible, to grant the tooth the best chance of surviving the trauma.

Trauma to a Primary (Baby) Tooth

The greatest incidence of trauma to primary teeth occurs at about two or three years of age when the child is developing motor skills. Despite their transitory nature, baby teeth are important for controlling the growth pattern of a child’s face as well as affecting a child’s speech patterns. As a result, carelessness in responding to primary tooth emergencies could permanently affect a child’s oral health. Should a child experience dental trauma that loosens a baby tooth prematurely, the parent or caretaker should immediately take the child to the dentist, since the tooth may need to be extracted to avoid damage to the developing permanent tooth beneath.

Likewise, should a child traumatically lose a baby tooth (i.e., due to excessive wiggling of a loose tooth), the parents or caretakers should take the child to the dentist immediately to examine the area and rule out the possibility of bone fracture or other damage. Premature loss of primary teeth can have negative repercussions, given that these teeth maintain the proper alignment of permanent teeth, thus increasing the likelihood that the second set will come in straight. Although a prematurely lost baby tooth should not be replanted because of the potential for injury to the developing permanent tooth, in some cases, fixed or removable appliances can be fitted for aesthetic purposes or to regain a loss of oral or phonetic function.

Preparing for and Avoiding Dental Emergencies

Dental emergencies such as a loose tooth can be avoided or mitigated by taking a few simple precautions such as wearing a mouth guard during rigorous contact sports, avoiding chewing on hard foods, candy, or ice, and seeing one’s dentist to treat nocturnal grinding or clenching.

As an additional precaution, one should prepare a dental emergency kit, including the dentist’s name and phone number, saline solution (in which to immerse an avulsed tooth; be sure to update the solution periodically), a clean cloth or handkerchief, gauze, a small container with a lid, and ibuprofen. The latter is very important, since aspirin can cause excessive bleeding during a dental emergency or trauma.