It's something every parent worries about. Your child comes back from the playground with a tooth knocked out after falling off the jungle gym. To complicate the situation, the accident occurs on a Sunday afternoon, and your family dentist is not in the office until Monday. The question is: what to do? Fortunately, there are some things that you can do to save a knocked out tooth.
The first thing to do is to find the tooth and immediately rinse it off, but do not scrub with plain or salt water. You should then try to determine if it is a baby or an adult tooth. Although this requires some instruction, there are general guidelines that can assist you.
First, baby teeth are smaller and usually whiter than adult teeth. The age of the child is also important. If the child is under 5 years of age, the tooth is most likely a baby tooth and does not need to be saved. If the child is more than 12 years old, it is probably an adult tooth, and every effort should be made to preserve it. It is also important to know that the teeth most often knocked out are the upper two front teeth, directly in the middle of the mouth (the central incisors). These adult teeth usually come in when a child is 6 years old.
If you are relatively sure it is an adult tooth, the best thing to do is place it back into the socket that it was knocked out of. Remember to hold the tooth by the dental crown, and gently guide the root into the socket. A good way to remember the correct orientation of the tooth is to match the surrounding teeth and remember that the part of the tooth that faces outward is rounded or convex (for a front tooth). The best hope for success is if the tooth is re-inserted within five minutes. You should then see your dentist as soon as possible.
If you can get to your dentist within an hour, but are unable to re-insert the tooth into the socket, you should store the tooth in your child's saliva or in cold milk. Your dentist will examine and clean the area of injury. The tooth will be re-inserted and then fastened for stability to the surrounding teeth for 7-10 days. If the tooth heals, it will then require root canal therapy. Unfortunately, if the tooth is not re-inserted into the socket within one hour of the accident, there is a high likelihood that the tooth will be lost. Although not practical for year-round use, I recommend that all children involved in contact sports wear a customized athletic mouth guard to prevent injury to the teeth and jaw.
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