Broken or Knocked-out Teeth (cont.)
Broken or Knocked-Out Teeth Treatment
Self-Care at Home
Before focusing on the teeth, be certain that a life- or limb-threatening injury is not present. For example, if someone fell 10 feet and is not responding, and there is a puddle of blood by the mouth with teeth scattered about, don’t assume there is an isolated injury to the teeth. In the grand scheme of things, dental injuries can wait.
- If a tooth is completely knocked out, it should be quickly rinsed off with water, but never scrubbed. The tooth should be held by the crown (top), not the root, so you do not damage the ligaments. In a cooperative adult, the tooth should be put back in the socket.
- Many people may be uncomfortable reimplanting the tooth on their own. If this is the case, be sure to transport the tooth to the doctor or dentist in saline, milk, or saliva.
- You may also place the tooth between the cheek and gum line of either the person who lost the tooth or any willing adult. The mouth is the best place for the tooth because it protects the root by keeping it moist and providing protection against bacteria.
- Do not transport the tooth dry. This will cause damage within minutes. Transporting the tooth in water is also not recommended.
- In children or uncooperative adults, the tooth ideally should be placed in a "tooth saver" solution, which can be provided by your health care professional. Effective substitutes include saline, milk, or saliva. An uncooperative adult or child may swallow the tooth. Of greater concern, the person may inhale it, causing a choking episode.
- If bleeding from the socket is seen, rinse the mouth out with water. Place a wad of tissue or gauze on the socket and bite down on it. The pressure exerted will usually stop the bleeding.
- For loosened, pushed in, or broken teeth, avoid eating or drinking anything. If the tooth is broken in pieces, retrieve any remaining parts and transport them in one of the suggested solutions.
Joseph J Sachter, MD, FACEP
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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