Losing a Permanent Tooth

There are two basic ways to have a tooth removed: You can go to the dentist for a careful extraction, or you can take a serious blow to the face. Unfortunately, many people end up going with option number two. They catch a stray elbow during a basketball game, fall face-first on the sidewalk, or -- in rare cases -- get in a fistfight.

What should I do if I lose a permanent tooth?

A knocked-out (or, in dental speak, "avulsed") tooth is an emergency. If you don't get help soon, it will be impossible to salvage the tooth, and the socket can become badly infected. By taking quick action, you can save both the tooth and the socket.

Here's what you need to do:

• Find that tooth!
• Pick it up by the crown, not the fleshy root. If the root looks dirty, give it a quick rinse with a sterile saline solution, milk, or saliva. Don't scrub it or touch it -- you could wind up losing vital tissue.
• As unappealing as it sounds, try to put the tooth back in its socket. Then hold it in place with gauze or a clean washcloth until you get to a dentist.
• If the tooth won't go back in place, put it in a glass of milk or sterile saline solution. Don't put it in water. (Water doesn't preserve the tooth as well, which can make it more difficult to reimplant.) You can also carry the tooth tucked between your gum and cheek until you get to the hospital or dentist's office.
• Get to a dentist immediately. (And don't forget to bring the tooth!) If a dentist isn't available, go to a hospital emergency room.

What if my child knocks out a baby tooth?

Unlike permanent teeth, baby teeth can't be replaced. If your child knocks out a baby tooth prematurely, don't waste any time looking for it. Instead, comfort your child and help her rinse her mouth out with cold water. Then call a pediatric dentist right away. The dentist won't be able to save the tooth, but he can give your child pain relievers to make her feel better, and antibiotics to prevent an infection. Your child may also need a spacer, a device that keeps the other teeth from crowding into the newly formed gap. This gives future permanent teeth room to grow.

If my tooth isn't knocked out but just loosened, should I still see a dentist?

It's a good idea. Even if the accident left you with only a loose tooth, a dentist's attention can help reduce the risk that the tooth will die or fall out later.

How can I keep my teeth where they belong?

Sports injuries are a leading cause of knocked-out teeth. If you or your child play any sport with a risk of falls or blows to the face, helmets, face masks, and mouth guards should be standard equipment. According to the American Academy of Pediatric Dentistry, that list includes football, basketball, baseball, soccer, hockey, skateboarding, gymnastics, and martial arts. If store-bought mouthguards aren't comfortable, you can get a customized one from your dentist.

References

Peng L and AA Kazzi. Dental, avulsed tooth. eMedicine.

American Academy of Pediatric Dentistry. Sports safety and Dental Emergency.

American Dental Association. News release: ADA says review what to do in a dental emergency.

American Association of Orthodontists. Orthodontic Emergencies and Other Problems. http://www.braces.org