An avulsed tooth is when a tooth is completely knocked out from its socket in the alveolar bone. This occurs almost exclusively because of dental trauma. As always, prevention is key and it is always recommended to use helmets and mouth guards whenever participating in sports or events where tooth trauma may be possible.

When dental avulsion occurs to a permanent tooth, it should be handled like a dental emergency, as its one of the few actual dental emergencies that can actually happen. The tooth should be gently rinsed with water, but care should be taken not to touch the root and handle it as minimally as possible. The dentist may attempt to replace it and splint it to the adjacent teeth for several weeks to stabilize it. There is a chance that it will fail to be successfully re-implanted, especially if it takes longer than an hour for it to reach the dentist.

The tooth needs constant nourishment through its ligaments into the pulp. When it is knocked out, all the ligaments become severed along the root of the tooth. The hope is that if they place the ligaments next to each other, they will reattach and heal. One of the key parts of making sure this is a success, is making sure to prevent cell crushing. This happens when you touch the root of the tooth, and whenever a part of the tooth is touched that is not the crown. If the cells of the ligament get crushed, they will be unable to reattach to the other end of the ligament and heal properly.

Dentists often recommend that locations where a tooth may be lost keep a storage container suitable to store the tooth in order to extend the time before the tooth can be reattached. The most common ways to store it is in saliva, saline, milk, and balanced pH fluids. The mouth can be the best place to store it, but it almost guarantees that it will have cell crushing making it hard to re-implant. There are kits of solution that tend to be the most effective method of preserving the tooth, some allowing it to last up to 24 hours with minimal cell death. The tooth needs to stay moist, but it can’t be safely kept in water because the pH levels are too low so it ends up killing the cells. The low pH levels cause the cells to burst.

Tooth avulsion occurs more than you may think. Every year in the United States there are approximately 5 million reported cases. This happens traditionally in school aged children and military personnel as well as professional fighters and individuals who play contact sports. If a tooth does not recover in time, it typically ends with a Dental Implant.