Michael Apa, DDS, restorative and aesthetic dentist, the Rosenthal/Apa Group, New York City. Dr. Apa teaches aesthetic dentistry at the New York University College of Dentistry.
An occupational hazard in my line of work is that I’m always primed for terrible health news, so when a friend started to tell me that her mother had fallen in the driveway the day before, I expected to hear that she’d broken her hip. I was happy to learn that she’d merely knocked out her tooth! But “merely” wasn’t how it felt to her… fortunately, my friend knew what to do and where to go, so the tooth is now back in place and looks like it might heal just fine.
The incident motivated me to check in with Michael Apa, DDS, restorative and aesthetic dentist and instructor at NYU College of Dentistry, to learn about the right things to do in such a situation. His advice was surprising and practical. (Who knew dental first aid involved tea bags and cottage cheese?)
According to Dr. Apa, most intact teeth (ones that remain connected, even by just a bit of tissue) and many that have been knocked out altogether can be saved if you follow the right steps. First of all, be aware that this is a dental emergency and that it is important to act fast, because the longer a tooth is out of the socket, the less likely it is to be “re-established.” In that case, you’d need an implant.
Here’s what to do if you get a tooth knocked out:
If the tooth is loose but hasn’t left the socket…
If the tooth is out of the socket…
The goal is to try to put the tooth back into place in the gum, if it can be done. Time is of the essence — you’ll have the best chance of saving the tooth if you get to the dentist (or an urgent-care clinic or the hospital emergency room) within 30 minutes. Meanwhile…
Your dentist will clean your gum and stop the bleeding before trying to permanently reimplant your tooth. This is typically done by inserting and then splinting the tooth (with wires, a metal arch bar or plastic bond) for 10 to 14 days, which is how long it takes to fully reattach. Most people will not need stitches nor antibiotics, though a tetanus booster may be necessary if the tooth fell on the ground.
You’ll need to continue to monitor the tooth for some time afterward, with regular follow-up visits. Sometimes root canal becomes necessary down the road, as the nerves may have suffered irreparable damage.
A suggestion: The American Dental Association has endorsed an FDA-approved emergency kit, Sav-A-Tooth ($15), containing a storage case and special saline solution for one tooth. It is available from Amazon.com. One final note — this advice is meant for coherent adults, not children or adults who are groggy from injury and likely to swallow or inhale a loose tooth.