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As a child, losing a primary tooth can be an exciting moment. It usually means that the tooth fairy is going to visit you and shower you with some cash. As an adult, losing a permanent tooth can be quite devastating; it will take a lot more than a tooth fairy to make the situation better. There are many reasons why permanent teeth may fall out. It can occur due to poor oral hygiene. Periodontal disease occurs when bacteria under the gum line remain undisturbed and spreads the infection to eventually separate the teeth from the gums leading to mobility and eventual dental avulsion. There are also systemic diseases and illnesses such as oral cancer that can manifest in the oral cavity and disrupt bone structure which eventually would lead to tooth loss.
But what if neither of these issues is the reason your tooth fell out? What if it is because of a physical injury of hard impact that caused immediate avulsion of your tooth? Here is what you can do.
Head to your dentist immediately. Typically, for every minute that your tooth is out of the mouth, the chance of it being successfully re-implanted goes down by 10%. Your best bet is to locate your tooth and pick it up by the crown. Make sure to leave the root undisturbed – this is crucial. Rinse the tooth in milk and place it immediately back into your socket if possible. Do not clean the tooth because the root still has PDL (periodontal ligament) cells which are necessary for its reattachment into the socket.
If for some reason you cannot store the tooth back into the socket, store the tooth in milk and get it to your dentist as soon as possible.
What you can expect when you arrive to your dentist are some x-rays and examinations. The dentist will splint the tooth using an orthodontic appliance and composite while keeping it slightly out of occlusion. What this means is that the tooth will be kept in place with dental materials in a way that ensures that during mastication (chewing) and speech, no contact or pressure will be applied to that tooth.
After 4 weeks, the attachment will be examined by the dentist. In many cases, the tooth ends up needing endodontic treatment as the avulsion causes neurovascular disruption and pulpal necrosis. This requires a test for tooth vitality- this is when the dentist will spray Endo-ice on your tooth to assess a response. As there is also a concern for infection, x-rays will be taken again and proper follow-up will proceed.