What to Do If a Permanent Tooth Falls Out

Losing a permanent tooth is one of the most stressful dental emergencies that you can experience. You need to act fast if you have lost an adult tooth because the chances of successfully re-implanting the tooth depend greatly on how quickly you see a dentist. Here is an explanation of what you should do if you lose a permanent tooth so you can be prepared to act quickly and save the tooth.

Retrieve and Clean the Tooth

Your immediate priority after losing a permanent tooth should be to locate the tooth and remove any dirt or debris that may be on it. When you pick the tooth up, be careful to handle it by the crown only, not the root. The root of the tooth is fragile, and it is also covered in connective tissue cells known as fibroblasts that can be damaged if you handle the root.

Once you have retrieved the tooth, examine it to determine if it can be saved. Teeth that are broken or severely cracked are often unable to be re-implanted. If the tooth is dirty, rinse it with milk or water to remove as many contaminants as possible. Do not brush or scrub the tooth because this can damage fibroblasts and increase the chances that you will break the tooth.

Store the Tooth and Visit Your Dentist

The way you store the lost tooth on the way to see your dentist will have the greatest impact on replantation viability. The best way to store the tooth is to try to reinsert it in the dental socket. If the tooth is turned the right way and isn't broken, the tooth will often slip back into the socket with little resistance. Place gauze over the tooth and bite down gently to hold them in place.

If you can't place the tooth back in its socket, the next best option is to keep it moist outside of your mouth. Unfortunately, water will not do much to preserve the tooth's fibroblasts while you're on your way to the dentist. Instead, you should submerge the tooth in a cup of milk or your own saliva to maximize the amount of time before the fibroblasts on the root begin to die.

Replantation and Follow-up

The biggest complication of re-implanting a lost permanent tooth is that the nerves, blood vessels, and supporting tissues in the dental socket cannot be repaired. Because of this, replantation depends solely on the ability of the fibroblasts to fuse the root of the tooth with the jawbone. The damaged nerves and blood vessels will also cause the pulp of the tooth to decay over time, so a root canal is almost always required.

The first steps your dentist will take are to administer local anesthetic, cleanse the area with saline, and suture any cuts or tears in the gums. The dentist will then verify that the tooth is positioned correctly and apply a splint to hold the tooth in place for a number of weeks. The splint is made of dental resin and wire that runs from the loose tooth to one or more adjacent teeth.

Your dentist will perform a root canal during a follow-up visit, normally before the splint has been removed. You will also be prescribed antibiotics to reduce your risk of infection from germs that may have been present on the lost tooth. Several follow-up visits will be necessary to assess how well the tooth is reintegrating with the jawbone and to eventually remove the splint.

Replantation of a lost permanent tooth is a relatively simple process, but success is entirely dependent on how you react and how quickly you see your dentist. Keep these tips in mind and visit Joseph M. Perry, D.D.S., P.A., if you experience a lost tooth or any other dental emergency.