Fractured, Loosened, and Knocked-Out Teeth
A person who has brief, sharp pain while chewing or while eating something cold may have an incomplete (greenstick) fracture of a tooth. As long as the fracture is incomplete and part of the tooth has not split off, the dentist can correct the problem with a restoration.
The upper front teeth are prone to injury and fracture. If after an injury a tooth is not sensitive to air, most likely only the hard outer surface (enamel) has been harmed. Even if the enamel has sustained a small chip, immediate treatment is not required. Fractures of the intermediate layer of the tooth (dentin) are usually painful when exposed to air and food, so people with such fractures seek dental help quickly. If the fracture affects the innermost part of the tooth (pulp), a red spot and often some blood will appear in the fracture. Root canal treatment may be needed to remove the remaining pulp before it dies and causes severe pain.
If an injury loosens a tooth in the socket or if the surrounding gum tissue bleeds a great deal, a person should see a dentist immediately. Damaged baby (deciduous) teeth in the front of the mouth may be removed if the tooth is seriously loosened to prevent harm to the permanent teeth without losing space for those that are yet to come.
Knocked-out (avulsed) baby teeth should not be reimplanted for fear it will damage the permanent tooth bud. A knocked-out permanent tooth requires immediate treatment. The tooth should be rinsed off and placed back in its socket. If that is not possible, the tooth should be placed in a glass of milk (the milk provides a good medium for sustaining the tooth). In either case, the person and the tooth should be taken immediately to the nearest dentist.
If a tooth is reimplanted within 30 minutes, the likelihood that it will stay healthy is good. The longer the tooth is out of the socket, the worse the chance for long-term success. The dentist usually splints the tooth to the surrounding teeth for 7 to 10 days. Reimplanted teeth eventually need root canal treatment. If the bone around the tooth also has been fractured, the tooth may have to be splinted for 6 to 10 weeks.
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