The term dental avulsion refers to the complete removal of a tooth from its socket after a traumatic injury. Front tooth injuries during childhood are fairly common. When the tooth is completely knocked out of its socket (avulsed), it is a severe injury.

The maxillary central incisors are the teeth which are most impacted by avulsion injuries. Permanent teeth that have not yet matured have less mineralized bone structure. Furthermore, the periodontal ligamentum structure in such teeth is looser which causes these teeth to be less resistant against extrusive forces.

Therefore, children between seven and nine years of age typically suffer from avulsion in case of dental trauma. Experienced surgeon Dr. Landon D. McLain provides treatments for facial trauma to patients in Huntsville, Madison, Florence, Decatur, Scottsboro, Cullman, Athens, Alabama, and surrounding communities.

 

Replanting the Natural Tooth

Replanting the tooth as soon as possible is usually the best option. This holds true only in the case of permanent teeth. After the tooth is replanted, it can heal in two ways if properly managed. In ideal circumstances, the ligament around the tooth reforms and the longevity of the tooth is the same as any other tooth. This is called “periodontal healing.”

In cases of excessive ligament damage, the healing takes place by bony replacement. Effectively, bone replaces the tooth and is lost over a few years. This is known as “bony healing.’

 

Patient Guidelines

• The patient should remain calm.
• Locate the tooth, and lift it by the white part (crown). Do not touch the root.
• In case the tooth appears dirty, wash it briefly for around ten seconds under cold running water and place it in its position. The patient or parent should try to replant the tooth. The patient should be made to bite on a handkerchief to hold the tooth in place.
• In case this is not possible, store the tooth is an appropriate medium such as a glass of milk or a special storage unit available for knocked out teeth (for instance, saline or Hanks balanced storage medium). The tooth can be transported in the mouth as well by placing it between the molars and the inside of the cheek. However, if the patient is very young, they may swallow the tooth. Therefore, it is perspicacious to ask the patient to spit in a container and store the tooth in it. Do not store the avulsed tooth in water.
• Seek immediate dental treatment.

In case the tooth is replanted before the patient reaches the oral surgeon’s office, the surgeon will typically undertake the following:

• Let the tooth remain in place
• Cleanse the area with saline, water spray, or chlorhexidine
• Suture gingival lacerations if required
• Assess the normal placement of the replanted tooth clinically as well as with an x-ray
• Place a flexible splint for up to two weeks
• Systematically administer antibiotics with tetracycline being the first choice. If the patient is young, the surgeon may administer phenoxymethyl penicillin (Pen V) or amoxicillin at suitable a dosage on the basis of the patient’s weight and age as an alternative to tetracycline.
• In case the avulsed tooth has been in contact with contaminants such as soil and if uncertain of tetanus coverage, refer to a physician for a tetanus shot.
• The surgeon will also initiate root canal treatment between seven to ten days of the replantation and prior to the removal of the splint.

Dedicated surgeon Dr. Landon D. McLain receives patients from Huntsville, Madison, Florence, Decatur, Scottsboro, Cullman, Athens, Alabama, and nearby areas for facial trauma treatments.

McLain Surgical Arts is a leading cosmetic surgery practice headed by Dr. Landon D. McLain MD, DMD, FACS in Huntsville, AL. Dr. McLain is a double board certified cosmetic and oral & maxillofacial surgeon, offering a variety of procedures such as dental implants, wisdom teeth extraction, breast augmentation, liposuction, rhinoplasty, tummy tuck, facelift, Botox, and laser skin resurfacing. For more information or to schedule a consultation call 256.429.3411 or click here.

Now taking patients from Huntsville, Scottsboro, Decatur, Madison, Athens, Florence, Cullman, AL and surrounding areas.