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Knocked Out (avulsed) Permanent Tooth Information

• Prior to the injury to your child’s mouth, the tooth was held in place and attached to bone by fibers and cells called the periodontal ligament. These fibers were torn apart from the tooth and damaged during the accident or by the length of time the tooth was out of the mouth. We know that if the tooth is out of the mouth longer than 5 minutes, it will never be the same again. The periodontal ligament cannot re-establish connection, but can heal by alternate methods. There are things that we can do to help establish this connection, but ultimately it is up to the body to heal itself.
• The long term prognosis for knocked out teeth is poor. Eventually, most teeth that have been knocked out will need extraction. It is our goal to prevent this as long as possible.
• The nerve (what gives teeth blood supply and feeling) was also separated from the body and damaged. The nerve tissue is unable to re-establish connection to the body and will die. The dead tissue will need to be removed to prevent infection. It is important to schedule an appointment with an Endodontist (Root Canal Specialist) as soon as possible to have the tooth evaluated.

Things we know

• Nerve healing and periodontal ligament healing is dependent on three things:
  • Length of time the tooth was out of the mouth (the least amount of time the better)
  • What medium was the tooth stored in while out of the mouth
  • The age of the child (the older the better)
• The best was to prevent infection is a root canal, but it is not a guarantee

Things that cause a tooth to fail:

• Infection can cause tooth root to dissolve
• The tooth root can become attached to the bone and remain in the same location as the child grows. This will cause the tooth to appear shorter than the teeth next to it)
• The tooth root can become a part of the bone and dissolve away.

Home Care Instructions:

• Soft diet for two weeks
• Rinse with Chlorohixidine mouth was for two weeks
• Normal brushing twice a day
• Take antibiotic prescribed by dentist as instructed
• Call Endodontist for root canal treatment

Future Treatment Needs:

• The splint placed to hold the tooth in position will be removed in two weeks
• Radiographic (x-ray) evaluation of the tooth will occur regularly for an extended period of time.