Dental evulsion

Dental avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma. The condition is considered a dental emergency, and immediate action is crucial for the best possible outcome. Dental avulsion affects both primary (baby) teeth and permanent teeth, with varying management strategies for each case.

Causes

Dental avulsion is most commonly caused by physical trauma to the face or mouth. This can occur during sports, accidents, fights, or falls. Other less common causes include severe periodontal disease, which can weaken the supporting structures of the teeth, making them more susceptible to displacement.

Symptoms

The most obvious symptom of dental avulsion is the absence of a tooth in its socket. Other symptoms may include bleeding from the socket, pain, swelling of the surrounding gum, and in some cases, shock.

First Aid and Treatment

Immediate action is crucial for a tooth that has been avulsed. The following steps are recommended:

1. Find the tooth: Handle the tooth by the crown (the part that is visible in the mouth), not the root. 2. Clean the tooth: If the tooth is dirty, gently rinse it with milk or saline solution. Do not scrub the tooth or remove any attached tissue fragments. 3. Replantation: If possible, try to gently insert the tooth back into its socket. Bite down softly on a clean cloth to hold it in place. 4. Keep the tooth moist: If replantation is not possible, keep the tooth moist by placing it in milk, saline solution, or a tooth preservation product. 5. Seek dental or medical help: Visit a dentist or an emergency room as soon as possible. Time is critical for successful replantation.

For permanent teeth, the goal is to replant the tooth as soon as possible, ideally within 30 minutes of the avulsion. Primary teeth are generally not replanted to avoid damage to the developing permanent tooth.

Long-term Management

Following the immediate treatment, endodontic (root canal) treatment may be necessary for the replanted tooth to prevent or treat infection. The tooth will also need to be monitored over time for signs of resorption, infection, or ankylosis (fusion to the bone).

Prevention

Preventive measures include wearing mouthguards during sports or activities that pose a risk of facial injury, maintaining good oral hygiene to prevent periodontal disease, and using seat belts and helmets.

Complications

Complications of dental avulsion include infection, improper healing, ankylosis, and resorption of the tooth root. Psychological impact, especially in children and adolescents, can also be significant.