What to do if you get a tooth knocked out:

Getting to a dentist within 30 minutes can make the difference between saving and losing a tooth. When a tooth is knocked out:

• Immediately call your dentist for an emergency appointment.
• Handle the tooth by the crown (the part that is normally visible), not the root. Touching the root (the part of the tooth below the gum) can damage cells necessary for bone reattachment.
• Gently rinse the tooth in water to remove dirt. Do not scrub.
• Place the clean tooth in your mouth between the cheek and the gum to keep it moist.
• It is important not to let the tooth dry out.
• It is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk.

The dentist should carefully examine the area where the trauma occurred to make sure that a blood clot didn't form in the socket and that the surrounding tissues are intact (no loose bony pieces). If the tooth is in one piece the dentist will place it back in the socket and splint (immobilize) it to allow the surrounding tissues to heal.

If successful the periodontal fibers might reattach the tooth to the bone and make it feel like it did before the trauma. If this happens the tooth will need root canal treatment after it is stable enough to be worked on.

What to do if the tooth is pushed out of position and becomes loose:

• See a dentist in the same day if possible to have the tooth and surrounding hard and soft tissues evaluated. Your dentist will check and make sure that the tooth is in one piece and not broken.
• Depending upon the severity of injury the tooth might need to be splinted (immobilized) to allow the surrounding tissues to heal.
• If there is a cosmetic defect like a chip that occurred during the trauma, bonding resin composite (white filling) can bring the tooth back to its original appearance.

After the tooth stabilizes it should be re-evaluated for the need of root canal treatment. The tooth might change color, which doesn't necessarily indicate the need for root canal therapy. The need for therapy is more likely in teeth with fully formed roots.

What is the cause of a sharp, localized tooth pain during chewing?

Very commonly, sharp pain during chewing is an indication that the tooth is cracked and part of the tooth can fracture off. Cracks in teeth occur either due to trauma, grinding, clenching, decay (cavity) or heavily filled teeth. "Cracked tooth syndrome," relates to a variety of symptoms and signs caused by a crack or many cracks in a tooth. Early diagnosis is needed to improve the chances of saving a cracked tooth.

Symptoms include:

• Sharp and erratic pain upon chewing or after release of biting pressure: not all cracks cause pain.
• Sensitivity to cold or hot foods, drinks, or sweets.
• Difficulty in locating which tooth hurts, either upper or lower
• If you suspect that you may have a cracked tooth, discuss this with your dentist.

If the crack causing the discomfort is in its early stages the tooth can be stabilized with a crown. If however, there are multiple symptoms, which are long-standing, and increasing in severity the tooth might require root canal treatment before a dental crown is fabricated.

©Copyright 2005 Virtual Dental Center All Rights Reserved