Saving knocked-out teeth

About a quarter of all children will damage their permanent teeth by l4 years of age, while a third will do some damage to their primary (baby) teeth.

As might be expected, twice as many boys damage their teeth. Having prominent (buck) teeth further increases the risk depending on how far forward the front teeth are positioned.

Dentists today are seeing fewer children with dental injuries, as most children who play contact sports are now required to wear mouthguards. The other main cause of injuries are non-contact leisure activities such as bike riding, skateboarding, in-line skating, swimming etc.

Permanent teeth that have been knocked-out can be saved but it is vital that you act quickly:

First-aid treatment

1. Find the tooth. Search around the scene of the accident as teeth can be thrown a surprising distance. Check the person's clothing for teeth that are thought to be lost. Remain calm. The injury often looks worse than it actually is.

2. If the tooth is clean, replant immediately into the socket. The best place for the tooth is back inside the socket. Use the other teeth as a guide. Hold the tooth by the crown. Do not touch any part of the root of the tooth as this can damage the delicate cells on the surface. Push the tooth into the socket. This should be done quickly and the tooth will normally click back into position.

3. If the tooth is dirty, then rinse in milk or saline and then replant.

4. If the tooth cannot be re-planted, store the tooth in milk. The tooth must be kept moist, but DO NOT USE WATER. Milk is the best fluid in which to store the tooth before seeing your dentist. It is readily available, is cold, generally sterile and will keep the cells on the outside of the root alive. If milk is unavailable then use saline (for contact lenses); plastic cling wrap; or place the tooth under the tongue or between the person's lip and gums.

5. See your dentist immediately. The tooth will need to be held in place with a splint for about two weeks. After this time the pulp (nerve) needs to be removed and a root canal therapy performed. It is essential that a root canal therapy (RCT) is started within two weeks, otherwise the tooth may be rejected by the body.

Even if all the above points are followed, the tooth may still be lost. The prognosis is determined by the amount of time out of the mouth; the damage to the root surface of the tooth; and whether or not the tooth was kept moist.

Never throw away a broken tooth fragment or a tooth that has been knocked-out. Even those teeth with a poor long-term prognosis can still be replanted to guide normal growth and dev-elopment of the teeth.

In summary, replant the tooth as soon as possible or store in milk, and see your dentist quickly.