Dental tips-Avulsion

I am writing this to share some of the informations i learn from paying thousands to the university. And, i think these informations will seriously help to increase the chance of saving your tooth and your smile. So, take a few minute to read.

Avulsion is one of the common injury that can happen to anyone, especialy someone who are actively involve in sport. Avulsion can also happen in trauma, accident, trip over and in the case when excessive force is applied to the tooth or chin. So, what is avulsion? Avulsion is the total displacement of tooth out of the socket. And, it is importance that you know how to handle the tooth when it is outside your mouth.

A tooth is held in the socket via some elastic connector that we call Periodontal Ligament (PDL) in Dentistry. PDL attach to tooth and socket surfaces that contain living cells that have repair ability. Avulsion leads to complete breakage of the PDL. That means if you insert the tooth back into the socket soon enough, your tooth may have a chance to live by repairing itself. But, the chance for your tooth to live goes down with increased age and time lapse after accident. For example, your top front teeth will have complete tooth and root formation at about 13 yo, if the accident happened before 13 yo, the chance for you to save your top front tooth is increased. In a mature tooth, the tooth will still have pretty good chance of serving its function with appropriate dental treatment, such as root canal treatment.

Ok, Let's talk about how to handle your tooth. As I mentioned above, the surface of the avulsed tooth has living cell and part of the PDL, it is essential to prevent touching the tooth surface with your contaminated hand. Hence, pick the tooth up at the crown (top part of the tooth that you usually see in your mouth).

Then, give the contaminated root surface a rinse with solution of pH and osmolarity that provide optimal condition for the cells to live. The solutions suggested by my expensive textbook are cold milk, saline solution (even you contact les solution), saliva or some special solution that is used to store organs during transplant (but that is not practical, ambulance could have one). The above is the ideal management of avulsion. But if for some reason, you cannot replant the tooth, we have to talk about how to store the tooth.

Store it in one of the solutions suggested above, or in between your cheek. Remember, the time counts. Go to the dentist as soon as possible.

All the measures only apply to your permanent tooth, baby tooth that is avulsed shoud never be replanted. As a general guideline, your permanent front teeth erupt at 7-8.5 yo. So, front teeth that you have got before 7 should be baby tooth. The baby tooth may affect the permanent tooth underneath it-PERMANENTLY.

So, let's talk about some stastic now. It is said that tooth replanted in ideal position within 15 minutes in a person with immature tooth (below 13 yo) has a very high chance to live. Otherwise, there can be healing that lead to inflammation, union with the bone and eventual tooth loss. But everything happen after tooth replantation can be taken care of in the dental clinic. Every problem has a solution. If you are interested in knowing more, you can consult your dentist or even ask me. I will be more than happy to tell you.

Last but not least, i will reinforce the same old statement- Prevention is always better than treatment.

If you are driving, wear helmet or put on your seatbelt.
If you are involve in a sport or any activity that can put you at risk of orofacial injury, take some protective precautions. Ask your dentist for a custom made mouthguard and make sure you do utilise them. Remember children are more vulnerable than adult, take care of them too.

There are more knowledge about immediate treatment in trauma. I will talk about it more in the future.