The term dental avulsion means the complete removal of a tooth from its sockets following a traumatic injury. Injuries to the front teeth are quite common during childhood. It is a severe injury when the tooth is completely knocked out of its socket (avulsed).
Avulsion injuries have the most impact on the maxillary central incisors. There is less mineralized bone structure in permanent teeth that have not matured yet. Also, the periodontal ligamentum structure in such teeth is looser. This makes these teeth more vulnerable to extrusive forces.
For this reason, children between the ages of seven and nine years usually experience from avulsion due to dental trauma. McLain Surgical Arts, led by Dr. Landon D. McLain, provides oral surgery to patients in Huntsville, Madison, Florence, Decatur, Scottsboro, Cullman, Athens, Alabama, and surrounding locations.
Replanting the Natural Tooth
The best option is to replant the tooth as soon as possible. Once the tooth is replanted, it can heal in two ways if treated properly. The best case scenario is that the ligament surrounding the tooth reforms and the longevity of the tooth is the same as other teeth. This is known as “periodontal healing.”
If the ligament damage is excessive, the healing will occur with a bony replacement. “Bony healing” means that the bone replaces the tooth and is lost over the next few years.
What Your Dentist Will Do
It can sometimes be simple to put the tooth back in place. At other times, it can be complex, such as when the bone or tooth is broken. The dentist will use water to flush debris from the socket.
Subsequently, they will slip the tooth back in position. It is vital to re-plant the tooth as soon as possible. This should ideally take place within the hour of the injury.
The dentist may undertake a root canal simultaneously or may wait. The best treatment course will depend upon how long the tooth remained out of the mouth and other aspects.
The dentist will, in any case, splint the avulsed tooth to the other teeth on either side using a soft wire and/or composite material. This will help hold the tooth in position for several days. The dentist will decide the duration for which the splint should remain in place.
In case the bone around the tooth was not fractured, the root typically will re-attach tightly to the bone in around three to four weeks. A repair time of six to eight weeks may be necessary if there is more damage to the area.
The dentist should re-examine the tooth in three to six months. Unless there are any indications of an infection, the next visit will take place at the annual checkup. The dentist will follow-up for the next two to three years to make sure that the tooth replanting was successful.
If the tooth is replanted before the patient reaches the oral surgeon’s office, the surgeon may do the following:
- Allow the tooth to remain in place
- Cleanse the site with saline, water spray, or chlorhexidine
- Suture gingival lacerations, if necessary
- Evaluate the normal placement of the tooth with an x-ray as well as clinically
- Place a flexible splint for up to two weeks
- The surgeon will also commence root canal treatment between seven to ten days of the replantation and before removing the splint
Dr. Landon D. McLain receives patients from Huntsville, Madison, Florence, Decatur, Scottsboro, Cullman, Athens, Alabama, and nearby areas for oral surgery.
McLain Surgical Arts is a leading cosmetic surgery practice headed by Dr. Landon D. McLain MD, DMD, FACS in Huntsville, AL. Dr. McLain is a double board certified cosmetic and oral & maxillofacial surgeon, offering a variety of procedures such as dental implants, wisdom teeth extraction, breast augmentation, liposuction, rhinoplasty, tummy tuck, facelift, Botox, and laser skin resurfacing. For more information or to schedule a consultation call 256.429.3411 or click here.
Now taking patients from Huntsville, Scottsboro, Decatur, Madison, Athens, Florence, Cullman, AL and surrounding areas.