Tooth Knocked Out Fast Action to Save a Smile

Fast Action to Save a Smile

Kids play hard--sometimes too hard. After unex pected contact with a ball, bat, jungle gym or a fist, your child can come home with a gap in his smile where one or two teeth used to be. Usually, it's the upper front two that take the brunt of the blow.

If it's a baby tooth, of course, you don't think twice about saving the tooth. It's best to alert your dentist, however, because if the permanent tooth is years away from making its appearance, your child may need a spacer to keep the rest of the teeth from shifting out of place.

But if the tooth that gets knocked out is a permanent one, you do want to take quick action to try to preserve the tooth. And you need to get to the dentist quickly so it can be replaced. If you act fast and take the recommended steps, there's a good chance that knocked-out tooth can be saved.

Here's what you need to do.

Handle with care. Once you've found that precious tooth, hold it by the crown, not the root. ''The root is covered by a delicate tissue, called the periodontal ligament, that needs to be protected if the tooth is to be successfully replanted,'' says Steven Vincent, D.D.S., associate professor at the University of Iowa College of Dentistry in Iowa City. For the same reason, don't scrub the tooth.

Replace the tooth. The safest place to store that tooth is where it came from--back in the socket. Rinse the tooth quickly with milk or saline contact lens solution. ( Use tap water as a last resort because it usually contains chlorine, which can also damage the important periodontal ligament.) If your child is calm--and willing to cooperate--gently put the tooth back into place.

''Even if you insert it facing the wrong direction, that can be corrected later,'' says Luke Matranga, D.D.S., president of the Academy of General Dentistry and chairman of the Department of Comprehensive Dental Care at Creighton University Dental School in Omaha. ''The important thing is that it's in the best location possible, its own natural home.'' Once it's in, have your child bite down gently on a gauze pad or tissue to hold it in place and get to your dentist as quickly as possible.

Reach for the moo-juice. If reinserting the tooth isn't possible, put it in a jar or cup of milk. According to dentists, milk has the right kind of chemical makeup--measured in terms of alkalinity ( pH)--to help keep that tooth in good shape for a while. ''Milk is an excellent transport medium because it has a pH compatible with the periodontal ligament tissues,'' says Dr. Vincent. ''But that doesn't mean you can dawdle; milk won't preserve the tooth for an extended period of time.''

Or put the tooth in your mouth. No milk on hand? ''If the only moisture available is inside your own mouth, then put the tooth there, between your teeth and cheek,'' advises Stuart Fountain, D.D.S., a dentist in Greensboro, North Carolina, and associate professor of endodontics at the University of North Carolina's Chapel Hill School of Dentistry. You can also put it inside your child's mouth if you're sure he's old enough and calm enough not to swallow it.

Wrap it up. A final option is to wrap the tooth in a moist tissue or cloth, says John Bogert, D.D.S., pediatric dentist and executive director of the American Academy of Pediatric Dentistry in Chicago. Another option is putting the tooth in a plastic bag with a little water or milk. That will help prevent the tooth from drying out and also help protect it.

Supply a handkerchief to bite down on. This will help stem bleeding and ease the pain, says Dr. Vincent. ''Actually a sterile gauze pad is better, if you have one handy. But a towel or handkerchief will do.''

Avoid future losses. If you know your child is going to be active in sports, particularly skating, outfit her with a protective mouth guard, says Dr. Fountain. You can find these at sporting goods stores.