A guide to partially dislodged teeth
What is a partially dislodged tooth?
If you knock a tooth out, it can be distressing. Sometimes, however, the tooth is not entirely knocked out. Dentists call this a partially dislodged tooth and it is one of the most common types of dental emergency. With the right care and attention, the tooth will usually be able to be replanted and repaired. However, the success of the treatment depends in a large part whether you take the right actions immediately and get to your dentist quickly.
In this article, we will look at how and why teeth become dislodged and then discuss the steps that you can take immediately to try and save the tooth. We will also think about how you and your dentist can look after the tooth in the longer term. If your tooth has been dislodged once, it may well be more vulnerable to being dislodged again in the future.
Why does it happen?
Unfortunately, our teeth are a fairly exposed part of our body. There is not muscle or fat to protect them against impact, as there is with the bones in our body. So if you play a physical sport, for example, then it is highly likely that, sooner or later, your teeth are going to take a hit.
It’s not just on the sports field where accidents can happen either. It far from unusual for a young child to dislodge a tooth when they are playing an energetic game around the house. So knowing the right steps to take should be second nature for parents.
The good news is that our teeth do have some natural protection. Like a tree rooted into the ground, they are rooted deep into our gums and into the jaw bone with a strong root. So, as long as our teeth and gums are healthy, they are usually quite difficult to dislodge.
But it does happen. Dental injuries can be particularly distressing. However, if it happens to you it is important to remember that there are certain essential things you need to do to look after the damaged tooth.
What can you do immediately?
From a professional perspective, there are two distinct types of dislodged tooth. The first type is when the tooth is dislodged from the jawbone. It has not come out completely, but you can usually feel it waggling around loosely.
The second type of partially dislodged tooth is when the tooth is knocked deeper into the gum. This type of problem usually looks worse (and can feel more painful), however both types of dislodged tooth can normally be treated in the same way.
So, let’s say you’re playing a game of football or netball. A stray elbow gives you an accidental crack in the mouth and you need to leave the field of play with a partially dislodged tooth. What should you do next?
First things first, you should contact your dentist immediately. As a rule of thumb, dentists recommend that patients with dislodged teeth should try and get treatment within the hour. This increases your chances of having your tooth successfully replanted.
Of course, if your tooth has been dislodged due to some type of trauma, then there is a good chance that you will be disorientated or even suffering from concussion. It may be a good idea to have someone you know and trust as an emergency contact, who has the details of your dentist (especially if you regularly play sport!).
The second part of your immediate treatment should be some form of pain relief. Strong, over-the-counter pain killers such as Ibruprofen may help. Often, the dislodged tooth will also be accompanied by further injury to the jaw, cheeks or face, so a large ice pack can help to soothe the affected area and keep the swelling down as much as possible.
What should you avoid doing?
When you feel a tooth waggling around loosely in your mouth, it can be very, very tempting just to pull the tooth out and worry about the consequences later.
However, every dentist would recommend leaving your dislodged tooth in place and getting some treatment as soon as possible. So don’t be tempted to waggle the tooth with your fingers or push it back and forth with your tongue. This could loosen the tooth still further.
At this stage, there is still every chance that your tooth can be saved. So just concentrate on getting to your dentist as soon as you can!
What will your dentist do?
Ok, let’s imagine that you’ve made it to the dentist successfully and that you’re in the chair ready for some emergency treatment. What can you expect?
First of all, your dentist will take a look at the tooth to see if the tooth’s blood supply and nerves are still connected properly. If this is the case, then the tooth still has its lifelines in place and remains alive. Therefore, it can be saved, repaired and replanted.
Replanting a tooth that still has its blood supply and nerves connected is a relatively straightforward treatment for your dentist. They will clean around the damaged tooth and ensure that there is no debris in the open socket. Then the tooth can be re-inserted into the socket and held in place with a splint. In time, the gums will heal over and allow the tooth to become stable. Wearing a splint can be bulky and uncomfortable. However, it is important that your dislodged tooth is held in the right position so that, once it has stabilised, it is aligned with the rest of your teeth so that it does not affect your ‘bite’.
But what happens if the nerves and blood supply to the tooth have been irreparably damaged? In this case, you may need root canal treatment. Root canal treatment will enable your dentist to replace the tooth in its original position, rather than leaving a gap which may affect your bite. It also means that, even though the blood supply has been damaged, the tooth is protected against infection and the possibility of an abscess forming.
What is root canal treatment?
Root canal treatment has a fearsome reputation amongst dental patients. In fact, it is such a hot topic, we have given it its own guide elsewhere on this website. So if you want to learn more about root canal treatment, that’s the place to go!
Here, it is sufficient to say that root canal treatment is required when the inner pulp of a tooth has been, or is in danger, of becoming infected. Root canal treatment involves drilling into the tooth to remove the pulp. From this point on, the tooth is technically dead, as the blood supply and nerves have been removed.
The space where the pulp should be is replaced by a neutral material which stops infection from entering the tooth. While the tooth may be dead, the benefit is that it can still be replanted so that there is no gap left in your bite. Root canal treatment will also stop the tooth from becoming discoloured.
What happens if the tooth cannot be saved?
On occasions, the tooth may be too badly damaged for root canal treatment to save it. If this happens, the tooth will need to be extracted. Your dentist should explore every other avenue of treatment before recommending that your tooth should be extracted. Extraction should always be a last resort.
Many patients see tooth extraction as the obvious answer to the problem. It means that they can avoid complex root canal treatment, they do not need to wear a cumbersome tooth splint and, provided their gum heals quickly, they can get on with life fairly soon afterwards.
However, this is to overlook the implications of a missing tooth. When you lose a tooth, it can affect how you talk, chew and eat, and therefore place extra pressure on the surrounding teeth and the jaw. It can mean that the remaining teeth degrade or that the extra pressure on the jaw leads to further aches and pains.
What can I do to avoid a dislodged tooth?
Of course, it is very difficult to avoid dislodging a tooth. After all accidents happen. However, there may be certain situations where you can minimise the risk to yourself. For example, if you are involved in physical contact sports, you should always wear a mouthguard.
If you have had a dislodged tooth repositioned and replanted, then it is important that you look after that tooth carefully in the longer term. It may be more vulnerable to infection than your other teeth, or to becoming dislodged again. Your dentist should be able to give you a schedule of future appointments so that you can have the tooth checked to ensure that it has stabilised properly. It is important that you keep up regular visits to your dentist, so that he or she can monitor the dislodged tooth and also the health of the teeth, gums and jaw bone around it.