Get out the milk – and other vital measures when a tooth is knocked out

7 January 2020

If an accident happens while playing sport or as a result of a childhood mishap and a tooth is knocked out, the
faster you act the better the chance of saving it.

These school holidays the Australian Dental Association (ADA) is urging anyone engaged in physical activities
to know what to do if this situation arises. Acting swiftly and decisively is key.

"Accidents can happen for kids or adults at any time – some with quite serious consequences for our teeth,"
said ADA President Dr Carmelo Bonanno.

"But the trauma of a dental injury can be minimised if you know what to do if you or a family member suffers
damage to teeth."

Here’s the ADA’s advice on what to do:

- If your child knocks out a ‘baby’ tooth (typically in place until the age of seven) before it’s ready to come out,
find the tooth and only hold it by the crown (the visible, white enamel part), and not the root. Depending on
your child’s age, the baby tooth may not have much root structure remaining.

If you’re unsure if it’s a ‘baby’ or ‘adult’ tooth, don’t try to reinsert it back into the mouth. Instead put it into
a sealed container containing a small amount of cow’s milk or your child’s saliva and head straight to your
dentist. Why milk? The milk, or saliva helps to keep the roots intact while water can damage the root’s cells.

If the accident happened after normal dental practice hours, head to an after-hours dentist in your state or
territory which can be found at the ADA’s Find a Dentist facility.

"The dentist will check for any other damage in the mouth. Baby teeth aren’t put back into the mouth because
an adult tooth will replace it eventually," explained Dr Bonanno.

- The same handling rules apply to adult teeth. If the tooth is dirty, give it a gentle rinse in milk, the preferable
option, or briefly in tap water, but don’t scrub it. An ideal scenario for the best outcome is to see a dentist
within 30 minutes of the accident happening.

With adult teeth you should place the tooth back into position inside the mouth, making sure it’s facing the
right way around. Then gently bite down on soft cloth or tissue or use aluminium foil or your mouthguard to
hold it in place. If you can’t replant the tooth in its original position, transport it to your dentist in milk or saliva,
but not water.

Your dentist will then typically splint it to the adjacent teeth while waiting for the adult tooth to re-attach in
its socket.

Other big no-no’s for tooth transportation include wrapping the tooth in paper towel or a serviette, scrubbing
the root surface of the tooth when rinsing it, and delaying seeing a dentist.

The sooner you do, the better the long-term outcome. Failure to see a dentist quickly following a tooth getting
knocked out may result in loss of that tooth.

If a tooth becomes cracked, chipped or fractured in an accident, take the fragment with you to the dentist in
a sealed container, though liquid isn’t necessary.

“The most effective way to prevent dental injuries during sport or games is to wear a custom-fitted mouthguard made by a dentist,” he added.

"With young children, it’s important to be wary of situations where they’re more likely to fall in such a way
that they can damage their teeth such as riding a bike or skateboarding. Mouthguards absorb and spread the
impact of a blow to the face, which may otherwise result in an injury to the mouth or jaw."

The Australian Dental Association and Sports Medicine Australia have developed a Mouthguard Policy which
sports clubs are encouraged to sign up to.

Where to go for help
In cases of dental trauma during the holidays or after hours, check if your usual dentist handles emergency
treatments. If not, use the ADA’s Find a Dentist service to locate a dental practice to assist you. Arrangements vary from state to state depending on where patients live.
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