Tooth Avulsion (knocked out tooth due to trauma): Attention: Coaches, Parents and Kids!

Dr. Jim here! As a follow up to Dr. Garrett’s post on athletic mouth guards, I wanted to talk about tooth avulsion also known as the complete loss of a permanent tooth out of its aveolar socket, usually by trauma. This is something we typically see during the summer when kids are more active,  and when kids and adults are involved in competitive sports.   Baseball, soccer, basketball, rugby and hockey are sports that often result in teeth being knocked out as well as activities such as skating, roller blading, jumping on a trampoline and general rough housing.  Perhaps surprisingly, it isn’t as common to have tooth loss in Football because mouth guards are mandatory.

The following is a helpful guide if you, your child or a child you are coaching loses their permanent tooth.  If permanent teeth are handled correctly, they can be successfully and permanently replanted, as seen below.

If a tooth is avulsed, make sure it is a permanent tooth (primary teeth, aka: baby teeth- should not be replanted).
•Keep the patient calm.
•Find the tooth and pick it up by the crown (the white part).  Avoid touching the root.
•If the tooth is dirty, wash it briefly (10 seconds) under cold running water and reposition it. Try to encourage the patient or parent to replant the tooth. Have the patient bite on a handkerchief to hold it in position.
•If replanting the tooth is not possible, place the tooth in a suitable storage medium.  Suitable mediums include:   a glass of milk;   a special storage media for avulsed teeth  (e.g. Hanks balanced storage medium or saline);  in the mouth- keeping it between the molars and the inside of the cheek; and, if there is any chance the patient might swallow the tooth- get the patient to spit in a container and place the tooth in it. Avoid storage in water!
•Seek emergency dental treatment immediately.
All athletic first aid kits should include a storage medium like “Save A Tooth.” It is a balanced salt solution that preserves the tooth for up to 24 hours . It can be purchased on various websites including I have frequently given them out to patients to give to their coaches.  I strongly recommend purchasing a container for you household and car first aid kits.

Play hard and stay safe!

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