Reimplantation refers to the insertion and temporary fixation of completely or partially avulsed (knocked out) tooth or teeth that have resulted from traumatic injury. The most common teeth to be avulsed are the upper front permanent teeth. In instances where primary teeth have been avulsed reimplantation is usually not sought as these teeth will be naturally replaced by permanent teeth at a later time.
There are really no ways to prevent avulsed teeth as it is usually an accidental and rare phenomenon. The best preventative measure would be to wear a mouth guard during activities where the threat of teeth being knocked out is higher (an example being sports).
The success of reimplantation depends on the amount of time that the tooth is out of its socket. If the procedure has been completed within one hour reattachment success is much higher. Upon the avulsion of a tooth or teeth it is important that the affected teeth are retrieved and kept moist. It is important that the tooth is handled only by its crown and not its root. The tooth should be stored in milk or clean water to keep it clean. The best setting for a knocked out tooth though would be to hold it within the cheeks inside of the mouth so the tooth is kept in its natural setting.
After the tooth is reimplanted into its original socket it can undergo a process of splinting to adjacent teeth. This process helps stabilize the tooth as the bone around it heals and the split can hold for two to eight weeks. During this period the patient should avoid biting on the splinted teeth and continue to brush their other unaffected teeth thoroughly as a way to keep their mouth as clean and therefore healthy as possible. Additionally only soft foods should be eaten.
The threat of gingivitis (gum inflammation) is high on the affected teeth as splinted teeth cannot be brushed normally. In addition to this hindrance the splint has the added disadvantage of collecting extra dental plaque and food debris.
For this reason it is recommended that the reimplanted tooth should undergo endodontic treatment generally a root canal procedure. These teeth are subsequently observed for symptoms of dying pulp (discoloration gum abscesses tooth pain) for at least five years after reimplantation.
In addition to these surgical operations there are a variety of over-the counter medication that can aid the reimplanted tooth. For pain relief there is acetaminophen (TYLENOL) or ibuprofen (ADVIL) to prevent gum inflammation there are different varieties of mouth rinse and for those patients which have additional lacerations (significant soft tissue cuts) there is the possibility of receiving oral antibiotics and tetanus taxoid injections.
