Tooth Reimplantation

Tooth reimplantation is when a tooth is put back in place that has been knocked out (avulsed). Tooth reimplantation is an emergency dental procedure. The tooth may be knocked out of the gum socket or partially dislodged from the gum socket during a high impact sport or activity. Baby (primary) teeth are not reimplanted, but evaluation by a dentist is recommended.    

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

  • Details of the accident.

RISKS AND COMPLICATIONS

This procedure is safe. However, general complications may include:

  • Damage to surrounding nerves, tissues, or structures.

  • Infection.

  • Blood clots.

  • Bleeding. 

There is a chance that the tooth will not reattach its roots to the socket. If it does not reattach, it will not become a viable tooth. This depends on how long the tooth was separated from the gum and the maturity of the root.

BEFORE THE PROCEDURE

The tooth should be reimplanted within 1 hour of the tooth injury. If you or someone you know has a tooth knocked out:

  • Find the tooth if it is outside of the mouth.

  • Rinse the tooth with milk or water if it is dirty. Do not scrub it. Do not touch the roots of the tooth.

  • Gently reposition it in the original gum socket. If it cannot be repositioned, place it immediately in water, milk, saline, or saliva.

  • Get to a dentist or emergency department immediately.

PROCEDURE

  • Your caregiver will examine the tooth and the gum area. The tooth may be gently cleaned and stored temporarily in a saline solution. X-rays may be taken.

  • The gum socket may be flushed with a water solution or saline solution and dried gently with gauze. The tooth is then repositioned in the socket. You may be asked to bite down on a gauze pad or tongue depressor to keep the tooth in position.

  • Your caregiver will stabilize the tooth in place with a splint that attaches to the adjacent teeth.

AFTER THE PROCEDURE

  • Only take over-the-counter or prescription medicines for pain, fever, or discomfort as directed by your caregiver.

  • Ice may be placed on the mouth or cheek area to reduce pain and swelling. 

  • Your caregiver will let you know what you can eat until the tooth has healed.

  • The splint will remain on your tooth for 7 to 10 days. If there were broken bones (fractures), the splinting period will be longer (2 to 8 weeks).

You may need a tetanus shot if:

  • You cannot remember when you had your last tetanus shot.

  • You have never had a tetanus shot.

  • The injury broke your skin.

If you get a tetanus shot, your arm may swell, get red, and feel warm to the touch. This is common and not a problem. If you need a tetanus shot and you choose not to have one, there is a rare chance of getting tetanus. Sickness from tetanus can be serious.

PREVENTION

An injury to the tooth may be prevented by:

  • Wearing a mouthguard during high impact sports or activities.

  • Wearing other protective headgear during high impact sports or activities.