Avulsion is knocking a tooth completely out of the socket - root included.
Avulsion of a primary (baby) tooth: No treatment is indicated. Re-implantation risks damage to permanent successor, ankylosis which prevents successors eruption.
Avulsion of a permanent (adult) tooth: occurs in 0.5-16% of dental injuries. It is considered one of the most serious dental injuries.
What to do if you have an avulsed tooth? If it is a baby tooth, do not panic but call your dentist and schedule a time to have your child assessed and an ACC claim be completed.
What about an adult tooth? ACT FAST. Find the tooth first of all, and do not touch the root. Pick it up by the crown (chewing surface). Put the sink plug in, and gently rinse under cold tap. If you can, try place back into the socket. If not, store in a suitable medium - milk, the cheek of the mouth. DO NOT PUT IN WATER. Call your dentist straight away and start heading there- they will see you immediately.
What will the dentist do? If you have placed it in to the socket (well done!), they will X-ray it to make sure it's in the right position. If you haven't reinserted it, they will gently irrigate with saline, and place the tooth in (all done under local anaesthetic) and x-ray it. They will apply a flexi splint, tell you to have tetanus injection and put you on antibiotics.
Will the tooth need root canal? If you have a closed apice (older person where the root has fully developed) you will need endodontic (root canal treatment) on that tooth in 7-10days. Same for an open apice (younger person who's root hasn't fully developed) where the patient got there long after one hour after it was avulsed or it was inappropriately stored.
What can we expect long term? It all depends on time, storage and whether the patient has an open or closed apice of the tooth. If it was closed apice, but was appropriately stored and patient got to the dentist within the hour, there may be no resorption or ankylosis. The tooth may be okay with just a root canal.
If the tooth had a closed apice or an open apice and it was inappropriately stored and they got to the dentist after an hour, then they are likely to get resorption and ankylosis. The goal is to try and keep the tooth as long as possible, BUT likely to have to have it removed and hopefully an implant placed (need to be over 21yrs).
If the tooth was appropriately stored, you got there within the hour and has an open apice, the outcome could be very positive with revascularization and no need for root canal.
You will be told:
take your antibiotic
have a tetanus shot
avoid participation in contact sports.
soft diet for 2 weeks. There after normal function as soon as possible.
brush teeth with a soft toothbrush.
use a chlorhexidine mouth rinse twice a day for 1 week
come back for review in 4weeks, 3months, 6months, 1 year and then annually