Do not touch the root or clean the tooth. Handle the tooth by the crown only. You should attempt replantation i.e. physically placing the tooth back into its socket, immediately if possible. If it is less than 5 minutes of injury then immediate replantation has the best prognosis. The tooth should be cleaned before replantation. The proper way to remove debris from the root of an avulsed tooth is to rinse it in cold water (either tap or clean bottled water), being careful not to scrub or scrape it. If the root appears clean, grasp the crown between your thumb and first finger with the smooth flat surface forward. Then push firmly and hold the tooth in place.
Sustained pressure is required to move blood that has accumulated in the socket. When the tooth is seated into its original position, it must be held there by hand or with a wad of wet tissue to keep it from extruding from the socket.
If, for any reason, the tooth cannot be replanted immediately then the patient and the tooth needs to be carried soon to the dentist in a proper preserving carrier media. This media can be cold milk or the patient’s own saliva and the intention is to prevent the tooth from drying.
How to manage the knocked out primary teeth?
Primary teeth are managed differently from adult teeth and are generally not replanted as primary teeth are concerned for the normal eruption of the underlying permanent tooth. Replanting primary teeth may cause infection to spread to the developing permanent tooth or interfere with the normal time sequence of the permanent tooth erupting into the mouth. The more important consideration is to retain space occupied by the lost primary molars that act as guides for erupting permanent teeth. Therefore, more important than replantation is to allow your dentist to determine how to maintain the space the primary tooth had occupied earlier. This may prevent the need for orthodontic treatment to correct the situation later.
