Accidents happen.
You fall face down and demolish a tooth. Standing a little too close to your slugger boyfriend at the batter’s box results in an accidental baseball bat to the face. Then there’s that golf cart that swerves too quickly around a corner and meets you head on. So you’ve lost a front tooth. Or more.
Don’t fret. Dentists have you covered. But you do need to know what to do before such an accident occurs and what your subsequent options are when it comes to tooth replacement.
First, immediately call your dentist when a permanent front tooth is knocked out. This is indeed an emergency. The tooth should be re-implanted within 30 minutes of the accident.
Follow these suggestions to improve the chances of saving your tooth:
Handle the tooth carefully. Try not to touch the root (the part of the tooth that was under the gum). It can be damaged easily.
If the tooth is dirty, hold it by the upper part (the crown) and rinse it with milk. If you don’t have any milk, rinse it with water. Don’t wipe it off with a washcloth, shirt or other fabric. This could damage the tooth.
Keep the tooth moist. Drop it into a glass of milk. If you can’t do this, place the tooth in your mouth, between the cheek and gum. A young child may not be able to safely “store” the tooth in his or her mouth without swallowing it. Instead, have the child spit into a cup.
Place the tooth in the cup with the saliva. If nothing else is available, place the tooth in a cup of water. The most important thing is to keep the tooth moist.
Try slipping the tooth back into its socket. In many cases, it will slip right in. Make sure it’s facing the right way. Don’t try to force it into the socket. If it doesn’t go back into place easily and without pressure, then just keep it moist (in milk, saliva or water) and get to the dentist as soon as you can.
If you are dealing with a child, their pain and fears will lessen if they suck on a Popsicle on the way to your dentist or a dentist on-call. Once the tooth is bonded into position it takes four-six weeks to take hold. In some cases, root canal therapy may help maintain the root attachment.
For chipped teeth, phone your dentist for the first available appointment and chew soft foods in the meantime.
At this point you have options for front tooth replacement if you are unable to re-implant the tooth:
Do Nothing
First, you can do nothing. Of course you won’t be all smiles for the annual family holiday card for years to come. Worse, by not replacing the tooth, the adjacent teeth may move toward the space and dramatically change your bite. Also the jawbone area shrinks after a natural tooth is removed due to the lack of stimulation normally provided by a natural tooth root.
Fixed Bridgework
For years this was the go-to solution for missing teeth. The teeth on each side of the gap are ground down to become “posts” for an attached fixed bridge to cover the area. Challenges abound with this approach. The two teeth that serve as posts for the bridge lose much of their protective outer layers. If something happens to one of the teeth, the bridgework can no longer serve its purpose. Additionally, it take more time that usual to floss the area.
Composite Bridgework
Many dentists now build bridges out of composite resin materials that fill in the bridge area, eliminating the need to grind down the adjacent teeth. As an added bonus, if one of the adjoining teeth experiences problems, the bridge can be removed, saving the existing teeth connected to the bridge. A composite bridge is not as sturdy as a fixed bridge or removable partial denture.
Removable Partial Denture
Like a retainer, a removable partial denture can be worn during the day in place of one or more missing teeth. It’s economical, but there are a few drawbacks. It can move around and affect eating and speaking. To keep it in place, metal clasps can be used. They may be visible when speaking and feel uncomfortable. The partial denture should be cleaned each night.
Temporary Removable Bridge
Heard of a flipper? This is placed in the gap left from the missing tooth or teeth. It sits directly on the gum tissue. Often a flipper is the best option after an accident while the mouth heals to accommodate a crown. However, there is a downside. Flippers are cumbersome. Eating an apple or something crunchy is difficult.
Shelley Shearer
Dental Implant
This is a long-term solution for tooth loss that restores your smile to its past perfection. The artificially-made implants look like the real deal. They are surgically inserted into the jawbone to support a restorative or replacement crown, bridge or denture. At a 95 percent success rate, implants are a durable, permanent way to replace teeth. While it is the most expensive option, it is the one with the least number of drawbacks and can keep your smile at its peak for a lifetime.
While accidents happen, at least you now know that seconds count and that you can depend on your dentist to make sure you won’t have an embarrassing, toothless grin.
Dr. Shelley Shearer is graduate of the University of Louisville Dental School and Founder of Shearer Family and Cosmetic Dentistry in Florence, the largest all-female dental practice in Northern Kentucky.
