When your teeth get knocked out

Dr. Steve Gustafson, of Gustafson and Morningstar D.D.S., oddly enough has been seeing more patients carrying pieces of their teeth into his office this year, or just pointing at the spot where most of the tooth was, due to sports injuries.

As sports popularity increases, so does the probability of injuries, particularly getting hit in the mouth in contact sports or soccer, tripping and falling during in-line skating, or bicycling and hitting a stone, sending you over the handlebars where often, your only option is to cleverly break your fall with your face.

Dr. Steve has seen quite a few of these recently. “Most of the sports injuries occur in recreational activities – pick-up basketball in somebody’s driveway, for example, so people should wear their mouth guards anyway. That’s why these things don’t happen as much in organized sports.” He also has seen the results of a couple disagreements involving alcoholic beverages and how that 14th shot of tequila can really settle an argument, but that’s rare compared to accidents or sports injuries.

“We see more fractured teeth than teeth entirely knocked out,” Dr. Steve said. “In cases like those, we restore the tooth with a bonding material or a veneer. However, how you get a broken part of a tooth or an entire tooth to us is the same.

“If you do get a tooth (or part of one)  knocked out, there are a lot of things you have to consider pretty quickly,” Dr. Steve said.  “First, retrieve the tooth. We can put it back where it was, but do not, sometimes I can’t say this enough, do not rinse it off. There’s a special coating on the root that needs to stay there, even if the tooth is dirty.”

How do you get the tooth to Dr. Steve for reinsertion?

“This is where thinking quickly comes in. If you’ve been seriously injured in the face, that needs to be tended to first. A serious injury would be something like a gash that’s bleeding and would require stitches. Head straight to an emergency room and give a nurse or doctor the tooth while they’re working on you. They’ll know how to preserve it until you can get to us, and the tooth will remain healthy longer than you think.

“To get it to the hospital, your best option is to put it in a glass of milk. There’s lots of protein in there and the tooth will stay healthy,” Dr. Steve says. “There’s a better way, but we’ll get to that in a minute. If you don’t have any milk, then put it in cold water with ice. Don’t wrap it in anything because then you risk rubbing off that coating on the root that I was talking about,” Dr. Steve added.

To stop the bleeding where the tooth was, Dr. Steve says you can take a wad of Kleenex if you’re desperate, fold it up, put it in the hole where the tooth was and bite down. “That’s really not the best thing to do, though,” he says. “If you’re playing sports, you should have a tea bag in your First Aid kit just for this occurrence.

“Folding a tea bag, placing it in the hole and biting down on it will help stop the bleeding because tea contains tannic acid. Don’t go get some wild flavored tea – plain tea will do just fine. And please take the little tag off the tea bag,” Dr. Steve adds.

If you’re not in need of hospital care and you’re heading straight to Dr. Steve’s office, you have a decision to make about getting the tooth there. It involves coherency. “You have to make a quick assessment – are you stunned? Dizzy? Ask someone else if you seem OK – if, except for the injury – you appear to be thinking clearly.

“If so, put the tooth under your tongue, or between your bottom lip and your front teeth, where people used to hold a wad of chewing tobacco (until they found out it was cancerous),” Dr. Steve said. “This is the best solution, because the tooth is in it’s own environment. But you really have to be careful – you don’t want to swallow it, so you have to pay attention. Even if it’s a little dirty, that’s OK – when we replace the tooth, we’re going to give you antibiotics anyway.”

Once you get into a dental chair, Dr. Steve is going to bond the tooth back into its original spot by essentially using a special cement to glue the tooth to the one on either side of it. “The idea is that it will take root again. It takes six to eight weeks before we know. I can tell you this – you won’t have any feeling in that tooth again, but at least it will be your tooth.”

On a related topic, Dr. Steve’s office makes custom-fitted mouth guards for only $25. They make them in the office, a patient can have a choice of color, and it’s good, inexpensive insurance. The guards you pick of the shelves at sporting stores aren’t custom fits and won’t absorb the impact.