How to Treat a Knocked-Out Tooth in the Wilderness

The key to treating a tooth that's been knocked out is sticking it back into the hole it came out of. If you can do that within 30 minutes, and get to a dentist as soon as possible, there's a chance the tooth can be saved.

Difficulty: Moderate

Instructions

Things You'll Need:

• Evacuation Plan
• Wilderness First Aid Classes
• Tea Bags
• Tea Bags
• Antibacterial Soaps
• Aspirins
• First Aid Kits
• Gauze Pads
• Ibuprofen
• Latex Gloves
• Dental Insurance
• Evacuation Insurance

1. Put on latex gloves if you are treating someone other than yourself.

2. Stop the bleeding by having the injured person bite on a piece of rolled gauze or a moistened non-herbal tea bag. The tea bag is preferable because the tannic acid in the tea will encourage clotting.

3. Administer a pain reliever immediately, such as aspirin or ibuprofen. The pain reliever should be swallowed, not placed against the exposed gum (this can burn the gum).

4. Rinse the tooth off gently with disinfected water. Do not scrub the tooth.

5. Push the tooth gently back into the hole it came out of.

6. Place the tooth in a bottle of water with a pinch of salt, or hold it in the mouth on the tongue or against the cheek if it won't fit back in the hole. Keep the tooth moist at all times.

7. Evacuate to a dentist immediately.

8. Avoid doing anything that will irritate the wound or damage the tooth during evacuation. Drinking hot fluids, smoking, sucking on the wound, probing it with the tongue, and biting down on the injured side should all be discouraged.

Tips & Warnings

• If you have any questions or concerns, contact a physician or other health care professional before engaging in any activity related to health and diet. This information is not intended as a substitute for professional medical advice or treatment.

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on 3/28/2006 I recently was searching Google for websites about how to treat knocked-out teeth and your site appeared in my search results. The reason I was searching is that I work for an endodontist who is one of the leading experts in the treatment of knocked-out teeth. He asked me to look into websites that provide treatment recommendations and provide them with cutting edge information for the successful treatment of this type of injury.

Your website is very much appreciated and provides parents and other individuals useful information about what to do when a tooth is knocked out. However, your site does not include the use of pH balanced cell preserving fluids, which have been proven the most effective type of storage media for knocked-out teeth. These fluids not only keep the tooth root cells hydrated and protected, they also help these cells maintain the necessary nutrients to stay alive. When these cells are provided nutrients, they can be stored for up to 24 hours and still be replanted and maintained successfully 91% of the time. The most thoroughly tested pH balanced solution is Hank's Balanced Salt Solution (HBSS); this is not a saline solution. HBSS can be found in an inexpensive commercially available form called Save-A-Tooth.

A review of things you should note about treating knocked-out teeth:

1. Immediate replantation can lead to the best success rate, but many times this option is not feasible so the tooth needs to be placed in a storage and transport media. If a tooth is replanted immediately debris should be gently removed by rinsing the tooth, never scrub.

2. Never store a knocked-out tooth dry or in tissue or cloth.

3. Water is a poor choice for storing knocked-out teeth because it actually causes the root cells to burst and become necrotic.

4. Saliva is a very bad choice for storing knocked-out teeth; it causes cells to burst and can also cause bacterial infection of the cells due to naturally occurring bacteria in the mouth. As a result, infection of the socket can occur after replantation leading to an increased risk of root resorption and tooth loss. If a tooth is not replanted immediately, the mouth is not a good place to store a knocked-out tooth. Also, never store a knocked-out tooth in a different person;s mouth, they may have different bacteria that can cause root resorption and even sickness due to contact with blood after replantation.

5. Milk is acceptable as a storage medium as long as it is kept cold and is fresh. Do not use evaporated or condensed milk. When milk is used to store a knocked-out tooth, a dentist should replant the tooth as soon as possible, within an hour of being knocked-out.

6. Hank's Balanced Salt Solution is the best option for storing a knocked-out tooth. This medium will keep the tooth root cells alive for 24 hours giving you time to treat more serious injuries before the replantation. HBSS has been shown to provide a successful replantation in 91% of cases, including real-world testing, not lab conditions. HBSS is now available in Save-A-Tooth that can be kept in a first aid kit so that knocked-out teeth are able to be treated quickly and effectively.