Whoops a daisy - don't panic

Hello again, I hope that you are safe and well. Happy New Year to you! Let’s hope it starts to get better than the last two strange ones; to say the least.

I started my first job as a qualified dentist 29 years ago in January 1993. I’ve seen some of my patients grow up from kids and to have their own. Makes me feel old at times. It’s been a journey; I can tell you and it’s not ready to stop just yet. I did my first ‘in the flesh’ course last month since the beginning of the pandemic. I loved it. Asked loads of questions and got involved. It was a small affair and well organised.

Winter obviously is a colder time and the chance of ice and snow. This can lead to accidents and dental trauma whether it’s having a great time sledging of just a slip-on black ice. The ‘heart in the mouth’ moment is when a tooth is knocked out or avulsed. It’s easy to say and not as easy to do, but don’t panic.

If it’s a baby (deciduous) tooth then do not try and put it back, it won’t last, and you damage the adult tooth underneath. If it’s an adult tooth it’s best to put it back.

Time is of the essence

The longer a tooth is out of its socket the less chance of it refixing and lasting. It’s best to get it back in immediately. It may not be for the faint hearted though. If the tooth is dirty then a gentle clean in milk, saline (if available), the patient’s saliva or very gently in water is OK. Water is not good to store the tooth in, fresh milk is the best. Also be careful not to hold the tooth by the root as this can damage the cells that are important for the refix. Hold the tooth by the crown; that has no cells on and make sure you have it the right way round. When you are happy it’s clean and the right way round seat it the socket and push it all the way home.

Keep pressure on it for a good five minutes to let the clot secure and hold the tooth. Then get the patient to bite down on a clean piece of gauze or handkerchief to secure in place. Seek immediate dental help. It will need to be assessed and splinted in place for a couple of weeks.

Success is best if put back immediately and, definitely, within 30 minutes, even if stored in milk. If the tooth is out of the socket for 60 minutes or more; even if stored in milk, the chances of success diminish. However, it’s usually worth a go to keep it for a bit and keep options open to a different way to sort it out later when a bit older, especially with children. Also, the sooner the tooth is put back, the easier and less painful it is. The area is sort of concussed and there is less chance of a clot forming that gets in the way. It will need to be checked-out every few weeks to see how it is doing. Older teeth (from about 10 years old) will need root canal treatment, most likely.

It’s a good life skill

I just thought that it was a good thing to share as you never know when it could really make the difference.

Have a great 2022!

Until next time. Take care and be good.