When the tooth is knocked out, it’s best to keep it in that patient’s mouth until they get to the dentist. The second best place is the parent’s mouth, third would be a cup of milk, fourth being a cup of water. So, in this case he was able to put the tooth back around his cheek to keep it in his mouth until he got to see me at the office. If you can get a tooth re-implanted within an hour your success rate goes up.
Really, it’s actually easy to put it back in place and normally it does not hurt the patient, so anytime a tooth is completely knocked out and you can put it back in, go ahead and do that but then get to a dentist because most of time those teeth will need to be splinted or tied together so they can’t move and can heal back together. I placed the etching on there first. What the etching does, it makes the microscopic holes in the tooth that allows the bonding, the splinting material to adhere to the tooth. In this case, the splinting material we use is called Ribbond, and it’s like a teflon tape and I measure how much distance we needed and cut off a strip and we bonded it to the front side of the teeth and added some flowable composite so that it would hold, so right now all those teeth are splinted together from about tooth number 22 through number 27. Normally, we would splint on the lingual side, the tongue side, but there was so much blood we couldn’t keep it dry enough to put the splint material on so in this case we had to splint on the outside of the tooth, on the lip side. After placing the bonding and splinting material, I went back and smoothed up where it had some rough edges so it wouldn’t bother the patient’s lip and since the tissue was also pulled away from the bone, I also placed one suture to hold that tissue back in place.
In this case, I felt pretty confident that he’ll be able to save them but they will probably require root canals. We will get him back in a week or two to take x-rays and keep under observation to see how the apices, the apex of the teeth, react to the reimplantation. More and more players are starting to wear mouth guards in most all sports now and so it’s very important that they have a good mouthguard that fits very well to help prevent some of these injuries that do occur.