“I lost a tooth.  What do I do now?”

That’s a question that many people ask or wonder about before, during or after it happens.  The answer, depends on several details.  If you are 7, put it under your pillow and wait for the tooth fairy.  Congratulations, you’re growing up.  Outside of this rite of passage for kids, it can get a little more complicated.

If a tooth gets knocked out (also known as avulsion) for any reason, the best thing to do is call your dentist immediately.  Once the tooth gets avulsed, the clock starts.  The longer it is until the tooth gets reimplanted, the less likely that it will survive the ordeal.  At about 60 minutes, the tooth has almost no chance that it would be able to be reimplanted successfully.  When possible, the best thing to do is immediately put the tooth back in.  If needed, the tooth can be gently washed with milk to remove debris.   Immediate reimplantation may not possible because of damage to the tooth or mouth, severe contamination of the tooth or sometimes just because the patient is not comfortable with it.  In these cases, there are several mediums that a tooth can be placed that can extend the survivability.  The best is Hank’s Balanced Salt Solution, which can extend survivability for up to 6 hours.  Cold milk is good alternative if Hank’s is not available.   Key elements are minimal handling of the tooth and most importantly, time.   Unless a dentist is not available, the emergency room is not typically a satisfactory place to go.  Often the wait to be seen will be greater than the time a tooth may be kept out of the mouth, and patients that go straight to the emergency room often lose the tooth anyways.

If you watch T.V., read the paper (or our blog), then you probably know that when a tooth is not restorable or is lost, then implants have become the gold standard when it comes to replacement.  There are several other options, including removable dentures, fixed bridges or just leaving the space; but none of these typically have the long term predictability or deliver the overall patient satisfaction that many of us demand.  If a tooth has lost the good fight, see your dentist or oral surgeon to discuss all the options.  At our office, there is no charge for implant evaluations, so at the very least you can hear all your options before making any commitment financially.