Avulsion is a traumatic injury where the tooth is completely thrown out of its alveolar socket. This injury requires an urgent treatment that includes immediate replantation if possible. The tooth has to be transported in an appropriate medium such as milk, saliva, physiologic saline, water or special transporting kits. Deciduous teeth should not be replanted, because of the possible damage to the germ of the permanent tooth. It usually happens to kids, but it can occur at any age.
The most common reason for avulsion is a traumatic injury. Since kids are very active, they tend to trip and fall, which can be the direct factor for avulsion. Other causes are always related to physical and mechanical force. So whether it’s a fall or a hit, a direct contact with a hard surface is usually the way that avulsion occurs. Car crashes, accidents, football, basketball, hockey, are some of the very common activities that can lead to avulsion.
When it comes to symptoms, there will be a lot of blood, so the others around the patient might not be able to see an empty socket. You can definitely notice that there is something missing in the place of the avulsed tooth. Pain is present and the strength may vary depending on other injuries. Since we’re talking about a traumatic injury, teeth avulsion can be accompanied by a number of other fractures, incisions, bruises, swelling and more.
The treatment depends on the age. It is very important to know the age of the patient since it affects the growth of the tooth. The main factor for this condition is whether the apex of the root is still developing or it is already closed. It can occur to deciduous teeth and to permanent ones. The permanent always calls for immediate treatment, this is an urgent condition. When it comes to the handling of permanent teeth, they have to be carried in a moist environment. There are special systems that can be used, but since most people don’t own them, they can use milk water, or place the tooth under the tongue on the way to the dentist. A tooth should be replanted as soon as possible. All the studies show that the replantation is successful if done within the one-hour period after the injury. After that, the success rates only decline. Deciduous teeth are not replanted, because they can harm the germ of the permanent tooth. Once the tooth is avulsed, the periodontal ligament that surrounds it is torn. The main thing that dentists want to achieve is to keep those periodontal cells vital and get a reattachment. The prognosis is always different and completely depends on the case. The factors that have an impact are the age of the patient, how the tooth was transported, whether it fell on a clean surface or not, the time spent between the injury and the treatment. Teeth with completely matured roots and apexes have a better prognosis, compared to the ones that are not fully developed.