Adult Tooth Injury
When to go to A+E
Call 999 or go to your nearest Accident and Emergency Department if the person affected:
- Has been knocked unconscious
- Is having difficulty breathing or speaking
When to see an emergency dentist
If you have suffered a bang to the mouth or face and there is a possibility it could have affected your teeth, we would recommend you visit a dentist immediately to make sure there has been no damage to them.
Dental injuries that definitely require an emergency dentist appointment include:
- Knocked teeth with or without any sign of bleeding
- Fractured teeth
- Teeth that have moved out of their original position
- Teeth that have been knocked out
If you have damaged the soft tissues inside the mouth and lips, you may require dissolvable stitches. This can normally be completed by a dentist. Any other cuts or wounds to other parts of the face will normally require a trip to your nearest A+E department.
What to do if you injure your adult tooth
Knocked tooth – Keep the area clean with a soft toothbrush and stick to eating softer foods.
Fractured tooth – Avoid any food or drink that causes you discomfort. Keep the piece of tooth if you have it and take it with you to the dentist. Take over the counter painkillers (Ibuprofen/Paracetamol). Make sure you aren't allergic and that they don't interact with any other medication you are taking. Stick to the recommended dosages and do not give Aspirin to children under the age of 16.
Tooth that has moved out of its original position – Avoid biting on the tooth and avoid any food or drink that causes you discomfort. Again, take over the counter painkillers (Ibuprofen/Paracetamol). Make sure you aren't allergic and that they don't interact with any other medication you are taking. Stick to the recommended dosages and do not give Aspirin to children under the age of 16. Book an appointment with an emergency dentist immediately.
Tooth knocked out – Firstly, keep calm, and follow the stages outlined below:
- Make sure the tooth is a permanent tooth. Baby teeth should not be re-implanted.
- Pick up the tooth by the crown (white part), and try not to touch the root. If the root is dirty, rinse it briefly under cold running water (maximum 10 seconds) and if possible, reposition it in the socket that it came out of, making sure it is the correct way around.
- If this is not possible, store the tooth in a suitable medium, e.g. a glass of milk or a special solution for avulsed teeth (Hank's solution). You can also store the tooth in your mouth and hold it between your lower molar teeth and your cheek. In the case of a young child who is at risk of swallowing the tooth, get them to spit into a container and place the tooth in it gently.
Emergency Dental Treatment
Knocked tooth – Most of the time no treatment is required, however if there is some slight mobility to the tooth, the dentist might place a splint. A splint is a method of holding a loose tooth in position by bonding a thin wire to the adjacent non-mobile teeth and the mobile tooth itself.
Fractured tooth – Depending on the severity of the fracture, the treatment may include:
Enamel Fracture – If it is only the first layer (enamel) that has fractured, the dentist may be able to bond it back onto the tooth, otherwise the dentist is likely to rebuild it with a filling.
Enamel/Dentine Fracture – If the tooth has fractured into the second layer of the tooth (dentine), the dentist will either temporarily seal the tooth to allow it to settle and restore it permanently at a later date, or they will place a permanent white filling at the first visit.
Enamel/Dentine/Pulp Fracture – If the tooth fracture has exposed the nerve/blood supply, in most adults, it is likely you will require root canal treatment to save the tooth. If you are a younger patient, there is a greater chance the dentist can preserve the health of your blood/nerve supply and restore the tooth with a filling or crown only.
Root fracture – If the root has fractured, and the dentist believes the tooth can be saved, it is likely they will reposition it and apply a splint for 1-4 months depending on the position of the fracture.
Tooth that has moved out of its original position – Treatment will depend on the type of movement and the development of the root of the tooth that is injured
Possible treatment includes:
- Repositioning the tooth manually with the dentist's fingers/forceps or with a type of brace.
- Splinting (described above) for a period of time
Tooth knocked out – Treatment of permanent teeth that have been knocked out depends on the development of the root and the length of time the tooth has been out of the mouth. In all cases, the dentist will attempt to re-implant the tooth, splint it for a period of time, provide antibiotics and check if a referral to you GP is required for a tetanus booster.
Additional information to help determine the treatment you might receive if you knock your tooth out:
Root fully developed and re-implanted under 60 minutes– Root canal treatment will normally commence soon after re-implantation and splinting.
Root fully developed and re-implanted after 60 minutes – Root canal treatment will normally commence soon after re-implantation and splinting. However, the prognosis for the long-term survival of the tooth is reduced.
Root not fully developed and re-implanted under 60 minutes – No root canal treatment is likely to take place unless there are signs that the tooth is dying.
Root not fully developed and re-implanted after 60 minutes - No root canal treatment is likely to take place unless there are signs that the tooth is dying. However, the prognosis for the long-term survival of the tooth is reduced.
Advice for all patients that have a dental injury to their permanent teeth
- Before providing treatment, the dentist should take a thorough history, clinically and radiographically assess you, and provide you with a diagnosis and treatment plan. There will normally be follow up appointments to monitor the injured teeth.
- DON'T DELAY booking in to see a dentist, the prognosis is likely to be better the sooner you are treated.
- In all cases, we hope your tooth stays alive, but in some circumstances, you may require root canal treatment. The worst-case scenario is that you could lose your tooth. There are guidelines the dentist may follow to improve the long-term prognosis of your tooth, but sometimes nature will take its course and there is nothing we can do to stop it.
The best ways to prevent injuries to permanent teeth include:
- Wear a mouth guard when playing contact sports.
- Drink alcohol responsibly and avoid taking recreational drugs, both can affect your motor skills and increase the risk of dental injuries.
Most dental injuries happen by accident and may not be preventable, in which case, please follow the instructions outlined above for your specific injury.
All the advice on this page is based on the evidence base of www.dentaltraumaguide.org.