AAID's advice on teeth suddenly knocked out

May 29 2010

Chicago Blackhawks star Duncan Keith's dental misfortune on the ice is an occupational hazard for hockey players, but teeth also can be lost in accidents, sports mishaps and falls that can happen to anyone. So what should you do when one or more of your teeth are suddenly knocked out?

The obvious advice is get to a dentist right away, but the type of injury suffered will influence how the damaged teeth can be treated, according to Joseph Orrico, DDS, president-elect of the American Academy of Implant Dentistry (AAID), www.aaid.com, who practices in Elmwood Park, Ill. and played semi-pro hockey.

"Sometimes teeth are completely knocked out -- roots and all, so in those cases place the tooth or teeth in a container of cold milk and get to a dentist within thirty minutes for a reinsertion procedure," said Orrico. "There's a short window of opportunity in which the remaining living tissue on the root surface can be kept alive. Milk has a neutral ph balance and is fortified with vitamins to make it an excellent fluid to help preserve teeth." He stressed that time has the greatest influence on the success rate for replacing teeth this way.

In situations when teeth are broken above the gum line, a dentist could recommend performing a root canal procedure to save the tooth structure and restore with a crown. If a tooth is fractured below the gum line, it may be best to extract the fragment and insert a dental implant, a bridge or a removable dental prosthesis. Age is a factor determining treatment options, says Orrico, because bone loss in the jaw over the years could be significant for younger patients with bridges or removable unsecured prostheses, causing oral health and cosmetic problems later in life.

Implants function like natural teeth and preserve the integrity of the jawbone. Orrico has treated hockey players and other young athletes who have suffered severe mouth trauma and believes implants probably are the best long-term option for Keith, a player with many years left in his pro hockey career. "An implant-secured prosthesis can be removed by the team dentist before games and reinserted afterward. For a young man in his twenties, the dental implants will protect against progressive bone loss. This is a better option than wearing an unsecured prosthetic, like many pro hockey players do, which does nothing to preserve the jawbone," Orrico advised.