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According to data obtained by the World Health Organization (WHO), approximately 20% of people have suffered a dental trauma at some stage of their lives. Among the dentoalveolar traumas are dental avulsion, one of the main reasons for dental emergencies.

What Is Dental Avulsion?

Dental avulsion occurs when a tooth is found outside the dental alveolus, the tooth is completely displaced, that is to say, the crown portion (the visible part of the tooth in the mouth) and the root portion (the non-visible part found inside the alveolar bone). Dental avulsion also compromises the supporting tissue of the tooth such as the periodontal ligament and the gums.

Who Can Suffer From Dental Avulsion?

Dental avulsion can happen to anyone, but there is a prevalence between 0.5 and 16% in permanent teeth and 7 to 13% in deciduous teeth. The anterior teeth such as the incisors are the most affected teeth in both types of dentitions. 

The main etiological factors of dental avulsion in deciduous dentition are due to blows from falling against hard objects, while in  permanent dentition, they are due to fights and the practice of risky sports. The WHO also tells us that it is also due to environmental factors, such as unsafe playgrounds, risky behavior, and violence.

Avulsion In Baby Teeth

In the case of an avulsion in a baby tooth, a reimplantation should not be performed in this type of dentition since reimplanting it may  cause damage to the germ of the permanent tooth.

It is also important to take a dental x-ray to rule out any type of luxation or fracture.

In these cases, it is essential to perform radiographic controls due to the possibility of presenting alterations in the permanent tooth due to the trauma, such as the appearance of stains, a change of color of the tooth, dilacerations or dental hypoplasia. It is also important to control the maintenance of the space left by the loss of this tooth and reduce crowding or crooked teeth.

Avulsion In Permanent Teeth

In the case of permanent dentition, reimplantation may be considered as a treatment; however,  it will not be possible in all cases since the prognosis and viability of the implanted piece will be based on the time elapsed between the trauma and the reimplantation in the tooth socket. Thirty minutes is the optimum time to obtain a good long-term result, drastically reducing this possibility in  treatments performed after 2 hours (according to some authors, 1 hour).

What To Do When Faced With An Avulsion?

The following measures should be taken when suffering a trauma that causes an avulsion:

• Locate the tooth involved.
• If the tooth is dirty, because it fell out of the mouth, it is recommended to rinse it with a jet of clean water for 10 seconds but without making contact with the root of the tooth; that is to say, the tooth should be taken from the coronary portion.
• Do not remove or detach the tissue found in the root.
• The tooth should be placed inside the socket, preferably before a clot has formed. 
• If it is not possible to reinsert the tooth into its socket, the tooth should be transported in a humid medium, such as Hank’s saline solution, submerged in a glass of milk, or finally in the patient’s own mouth.
• Visit the dentist as soon as possible for prompt treatment.
• Contact sports should be avoided for 2 weeks and the use of mouthguards is mandated for risky sports.
• Symptomatic treatment with antibiotic therapy and soft diet for 2 weeks. 

Complications – After-Effects Of Dental Trauma

The main sequelae that occur in the face of an avulsion or other dental trauma can be:

• Temporary dentition:
• Crown discoloration
• Pulp necrosis
• Abscesses-Fistula
• Affectation of permanent teeth
• Hypocalcification of enamel stains
• Hypoplastic enamel stains
• Alteration in the eruption sequence
• Alteration in the eruption axis
• Permanent dentition
• Loss of pulp vitality
• Spontaneous pain with abnormal response to vitality tests
• Root resorption

Contact Us 

If you have any questions about this or other topics, contact us at Channel Island Family Dental, as well as on our Facebook page. At Channel Island Family Dental, we are always attentive to your needs to make a timely diagnosis. In addition, our dentists in Oxnard, Santa Paula, Newbury Park  Ventura, and  Port Hueneme will guide you to the best treatment to give you back your best smile.

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