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Tooth Avulsion (Knocked-Out Tooth)

Dental emergency where a permanent or primary tooth is completely displaced from its socket.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ağız ve Diş Sağlığı department. Book Appointment →

What is Tooth Avulsion (Knocked-Out Tooth)?

Tooth avulsion is the total displacement of a tooth from its dental alveolus, most commonly affecting maxillary central incisors in children aged 7-12 during sports or falls. The periodontal ligament cells on the root surface die rapidly when exposed to dry conditions.

Time to replantation is the single strongest determinant of outcome: success rates exceed 90% if the tooth is reimplanted within 5 minutes, drop sharply after 60 minutes of dry storage and become unfavorable after 2 hours. Storage media in order of preference: Hank's balanced salt solution > cold milk > saliva > saline > water (worst).

Management follows IADT (International Association of Dental Traumatology) 2020 guidelines: handle the tooth by the crown only, gently rinse if dirty, replant immediately if possible, otherwise use appropriate storage and seek emergency dental care. Primary teeth are NOT replanted (risk of damaging permanent successor).

Symptoms

Empty socket with visible bleeding
Tooth completely out of mouth or in hand
Severe pain at the avulsion site
Soft tissue laceration of lip, gum or tongue
Possible associated jaw or facial injury
Loose neighboring teeth from impact
Difficulty closing the mouth properly
Visible alveolar bone fracture in some cases

Risk Factors

Contact sports without mouthguard
Children aged 7-12 years
Falls and bicycle accidents
Motor vehicle and sports collisions
Physical altercations or assault
Severe malocclusion with protruding incisors
Lack of protective gear in high-risk activities
Epilepsy or seizure disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Tooth completely knocked out — emergency
  • Time to dental clinic must be under 60 minutes
  • Heavy bleeding from the socket
  • Associated facial fracture suspicion
  • Loss of consciousness with the trauma
  • Tetanus immunization status uncertain

Treatment Methods

01
Hold tooth by crown, never the root
02
Gentle rinse with saline or milk if dirty (10 sec)
03
Replant immediately into socket if possible
04
Otherwise store in milk, saliva or HBSS
05
Seek emergency dental care within 30 minutes
06
Splint placement for 2 weeks (flexible)
07
Endodontic treatment within 7-10 days for mature teeth
08
Long-term follow-up for resorption monitoring

Which Department to Visit?

You can visit our Ağız ve Diş Sağlığı department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ağız ve Diş Sağlığı Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.