Accidents happen, but when you knock out a tooth, you can quickly start to panic. Whether you’ve experienced a sports injury, a fall, or an unexpected blow, it’s important to know what to do in order to preserve the tooth. Follow this step-by-step guide to improve your chances of saving your smile.

Step 1: Stay Calm and Assess the Situation

The most important step in any emergency situation is to remain calm. It’s easy to panic when you knock out a tooth, but that will make it harder to take the necessary steps.

And while you may be scared about your tooth, make sure you check for other injuries and, if needed, seek medical attention for serious wounds before you address the injury to your smile.

Step 2: Locate the Tooth

After assessing yourself for other injuries, find the knocked-out tooth as soon as possible. Handle it carefully —  only picking it up by the crown (the white, top part) and never the root. Touching the root can damage the delicate tissue needed to put the tooth back successfully. 

Step 3: Rinse Gently If Necessary

If the tooth is dirty, rinse it gently with milk, water, or saliva. You can rinse it quickly with water, but milk or saliva are better options for preserving the delicate tooth surface. Avoid scrubbing or wiping the tooth, as this can remove important cells necessary for reattachment.

Step 4: Try to Reinsert the Tooth

If possible, carefully push the tooth back into its socket; ensure you only touch the crown. Hold it in place with your fingers or by lightly biting down on a clean cloth or gauze. If you have a mouthguard, you can use that to help you keep the tooth in place. This step won’t help you reattach the tooth, but it will give it the best chance of survival. If reinserting isn’t an option, move on to step 5.

Note: A baby tooth should not be reinserted, as this could damage the permanent one underneath the gumline. The baby tooth could fuse to the bone and cause problems when it’s time to fall out and affect the growth of the adult tooth. 

Step 5: Keep the Tooth Moist

If you can’t reinsert the tooth, you need to keep it moist in order to keep it viable. 

You can store it in your mouth, between your cheek and gum. This should only be done if you are conscious and can safely hold it there without the chance of accidentally swallowing it. If you can’t store it in your mouth, place it in some milk or use a tooth preservation kit if you have one.

Avoid storing the tooth in regular tap water; your tooth can’t tolerate staying in water for extended periods of time. It could damage its delicate root surface and ruin the chance of preservation. 

Step 6: Get to a Dentist Immediately

A knocked-out tooth has the best chance of being saved if reimplanted within 30 to 60 minutes. Visit an emergency dentist or the nearest dental office as soon as possible after you knock out a tooth for professional care.

A dentist will ensure the tooth is positioned correctly and possibly take an X-ray. They may also need to numb the area, so they can move the tooth freely. 

Step 7: Follow Up on Dental Care

Even if the tooth is successfully reinserted, make sure you attend any follow-up appointments.  Your dentist may recommend wearing a splint on either side of the tooth for a few weeks to stabilize it, and further treatments like root canals may be necessary.

Preventing Future Dental Injuries

To reduce the risk of knocking out a tooth —

• Wear a well-fitting mouth guard when playing sports. For the best protection, you or your child should get a mouth guard custom-fitted at a professional dental office. 

• Avoid chewing on hard foods or non-food objects, such as ice or pens. You should also avoid using your teeth as tools to open or tear packaging. 

• Be mindful of your surroundings and take appropriate precautions to prevent falls, especially for young children and older adults.

• Practice good dental hygiene and attend routine dental visits to keep your teeth healthy and free from gum disease. Gum disease can make your teeth weaker and more susceptible to being knocked out if you get in an accident.
  

Don’t Panic When You Knock Out a Tooth

A knocked-out tooth may be one of the most serious dental emergencies, but quick and proper action can increase the chances of saving it. Just carefully and gently handle the tooth, keep it moist, and get to a dentist as soon as possible, and you can save your smile.

Root canals are a great way to save your tooth from infection and damage. However, like any other medical procedure, they aren’t always perfect. While the success rate for root canals is incredibly high, there are instances where your tooth may not heal as expected, or complications arise, also known as a failed root canal. 

If you suspect your root canal has failed, it is essential that you take action as soon as possible. But knowing you’re experiencing a failed root canal may be more difficult than you expect. Understanding the signs, causes, and treatment options can help preserve your oral health and your tooth. 

Signs of a Failed Root Canal

The first step to identifying a failed root canal is understanding the symptoms you may experience. The most common symptoms of a failed root canal include: 

• Persistent Pain: While it is common to feel some discomfort following a root canal, this pain should subside after a few days. If you’re experiencing ongoing pain in the treated tooth, it could indicate that the infection has returned or was not eliminated. 
• Swelling: Your gums may be swollen immediately following a root canal, but this often goes away within 48 hours. If your gums, face, or jaw near the treated tooth is still swollen after 48 hours, this may signal a problem with the tooth. 
• Sensitivity: Increased sensitivity to hot and cold foods or beverages and pressure on the treated tooth may be a sign of a lingering issue and will need to be addressed by a trusted endodontist as soon as possible. 
• Discharge: If you notice pus forming near the treated tooth or a persistent bad taste in your mouth, it may indicate discharge development in your gums and will need to be treated immediately to prevent further health complications. 
• Darkened Tooth: Following a root canal, you shouldn’t notice a change in the appearance of your tooth. However, if the tooth begins to turn gray or dark, it may indicate an internal problem. 
• Recurring Abcess: In more extreme cases, you may develop an abscess before your root canal. This should go away after treatment. However, if it returns, you may be experiencing a failed root canal. 

Common Causes of Root Canal Failure

There are several reasons why you may experience a failed root canal. First, you may have had an incomplete cleaning. This means there was missed infected tissue and bacteria during the procedure, allowing the infection to persist. You may also have complicated anatomy, which makes the procedure more difficult. 

If your root system is complex or unusual, it can make it far more difficult to clean the infected tissue from your tooth. Additionally, new decay can form around the treated tooth, compromising the filling or crown. If it is compromised, this new decay can allow bacteria to reenter the tooth, leading to repeat infection. 

Individuals involved in accidents that result in cracked or fractured teeth are also at an increased risk of root canal failure, as these cracks can expose the inner structure to bacteria. Finally, if your teeth have extra canals that are difficult to detect, they may remain untreated, leading to failure. 

What to Do If Your Root Canal Fails

While a failed root canal can be frustrating, there are reliable ways to treat the tooth and restore the health of your smile. In many cases, your best option is endodontic retreatment. You’ll need to repeat the initial root canal procedure. During retreatment, your endodontist will remove any remaining tissue and reseal the tooth. 

If retreatment isn’t a reliable option for your tooth, your endodontist may recommend an apicoectomy. This procedure removes the tip of the tooth’s root and seals it to prevent further infection. While it sounds complex and painful, this is a great way to save your tooth from further damage.

Finally, your endodontist may recommend tooth extraction and replacement. It is important to note that your endodontic team won’t recommend this unless absolutely necessary. They will do everything they can to preserve the tooth before taking this step. After extraction, they’ll discuss replacement options like dental implants or bridges to restore oral function. 

No matter what your endodontist recommends, it is best to follow their advice if you want to protect your smile from additional damage. Allowing an infection to go untreated can be incredibly detrimental to your oral and overall health, making prompt treatment essential if you want to avoid complex medical problems. 

How to Prevent Root Canal Failure

In addition to working with an expert endodontic team, there are a few things you can do to avoid failed root canals. Some of the easiest ways to protect your teeth from retreatment include:

• Visiting your dentist for twice-yearly cleanings and checkups.
• Maintain good oral hygiene, brushing twice daily and flossing at least once a day.
• Avoid chewing hard foods or objects that may crack your teeth. 
• Address any new decay and damage as soon as possible. 

Trust Our Experts in Northern Utah

If you are dealing with the discomfort of a failed root canal, you don’t have to face it alone. Instead, turn to our team at David G. Johnson, DDS., for support. Our team of experts has been providing reliable endodontic treatment to patients across the Wasatch Front for over 30 years. With our advanced tools and training, we can restore your tooth and relieve lingering pain.

When you’re ready to schedule an appointment to address a failed root canal, don’t hesitate to contact us at our Centerville or Layton office.