Reimplantation refers to the insertion and temporary fixation of a completely or partially avulsed (knocked out) tooth due to traumatic injury.  There is no realistic way to prevent the avulsion of teeth as it usually occurs due to an accident.  However, wearing a mouth guard during sports activities usually helps reduce risk. 

The most common teeth to be knocked out are the upper front permanent teeth, although primary teeth can also be avulsed.  Reimplantation of primary teeth is not usually performed as these teeth are naturally replaced by permanent teeth later in life. 

The success of reimplantation depends on the amount of time the tooth is out of the socket.  If reimplantation can be performed within one hour of the tooth being knocked out, success rates are much higher. 

What To Do When A Tooth Is Knocked Out

If a tooth is knocked out it is very important that the affected teeth are retrieved and kept moist.  Handle the tooth only by the crown, not the root.  Store the tooth in milk or a saline (salt water) solution to keep it clean.  Contact lens solution is ideal.  Do not store the tooth in water.  The best place to store the tooth is within the cheeks inside the mouth so the tooth is kept in its natural setting.

Reimplantation

A local anesthetic will be administered first to numb the gums.  The doctor will then reinsert the avulsed tooth into the socket.  After the tooth is reimplanted into the original socket it is important to keep the tooth completely stable until the bone around it has time to completely heal.  The doctor will splint it to the adjacent teeth to keep the tooth from moving. 

In some instances the doctor will perform an immediate root canal to remove the nerve of the tooth and replace it with plastic material so as to prevent infection and further dental procedures. 

After Reimplantation

Splinting should last about two to eight weeks and during this time the patient should avoid biting on the splinted tooth and continue brushing their unaffected teeth thoroughly.  It is very important to keep the mouth as clean as possible because the threat of gingivitis is high on the affected teeth because they cannot be brushed or flossed normally.