Avulsion (entire tooth knocked out)

1. Avoid additional trauma to the tooth while handling. Do Not handle tooth by the root. Do Not brush or scrub tooth. Do Not sterilize tooth.

2. If debris is on tooth, gently rinse with water.

3. If possible, reimplant tooth and stabilize by biting down gently on a towel or handkerchief. Do only if athlete is alert and conscious.

4. If unable to reimplant:

• Best - Place tooth in Hank's Balanced Saline Solution.
• 2nd best - Place tooth in cold milk.
• 3rd best - Wrap tooth in saline-soaked gauze.
• 4th best - Place tooth under athlete's tongue. Do this ONLY if athlete is conscious and alert.
• 5th best - Place tooth in cup of water.

5. Time is very important. Reimplantation within 30 minutes has the highest degree of success rate. TRANSPORT IMMEDIATELY TO DENTIST.

Luxation (tooth in socket, but wrong position)

Three positions

Extruded tooth - Upper tooth hangs down and/or lower tooth is raised up.

• Reposition tooth in socket using firm finger pressure.
• Stabilize tooth by gently biting on towel or handkerchief.
• TRANSPORT IMMEDIATELY TO DENTIST.

Lateral displacement - Tooth pushed back or pulled forward.

• Try to reposition tooth using finger pressure.
• Athlete may require local anesthetic to reposition tooth; if so, stabilie tooth by gently biting on towel or handkerchief.
• TRANSPORT IMMEDIATELY TO DENTIST.

Intruded tooth - Tooth pushed into gum - looks short.

• Do nothing - avoid any repositioning of tooth.
• TRANSPORT IMMEDIATELY TO DENTIST.

Fracture (broken tooth)

1. If tooth is totally broken in half, save the broken portion and bring to the dental office as described under Avulsion, Item 4. Stabilize portion of tooth left in mouth by gently biting on towel or handkerchief to control bleeding.

2. Should extreme pain occur, limit contact with other teeth, air or tongue. Pulp nerve may be exposed, which is extremely painful to athlete.

3. IMMEDIATELY TRANSPORT PATIENT AND TOOTH FRAGMENTS TO DENTIST.