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Featured: Dental Trauma, Knocked Out Tooth

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The following article is used here with permission from our friends Dr. Bones and Nurse Amy. Enjoy!

We have discussed the issue of trauma evaluation and treatment in various articles over the past year, but we have rarely brought up the issue of dental trauma.  During the Vietnam war, medical personnel reported that there were as many dental issues presented at Sick Call as medical issues.  In a collapse situation, therefore, we can expect a percentage of the Survival Medic’s patients to come with dental problems as well. Despite this, few people who are otherwise medically prepared seem to devote much time to dental health.

Today’s dentists have high technology on their side, but this technology will not be available if things go South.  Therefore, we look to historical methods of treating these problems.  Although some of these methods may not currently be in use, they may suffice to at least temporarily deal with the issue in times of trouble. . Of these issues, some will be related to trauma

Dental trauma may appear in various forms.  After an injury to the oral cavity, a person may have:

  • a portion of a tooth chipped or broken off (a dental fracture)

(here’s our link to part 1 about dental anatomy and tooth fractures):

http://www.doomandbloom.net/2012/04/dental-trauma-part-1-fractures.html

  • a loose tooth (a dental subluxation)
  • a tooth knocked out completely (a dental avulsion)

A tooth that is knocked loose but not out of its alveolar socket is called a subluxation. Lightly using your gloved hand or a cotton applicator should identify if it is loose and how much.  Minimal trauma may require no major intervention. If a tooth is loose, it should be pressed back into the alveolus (socket)  and “splinted” to neighboring teeth for stability.  Dentists use wire or special materials for this purpose, but you might find yourself having to use soft wax if professional help is not at hand. Prevent further trauma by placing on a liquid diet (juices, jello) for a time, until the tooth appears well anchored.  Soft diets (things like puddings or soft cereals) are also ok.

The most favorable situation when a tooth is completely knocked out (an “avulsion”) is that it came out in one piece, down to its root and ligament.  In this circumstance, time is a very important factor in possible treatment success.  If the tooth is not replaced or at least placed in a preservation solution, the success of reimplantation drops 1% every MINUTE the tooth is not in its socket.

A good preservation liquid for teeth that have been knocked out is “Hank’s Solution”. This is a balanced salt solution that has been used to culture living cells, and it helps protect raw ligament fibers for a time.  Hank’s Solution is available commercially as “Save-a-Tooth”.  Although you can make your own Hank’s Solution, it is a fairly complex process. (http://www.thelabrat.com/protocols/Hanks.shtml)

If you are not at your retreat at the time of injury:

  • Find the tooth
  • Pick it up by the crown, avoid touching the root as it will damage the already damaged ligament fibers.
  • Flush the tooth clean of dirt and debris with water or saline solution. Don’t scrub it, as it will damage the ligament further.
  • If you don’t have preservation solution, place the tooth in milk, saline solution, or saliva (put it between your cheek and gum, or under your tongue). This will keep your ligament cells alive longer than plain water will.

If the tooth has been out for less than 15 minutes, you may attempt to reimplant it…

 

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