Tooth Reimplantation

Tooth reimplantation is an emergency dental procedure involving the reinsertion of a tooth that has been completely knocked out (avulsed) from its socket. Time is critical — the best outcomes occur when the tooth is reimplanted within 30 minutes of avulsion. The survival of the periodontal ligament cells on the root surface determines the long-term prognosis. If a permanent tooth is knocked out, it should be handled only by the crown (never the root), gently rinsed with milk or saline if dirty, and ideally placed back into the socket immediately. If reimplantation at the scene is not possible, the tooth should be stored in milk, saline, or the patient's saliva during transport to the dentist. Upon arrival at the dental office, the tooth is reimplanted and splinted to adjacent teeth for one to two weeks to allow healing. Root canal treatment is typically needed within two weeks of reimplantation. Follow-up appointments monitor for complications including root resorption, ankylosis, and infection. Patient education about emergency protocols significantly improves reimplantation success rates.