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Tooth Replantation

Last updated May 7, 2019

Approved by: Maulik P. Purohit MD, MPH

(U.S. Air Force photo by Airman 1st Class Emily A. Bradley/Released)

Tooth Replantation is a surgical procedure that involves reinserting a tooth that has been knocked or torn from its socket, back to its normal position.

Background Information:

What are the other Names for the Procedure?

  • Replantation of Tooth
  • Surgical Replacement of the Dislodged Tooth

What is the Tooth Replantation surgical procedure?

Tooth Replantation is a surgical procedure that involves reinserting a tooth that has been knocked or torn from its socket, back to its normal position.

What part of the Body does the Procedure involve?

A Tooth Replantation procedure involves the teeth, gums, and mouth.

Why is the Tooth Replantation surgical procedure Performed?

A Tooth Replantation is performed to prevent the permanent loss of a tooth.

What are some Alternative Choices for the Procedure?

There are no known alternatives to a Tooth Replantation technique.

What are the Recent Advances in the Procedure?

Cells called fibroblasts (cells that make connective tissue) are present around the tooth and help in anchoring the tooth in place. Artificial fibroblasts may be used to aid the replantation process.

What is the Cost of performing the Tooth Replantation surgical procedure?

The cost of Tooth Replantation procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding Tooth Replantation and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

Prior to Tooth Replantation surgical procedure:

How is the Tooth Replantation surgical procedure Performed?

  • The Tooth Replantation procedure is performed after numbing the area with local anesthesia
  • The tooth is inserted back in the socket (sometimes after removing the nerve in the root canal) and held in place using a splint. Any gum defect is also repaired
  • The splint is kept in place for a few weeks and removed after ensuring the stability of the replanted tooth

Where is the Procedure Performed?

A Tooth Replantation procedure is usually performed in an out-patient surgery center facility, a dentist or oral surgeon’s clinic/office, an emergency room, or a hospital.

Who Performs the Procedure?

A dentist or an oral surgeon performs the Tooth Replantation procedure.

How long will the Procedure take?

The procedure may take anywhere from a few minutes to an hour to perform.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Tooth Replantation procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are currently being taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For individuals suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for the Tooth Replantation procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Tooth Replantation surgical procedure?

There are usually no diagnostic tests performed before a Tooth Replantation procedure, due to the immediate requirement for surgery.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is Tooth Replantation procedure?
  • Why is this procedure necessary?  How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests or periodic visits to the healthcare facility required, after the procedure?
  • What are the costs involved?

During the Tooth Transplantation surgical procedure:

What kind of Anesthesia is given, during the Procedure?

Local anesthesia by injection is administered for the procedure.

How much Blood will you lose, during the Procedure?

There is hardly any blood loss during the Tooth Replantation procedure.

What are the possible Risks and Complications during the Tooth Replantation surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

  • Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
  • Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness, such as autoimmune disorders and chronic infections
  • Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Tooth Replantation surgery are:

  • Excessive bleeding
  • Infection within the surgical wound
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Tooth Replantation surgical procedure?

At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.

After the Tooth Transplantation surgical procedure:

What are the possible Risks and Complications after the Tooth Replantation surgical procedure?

The possible risks and complications that may arise after a Tooth Replantation procedure are:

  • Excessive bleeding
  • Infection surrounding the surgical wound
  • In rare cases, rejection of the tooth may occur (mostly if performed immediately after a trauma)

What is the Prognosis after the Surgery?

The prognosis following a Tooth Replantation is generally good, especially if the procedure is done within a couple of hours of losing the tooth.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Pain that worsens and swelling around the gums and teeth
  • Bleeding or fluid drainage from the surgical wound
  • The occurrence of any symptom that causes uneasiness such as nausea or vomiting
  • Signs of an infection
  • Headache, muscle aches
  • Dizziness
  • Fever, feeling sick
  • Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Tooth Replantation surgical procedure?

At home, the following post-operative care is recommended after a Tooth Replantation procedure:

  • Avoid rinsing your mouth, spiting, smoking, or using drinking straws, for the first day after the procedure. Then, proceed to rinse your mouth with warm salt-water every couple of hours
  • Use a soft toothbrush to brush your teeth
  • Avoid biting down on the affected tooth until it has completely healed. Eat soft, chewable foods for a couple of days after the procedure
  • Complete the course of prescribed medication under advice of the physician
  • Take antibiotic medication to help combat or prevent infection, per your physician’s advice
  • Avoid taking nonprescription medications such as aspirin. However, individuals may take acetaminophen to relieve pain (per the physician’s advice)
  • Avoid all activities that are physically strenuous for about 3 weeks after surgery
  • Resuming normal daily food and fluid intake after the procedure will result in a faster healing process. If a normal daily diet seems difficult at first, attempting a high-protein liquid diet for a few days might help
  • Avoid drinking alcoholic beverages until there is a complete healing

How long does it normally take to fully recover, from the Procedure?

A splint may be used to hold the tooth in place.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The procedure does not involve the surgical removal of any tissue.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient

Who will you receive a Bill from, after the Tooth Replantation surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • An out-patient surgery center facility, dentist or oral surgeon’s clinic/office, an emergency room, or a hospital
  • An anesthesiologist (if anesthesia was administered)
  • A dentist or an oral surgeon

The patient is advised to inquire and confirm the type of billing, before the Tooth Replantation procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: June 27, 2015
Last updated: May 7, 2019