Losing a tooth can be physically and emotionally trying, as the resulting empty site is not aesthetically pleasing and is difficult to fill and difficult to replace. Long-term sequelae include shifting of remaining teeth with resulting misalignment and periodontal disease. As early as 400 BCE, Hippocrates suggested that displaced teeth should be replaced and fastened to adjacent teeth with wire. Modern emergency departments focus on reimplanting teeth as soon as possible, minimizing periodontal damage, and preventing infection of the pulp tissue. The usual cause is a directed force sufficient to overcome the bond between the affected tooth and the periodontal ligament within the cradling alveolar socket.
Avulsion results in hypoxia and eventual necrosis of the pulp.
The primary goal of rapid reimplantation is to preserve the periodontal ligament, not the tooth. Facial injuries are common during war. During the Korean War, maxillofacial injuries numbered 3,000. Morbidity to the teeth may be individualized to primary or permanent teeth. In youths, falls and sporting activities account for the majority of injuries.