• What do you do first? Move off the trail and if you are with other riders post someone to warn oncoming riders. Perform a primary survey to assess other injuries. If you don’t need to treat other injuries, you can now focus on reimplanting the tooth.

Find the tooth. Take look at the image of a tooth lying in dirt so you know what it looks like. Once it is found, the best thing to do is to try to put the tooth back in its socket, so be careful of the tooth. A tooth can survive with a high rate of success if reimplanted in the first 20 minutes after the accident. This isn’t always practical when you consider the amount of time needed to assess the situation, secure the trail, survey the patient, find the tooth, prepare the tooth and socket, and get the tooth back into the socket. While not ideal, the prognosis is still good if this can all be done quickly.

Step I – Find the tooth. This might be difficult. Only handle the tooth by the crown, the roots have periodontal ligament cells that need to be preserved so that the tooth can reattach once it’s back in the socket.

Step 2 – Clean the tooth. On the trail you may need to use whatever liquids you have available. First choice is water. Simple rinse the tooth to remove dirt or other particles. If you have some stubborn pieces of gravel etc. you can gentle pick those off. DO NOT scrub the root.

Step 3 – Manage the Socket. The socket will bleed and eventually the blood will clot. If it looks clean implant the tooth. If you can see a clot has formed have the rider rinse vigorously with water to loosen the clot. You can also try to squirt the socket if possible. Once clean the tooth should go right in. Keep moderate pressure on the tooth to help seat it into place.

Step 4 – Stabilize the tooth.  The tooth may still be mobile and want to ‘fall out.’ The rider may need to hold the tooth in place with a tongue or finger until they get to a dentist.

IIf you cannot reimplant the tooth, take the patient and the tooth to the dentist as quickly as possible. Unfortunately, there is not a good liquid that is also commonly taken to the race or when riding. The best solution to store a tooth in as you get the rider to a dentist is Hank’s Balance Salt Solution. But you would have to have purchased this.  So here are some other solutions that can be used with approximate storage times to keep the tooth and its ligaments alive. 

Milk is the best choice:  4-8 hrs.

Coconut water is very good:  1-3 hours

Salvia can be used in a pinch: 1 hour

Sports Drinks are bad and should be used as a last resort: 20 – 30 min

Water – Unfortunately storing a tooth in water destroys cells at the root of the toot, but it can be used to rinse the tooth 

Riders, coaches, families all need to go to the cars. DO NOT GO TO THE TEAM TENT. If lightning were to strike the poles or the ground near the tent, multiple injuries or deaths could occur. While a tent will protect you from rain, it actually increases the risk of lightning injures and death.

This is an old term which has no meaning. Remember, when you hear lightning go to the cars and get in.

There is no safe place outdoors. You need to go inside or into a car or truck. Cars and trucks are very safe in a lighting storm. in fact, they are one of the safest places to be. They are protected from ground strikes, and if a bolt hits the vehicle, lighting will pass around on the outside, protecting the people inside.