Dental avulsion: Difference between revisions
(→DDX) |
(dx additional info) |
||
Line 4: | Line 4: | ||
==Diagnosis== | ==Diagnosis== | ||
*Where is the tooth? | |||
**It may be intruded, aspirated, swallowed, or embedded in the oral mucosa | |||
**Consider facial films, CXR | |||
*Additional Injuries? | |||
*Age and head bleed risk? | |||
==Differential Diagnosis== | ==Differential Diagnosis== |
Revision as of 13:35, 9 February 2015
Background
- Dental emergency
- Often associated with alveolar ridge fracture
Diagnosis
- Where is the tooth?
- It may be intruded, aspirated, swallowed, or embedded in the oral mucosa
- Consider facial films, CXR
- Additional Injuries?
- Age and head bleed risk?
Differential Diagnosis
Dentoalveolar Injuries
Odontogenic Infections
- Acute alveolar osteitis (dry socket)
- Acute necrotizing ulcerative gingivitis (trench mouth)
- Dental abscess
- Periapical abscess
- Periodontal abscess
- Ludwig's angina
- Pulpitis (dental caries)
- Pericoronitis
- Peritonsillar abscess (PTA)
- Retropharyngeal abscess
- Vincent's angina - tonsillitis and pharyngitis
Other
Management
- Adult
- Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
- If reimplanted within 1hr 66% chance of good outcome
- Rinse tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth
- Manipulate tooth only by the crown
- Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline
- Penicillin or clindamycin
- Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
- Child
- Do not reimplant primary teeth
- Refer to pedodontist for space maintainer
- Do not reimplant primary teeth
See Also
Source
- ER Atlas
- Tintinalli
- UpToDate