Dental avulsion: Difference between revisions
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==Background== | ==Background== | ||
*Dental emergency | |||
*Tooth is completely removed from its socket | |||
*Often associated with alveolar ridge fracture | |||
==Diagnosis== | ==Diagnosis== | ||
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##Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury) | ##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 | ###If reimplanted within 1hr 66% chance of good outcome | ||
###Rinse tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth | ###Rinse (no scrubing!) tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth | ||
###Manipulate tooth only by the crown | ###Manipulate tooth only by the crown | ||
##Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline | ##Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline | ||
##Penicillin or clindamycin | ##Penicillin or clindamycin | ||
#Child | #Child | ||
##Do not | ##Do not re-implant primary teeth | ||
###Refer to pedodontist for space maintainer | ###Increased risk of interference with the eruption of the permanent tooth<ref>Amsterdam JT: Oral Medicine, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 68:p 853-856</ref> | ||
##Refer to pedodontist for space maintainer | |||
==See Also== | ==See Also== | ||
*[[Dental Problems]] | *[[Dental Problems]] | ||
== Source == | == Source == | ||
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*Tintinalli | *Tintinalli | ||
*UpToDate | *UpToDate | ||
[[Category:ENT]] |
Revision as of 13:39, 9 February 2015
Background
- Dental emergency
- Tooth is completely removed from its socket
- 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 (no scrubing!) 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 re-implant primary teeth
- Increased risk of interference with the eruption of the permanent tooth[1]
- Refer to pedodontist for space maintainer
- Do not re-implant primary teeth
See Also
Source
- ER Atlas
- Tintinalli
- UpToDate
- ↑ Amsterdam JT: Oral Medicine, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 68:p 853-856