Difference between revisions of "Dental avulsion"

(dx additional info)
(reference, additional info)
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==Background==
 
==Background==
#Dental emergency
+
*Dental emergency
#Often associated with alveolar ridge fracture
+
*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 reimplant primary teeth
+
##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]]
 
[[Category:ENT]]
 
  
 
== 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

Other

Management

  1. Adult
    1. Replace avulsed tooth as soon as possible (as long as no alveolar ridge fx, no severe socket injury)
      1. If reimplanted within 1hr 66% chance of good outcome
      2. Rinse (no scrubing!) tooth in saline, suction socket (if necessary), reimplant tooth, bond tooth to neighboring teeth
      3. Manipulate tooth only by the crown
    2. Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline
    3. Penicillin or clindamycin
  2. Child
    1. Do not re-implant primary teeth
      1. Increased risk of interference with the eruption of the permanent tooth[1]
    2. Refer to pedodontist for space maintainer

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