Dental avulsion: Difference between revisions
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**Rinse (no scrubing!) 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 | ||
**Avoid touching root to minimize damage to periodontal ligament | |||
*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]] |
Revision as of 18:41, 17 August 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
- Avoid touching root to minimize damage to periodontal ligament
- Storage solution (in order of efficacy): Hank's balanced salt solution > Milk > saliva > saline
- Penicillin or clindamycin
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
See Also
Source
- ↑ 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