UMEM Educational Pearls

Category: Orthopedics

Title: Dental Avulsion in the field/sporting event

Keywords: Dental avulsion, tooth, trauma (PubMed Search)

Posted: 1/27/2018 by Brian Corwell, MD
Click here to contact Brian Corwell, MD

Dental Avulsion in the field/sporting event

- Only replace avulsed secondary teeth

- Handle the tooth by the crown only

- Rinse tooth with cold running water gently (the root should not be wiped)

- Immediate attempt to reimplant permanent tooth into socket by 1st capable person:

* Time is tooth: Each minute tooth is out of socket reduces tooth viability by 1%

* Best chance of success if reimplant done within 5–15 min*? Poor tooth viability if avulsed for >1 hr

- If unsuccessful, place tooth in a transport solution (from most to least desirable):

- Hanks balanced salt solution (HBSS)

* Balanced pH culture media available commercially in the Save-A-Tooth kit

* Effective hours after avulsion

- Cold milk:

* Best alternative storage medium

* Place tooth in a container of milk that is then packed in ice (prevents dilution)

- Saliva:

* Store in a container of parent or child's saliva

- Never use tap water or dry transport