UMEM Educational Pearls

Category: ENT

Title: Avulsed Tooth

Keywords: Avulsed Tooth, hanks solution, dental emergencies (PubMed Search)

Posted: 3/16/2008 by Michael Bond, MD (Updated: 12/9/2019)
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Dental Emergency -- Avulsed Tooth

  • Never reimpant a primary tooth.  If replaced, primary teeth have a high likelihood of fusing to underlying alveolar bone, which causes dentoalveolar ankylosis and can result in facial deformities
  • Never wipe off a tooth, or hold it by the root. The periodontal ligament is easily wiped off and the tooth will not reimplant without it.
  • For maximal success, the tooth should be reimplanted within 60 minutes.
  • Avoid allowing the periodontal ligament from drying out.  Transport the tooth in (listed in order of preference):
    • Hanks Solution or EMT Tooth Saver
    • Milk
    • Saline
    • Saliva
  • Once the tooth is reimplanted it should be held in place with a wire splint or Coe-Pak that bridges the avulsed tooth to the ones on either side of it.
  • Place the patient on antibiotics (Penicillin or Clindamycin) in order to prevent any infections.
  • If the avulsed tooth can not be found a Chest X-ray should be obtained to ensure that the tooth was not aspirated.