Dental Emergencies

Knocked Out Tooth?

I. Management at Site of Injury

1. Do not handle the root surface (hold tooth by the crown).
2. If it is a permanent tooth, replant immediately, if possible. If contaminated, rinse with water or saliva quickly before replanting. Primary (baby) teeth should not be replanted.
3. When immediate replantation is not possible, place tooth in the best transport medium available.

II. Transport Media (In order of preference)

1. Saliva
2. Milk
3. Saline

III. Our management in the Dental Office

1. If extraoral dry time is less than one hour with or without storage in a physiological media (such as Hank's Balanced Salt Solution, milk, or saline), replant immediately.
2. If extraoral dry time is greater than one hour, soak in an accepted dental fluoride solution for 20 minutes, rinse with saline, and replant.

IV. Additional Considerations

1. Avulsed primary teeth should not be replanted.
2. Avulsed permanent teeth require follow-up evaluations for a minimum of 2-3 years to determine the outcome of therapy.
3. Inflammatory resorption, replacement resorption, ankylosis and tooth submergence are potential complications when avulsed teeth are replanted.

Other Dental Emergencies and Further Information

• Various dental emergencies - WebMD
• American Dental Assoc. information on dental emergencies
• Colgate information on dental emergencies
• Emedicine - fractured tooth

Thanks

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