A 12-year-old girl was hit in the face by an errant softball pitch while batting and has had her mandibular incisors knocked out. Which of the following represents the best plan of action?
The earlier the permanent teeth are reimplanted, the greater the rate of success, decreasing from 90% in the first 30 minutes to 5% after 2 hours. The rate of success is a function of the integrity of the periodontal ligament. The teeth can be rinsed in cold water, but not brushed (to avoid damaging the root and periodontal ligament). Milk and saline are good transport media if the child is uncooperative or for some other reason the teeth cannot be reinserted at the scene. Teeth may also be transported in the mouth of the older, cooperative patient or the parent. The immediate application of acrylic splints is needed to keep the teeth in place, so urgent dental attention is required. The need for full tetanus immunization should be evaluated. Unless the tooth is available, patients who are suspected of having a total avulsion should be evaluated for partial avulsion or total intrusion with a radiograph. A completely avulsed primary tooth is generally not replaced, to avoid damage to the underlying permanent tooth.
The teeth should be rinsed in hot water then carefully dried.
Foreign matter adhering to the teeth should be immediately scrubbed off.
The avulsed teeth may be preserved in tea, juice, or cola.
The avulsed teeth may be transported in the mouth of a cooperative patient.
Gastro Intestinal System