Pediatric emergency medicine trisk 3248 3248

TABLE 105.2
SEQUENCE OF PRIMARY TOOTH EXFOLIATION

If the avulsed tooth was a permanent tooth it should be first gently rinsed with
saline, taking care to hold the crown of the tooth and not the root. The tooth
should then be inserted into the socket in its normal position. Until splinting is
achieved, the tooth may extrude slightly due to pressure from the blood in the
socket. Avulsed primary teeth are generally not reimplanted because of the
complex treatment needed to preserve the tooth and potential damage to its
developing succedaneous tooth. If on-site reimplantation of an avulsed tooth is
not possible, the tooth should be placed in a storage medium that preserves the
vitality of the PDL of the root surface. ViaSpan or Hanks balanced salt solution is
an ideal cell culture for this purpose. A commercial product such as the 3M Savea-Tooth™ Emergency Tooth Preserving System (Smart Practice, Phoenix, AZ)
containing Hanks solution is available to place the tooth into during
transportation to the dental office. If none of these products are available, cold
milk is an excellent alternative transport medium. Although saliva or saline is not