1. What is Tooth Avulsion?
Tooth Avulsion is the complete displacement of a tooth from its socket in alveolar bone owing to trauma. The treatment for permanent teeth consists of replantation, immediately if possible.
![tooth-1](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-1.jpg)
2. What happens to an avulsed tooth?
- Periodontal attachment damage
- Dental pulp necrosis
- Dental cementum damage
![tooth-2](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-2.jpg)
3. What are the critical factors in management of an avulsed tooth?
- Time interval between injury and treatment
- Conditions under which the avulsed tooth is stored
![tooth-3](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-3.jpg)
4. What are the first aid measures for an avulsed tooth by trauma?
- Do’s
- Locate the tooth
- Hold the crown portion of the tooth only
- Rinse under running tap water
- Insert tooth back in its original place(socket) and position and gently occlude with gauze
- Don’ts
- No scrubbing or scraping while cleansing
- Do not use soap or alcohol
- Do not forget to plug the sink while washing under running water
![tooth-4](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-4.jpg)
5. If we are not able to position the tooth back in its socket, what is the next step we have to take?
Bring the tooth in a storage medium if not manageable.
![tooth-5](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-5.jpg)
6. What are the storage media we can use to bring the tooth?
- HBSS – Hanks balanced salt solution
- Milk
- Saline
- Contact lens solution
- Buccal vestibule or under the tongue
- Unsalted water
- Saliva
- In that order of preference.
![tooth-6](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-6.jpg)
7. Is there a time period within which I have to reach a dentist?
YES!
- Within 30 minutes of injury tooth in a storage medium is most ideal
- Within 20 minutes ‘extraoral dry time’, is optimal
- At least within 60 min dry time
- A dry time of more than 60 minutes, survival of root periodontal ligament is unlikely
![tooth-7](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-7.jpg)
8. What if we exceed 60 minutes and not able to carry in a storage medium?
- Periodontal ligament cells will not survive
- Endodontic treatment for the tooth is done extra orally
- Reimplantation is done followed by splinting
- Tooth gets ankylosed with jaw
![tooth-8](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-8.jpg)
9. What if we cannot find the tooth?
- o be continued………in “A Tooth for a Tooth – Part 2”
- Keep smiling till then 🙂
![tooth-9](https://www.kauveryhospital.com/images/newsletters/2017_inside/tooth-9.jpg)
![Dr. Rakesh-Oct-26-2015-03-31-37-Rakesh](https://www.kauveryhospital.com/images/newsletters/2017_inside/Dr.%20Rakesh-Oct-26-2015-03-31-37-Rakesh.jpg)
Article by Dr. Rakesh. U., BDS.,
Dental Surgeon
Kauvery Hospital, Chennai
References: 1. Pediatric dentistry – Principles and Practice, by MS Muthu, N. Sivakumar.