dental disorders
How To Replace and Splint an Avulsed Tooth
Contraindications
Absolute contraindications Primary tooth involvement Intruded tooth (pushed deeper into socket) Significant alveolar fracture, socket damage, or fractured or grossly decayed permanent tooth Moderate/severe periodontal disease in the area of the injured tooth Such patients should be referred to a dentist or oral surgeon for management. Avulsed primary teeth are not replaced because they typically become necrotic, then infected. They may also become ankylosed and thus not exfoliate, thereby interfering with the eruption of the permanent teeth. Relative contraindications Prolonged time out of socket (>2 hours) Congenital cardiac defects Immunosuppression Long-term prognosis is poor but do not discard the tooth; place the tooth in HBSS and consult with a dentist or oral surgeon regarding advisability of attempting replacement. If specialist advice is unavailable and/or follow-up is uncertain, advise patient of very poor prognosis. If patient desires, attempt replacement as described below if time is reasonably close to 2 hours. 