dental disorders
How To Replace and Splint an Avulsed Tooth
Aftercare
Give Tetanus Prophylaxis in Routine Wound Management if needed. Antibiotics are usually appropriate (eg,amoxicillin500 mg 3 times a day for 7 days, or weight-adjusted dose for children). The patient should not chew on the affected side, should ingest only liquids and soft foods, and should avoid hot and cold foods. Very gentle warm salt water rinses are done every 3 to 4 hours (while awake) until follow-up. Gentle brushing after meals (directed away from the gum line) and achlorhexidine(0.12%) 30-second rinse is done with spitting twice daily while the splint is in place. Ice chips and NSAIDs (nonsteroidal anti-inflammatory drugs, eg,ibuprofen400 mg every 6 hours) are given for pain; narcotic analgesics (eg,acetaminophenwithcodeine,hydrocodone, oroxycodone) may be used if needed for a severe injury. For relief of swelling, apply ice packs (30 minutes on, 30 minutes off) to the side of the face for 24 hours, then switch to warm compresses Arrange follow-up with a dentist as soon as possible, same day if possible, for hygienic splint placement (eg, wire and bonded resin). Instruct the patient that reinserting and splinting an avulsed tooth does not guarantee its survival. Even if reimplantation is successful, the tooth will require root canal therapy (rarely, a quickly reimplanted immature tooth with an open apex will revascularize and not require root canal). 