dental disorders
Fractured and Avulsed Teeth
Tooth avulsion
Avulsed primary teethare not replaced because they typically will become necrotic, then infected. They may also become ankylosed and thus not exfoliate, thereby interfering with the eruption of the permanent tooth. If apermanent tooth is avulsed, the patient should replace it in its socket immediately (handling it by the crown only) and seek dental care to stabilize it. If this cannot be done, the tooth should be kept immersed in saline or milk, or wrapped in a moistened paper towel and brought to a dentist for replacement and stabilization. If these substances are not available and the patient is conscious and not at risk for aspirating the tooth, the tooth can be placed in the patient's mouth during transport to a dental office. The tooth can be rinsed gently under cold water for a maximum of 10 seconds if dirty but should not be scrubbed because scrubbing may remove viable periodontal ligament fibers, which aid in reattachment. 8 years, when there is the possibility of tooth staining, another antibiotic should be considered (eg, penicillin VK 500 mg orally every 6 hours). Additionally, if the tooth came in contact with dirt, the patient's Tetanus-Diphtheria Vaccine status should be evaluated. If the avulsed tooth cannot be found, it may have been aspirated, embedded in soft tissue, or swallowed. A chest x-ray may be needed to rule out aspiration, but a swallowed tooth is harmless. Do not scrub an avulsed tooth clean because this may remove viable periodontal ligament fibers. A partially avulsed tooth that is repositioned and stabilized quickly usually is permanently retained. A completely avulsed tooth may be permanently retained if replaced in the socket with minimal handling within 30 minutes to 1 hour. Both partial and complete avulsions usually ultimately require root canal therapy because the pulp tissue becomes necrotic. When replacement of the tooth is delayed, the long-term retention rate drops, and root resorption eventually occurs. Nevertheless, a patient may be able to use the tooth for several years. 