An avulsed tooth is one that has been completely displaced from its socket. For permanent teeth, immediate replantation within 1 hour of avulsion has the best prognosis. The tooth should be gently rinsed and replanted in its socket, holding it in place until dental care can be received. If immediate replantation is not possible, the tooth should be transported in a moist environment like milk or saline to reduce the dry time before replantation by a dentist. Deciduous teeth should not be replanted due to risks of damage to the developing permanent tooth.

1. Shaharyar Khan
OMFS
THE AVULSED TOOTH

2. TOOTH AVULSION
• A tooth that has been completely displaced from its
socket.
• The avulsion of a permanent tooth is one of the few
emergency situations in dentistry.

3. MANAGEMENT
• Deciduous teeth
• Permanent teeth

4. DECIDUOUS TEETH
• DO NOT REPLANT THE TOOTH
• Damage to the developing permanent tooth
• Risk of ankylosis
• Make sure that the tooth is not intruded
• Stitch the soft tissue lacerations

5. PERMANENT TEETH
• Immediate replantation
• Replantation within 1 hour
• Extra-oral dry time < 20 min
• Extra-oral dry time 20-60 min
• Replantation after 1 hour

6. IMMEDIATE REPLANTATION
• Best prognosis
• Prognosis of the tooth is inversely related to the
extraoral dry time

7. PROCEDURE
• Gently wash the socket to remove any debris.
• Rinse the tooth in cold, running tap water for 10 seconds.
• DO NOT SCRUB THE TOOTH!!!
• Hold the tooth with the crown and gently replace it in the socket.
(Avoid touching the root)
• Hold the tooth in position or Have the patient bite on a
handkerchief
• Seek dental care immediately.

8. WHAT IF IMMEDIATE REPLANTATION IS
NOT POSSIBLE???
• The patient should bring the tooth to the dentist as soon as
possible.
• Reduce the dry-time – Keep the tooth moist
• Transport media
• Hanks balanced salt solution
• Normal Saline
• Milk
• Saliva (Buccal vestibule)
• Do Not use tap water

9. SAVE YOUR
TOOTH
Poster published by International
association of dental
traumatology, 2011

10. REFERENCES
• Torabinejad M., Walton R.E., Endodontic Principles and Practice, 4th ed.
• IADT “Save your tooth” poster
• Dental Trauma Guide 2010