ON SITE TX:
- Immediately rinse/gently remove foreign objects. If unable to replant tooth at site of injury then use a transport media to get to dentist - milk, saline or saliva.
- If the tooth is not reimplanted, and a transport media is not used, the emergency treatment by the doctor must be done within 1 hour. (If the tooth is dry for greater than an hour, reimplantation by the dentist is generally not indicated)
AT DR'S OFFICE:
- Clean off affected area (water, saline or chlorhexidine) - don't extract tooth if it has been re-implanted.
- If the tooth is out of the mouth, prepare it for reimplantation by: cleaning with saline, soak in 1mg/20ml doxycycline, remove coagulum from socket with saline, reposition the socket wall if fractured, gently replant the tooth with finger pressure.
- Take radiograph to verify position
- Flexible splint (fishing line, mild steel wire)
- Antibiotic Rx: Doxycyline 2x/day for 7 days or Penicillin 4x/day for 7 days
- Tetnus booster
7-10 DAYS LATER:
- Remove splint
- Begin to monitor for re-vascularization (thermal testing baselines)
- Continue to monitor - avoid endodontic treatment unless obvious signs of non-healing are present (pain, swelling, increasing radiolucency). It may take 3 months for the tooth to respond to thermal testing again.
- If endodontic treatment is necessary, follow guidelines for Apexification.
For more information regarding treatment of traumatic injuries: click here