Avulsed Tooth Follow-up

Author: Lynnus F Peng, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP more...

Updated: Aug 12, 2009

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Further Outpatient Care
Complications
Prognosis
Patient Education
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Further Outpatient Care

Advise patients to follow up with a dentist within 24 hours. Document arrangements for follow-up care.
Advise patients to avoid eating solid foods to prevent loss of stabilizing dressing.
Finding the missing tooth is critical because successful reimplantations have occurred even the tooth being in dry storage for 1 week.

Loss of tooth
Cosmetic deformity
Infection

Immature permanent teeth have a higher chance of survival than older permanent teeth.
Root canal is necessary when necrotic tooth pulp becomes infected. Infection can pass from the pulp through the dentin tubules and stimulate an inflammatory response, resulting in inflammatory root resorption.
The chance of a successful reimplantation is dependent upon the amount of time the tooth has been out of the socket. Education of patients toward self-reimplantation may help to decrease the out-of-socket time.

A dental mouth guard is an effective device for preventing dental injuries, and patients should be advised to wear them during activities where dental injuries are possible.^[3]
For excellent patient education resources, visit eMedicine's Teeth and Mouth Center. Also, see eMedicine's patient education articles Broken or Knocked-out Teeth and When to Visit the Dentist.

Contributor Information and Disclosures

Author

Lynnus F Peng, MD Assistant Clinical Professor, Department of Anesthesia, University of California at Irvine; Chairman of Anesthesia, Department of Surgery, St Jude Medical Center at Fullerton

Lynnus F Peng, MD is a member of the following medical societies: Alpha Omega Alpha and American Society of Anesthesiologists

Disclosure: Nothing to disclose.

Coauthor(s)

A Antoine Kazzi, MD Chair and Medical Director, Department of Emergency Medicine, American University of Beirut, Lebanon

A Antoine Kazzi, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Willard Peng, DDS, MS Keck School of Medicine of the University of Southern California

Willard Peng, DDS, MS is a member of the following medical societies: American Dental Association and California Dental Association

Disclosure: Nothing to disclose.

Rebecca Cheng Loma Linda University School of Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael Glick, DMD Professor and Acting Chair, Department of Diagnostic Sciences, New Jersey Dental School, University of Medicine and Dentistry of New Jersey

Michael Glick, DMD is a member of the following medical societies: American Academy of Oral Medicine and American Dental Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Mark W Fourre, MD Program Director, Department of Emergency Medicine, Maine Medical Center; Associate Clinical Professor, Department of Surgery, University of Vermont School of Medicine

Disclosure: Nothing to disclose.

John D Halamka, MD, MS Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Professor of Emergency Medicine, Professor of Internal Medicine, Program Director, Emergency Medicine, Case Medical Center, University Hospitals, Case Western Reserve University School of Medicine

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, Arkansas Medical Society, New York Academy of Medicine, New York Academy of Sciences, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

References

Qin M. [Pulp treatment of young permanent teeth after traumatic dental injury]. Hua Xi Kou Qiang Yi Xue Za Zhi. Jun 2009;27(3):237-40. [Medline].
Zadik Y, Marom Y, Levin L. Dental practitioners' knowledge and implementation of the 2007 International Association of Dental Traumatology guidelines for management of dental trauma. Dent Traumatol. Jul 9 2009;[Medline].
Santos Filho PC, Quagliatto PS, Simamoto PC Jr, Soares CJ. Dental trauma: restorative procedures using composite resin and mouthguards for prevention. J Contemp Dent Pract. 2007;8(6):89-95. [Medline].
Al-Jundi SH. Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study. Dent Traumatol. Feb 2004;20(1):1-5. [Medline].
Bakland LK, Andreasen JO. Examination of the dentally traumatized patient. J Calif Dent Assoc. Feb 1996;24(2):35-7, 40-4. [Medline].
Cobankara FK, Ungor M. Replantation after extended dry storage of avulsed permanent incisors: report of a case. Dent Traumatol. Aug 2007;23(4):251-6. [Medline].
Devlin DH. A historical review of dental and facial skeletal trauma. J Calif Dent Assoc. Feb 1996;24(2):29-34. [Medline].
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Harwood-Nuss A, Linden C, Luten R, eds. Dental injuries. In: The Clinical Practice of Emergency Medicine. 2^nd ed. Philadelphia: Lippincott, Williams & Wilkins; 1996:418-421.
Josell SD. Evaluation, diagnosis, and treatment of the traumatized patient. Dent Clin North Am. Jan 1995;39(1):15-24. [Medline].
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Krasner P, Rankow HJ. New philosophy for the treatment of avulsed teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. May 1995;79(5):616-23. [Medline].
Pohl Y, Filippi A, Kirschner H. Results after replantation of avulsed permanent teeth. II. Periodontal healing and the role of physiologic storage and antiresorptive-regenerative therapy. Dent Traumatol. Apr 2005;21(2):93-101. [Medline].
Rai P, Gupta U, Kalra N. Self-replantation of an avulsed tooth in torsoversion: a 10-year follow-up. Dent Traumatol. Jun 2007;23(3):158-61. [Medline].
Robert JR, Hedges JR. Emergency dental procedures. In: Clinical Procedures in Emergency Medicine. 2^nd ed. Philadelphia: WB Saunders Co; 1991:1045-1064.
Rosen P, Barkin R. Dental emergencies. In: Emergency Medicine Concepts and Clinical Practice. Vol 3. 3^rd ed. 1992:2381-2398.
Schaider J. Rosen & Barkin's: The 5-Minute Emergency Medicine Consult 2003. 2003:202-3.
Tintinalli JE, Kelen GD, Stapczynski, JS, eds. Emergency Medicine. In: A Comprehensive Study Guide. 6^th ed. McGraw-Hill Professional; 2003:1490-3.
Trope M. Protocol for treating the avulsed tooth. J Calif Dent Assoc. Mar 1996;24(3):43-9. [Medline].

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Avulsed Tooth Follow-up

Further Outpatient Care

Complications

Prognosis

Patient Education