eMedicine Specialties > Emergency Medicine > Ear, Nose, & Throat

Dental, Avulsed Tooth: Follow-up

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
Coauthor(s): A Antoine Kazzi, MD, Chair and Medical Director, Department of Emergency Medicine, American University of Beirut, Lebanon; Willard Peng, MS, Doctor of Dental Surgery Candidate, Department of Oral Medicine, University of Southern California; Rebecca Cheng, University of California at San Diego
Contributor Information and Disclosures

Updated: Aug 12, 2009

Follow-up

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.

Complications

  • Loss of tooth
  • Cosmetic deformity
  • Infection

Prognosis

  • 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.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Delaying reimplantation
  • Failure to properly handle and transport tooth
  • Attempting to reimplant primary tooth
  • Failure to provide tetanus prophylaxis
  • Failure to rule out aspiration of tooth chips when unable to recover tooth in the field
  • Failure to properly examine surrounding traumatized tissue for tooth chips
  • Failure to recognize domestic or child abuse
  • Failure to fully evaluate the temporomandibular joint, maxilla, mandible, and associated head or neck injuries
  • Failure to recognize possible airway compromise
  • Failure to warn patients that any trauma to teeth may disrupt the neurovascular supply and lead to long-term pulp necrosis or root resorption
 


More on Dental, Avulsed Tooth

Overview: Dental, Avulsed Tooth
Differential Diagnoses & Workup: Dental, Avulsed Tooth
Treatment & Medication: Dental, Avulsed Tooth
Follow-up: Dental, Avulsed Tooth
References
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References

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Further Reading

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Keywords

tooth loss, tooth avulsion, tooth reimplantation, knocked-out tooth, tooth trauma, missing tooth, losing a tooth, displaced tooth, tooth displacement, periodontal disease, alveolar socket, hypoxia, necrosis of pulp, tooth reimplantation, periodontal ligament, root canal, alveolar bone, dentoalveolar ankylosis, Panorex, maxillary fractures, mandibular fractures, Hanks solution, Save-A-Tooth, zinc oxide preparation, Coe-Pak, root canal, infected necrotic tooth pulp

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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, MS, Doctor of Dental Surgery Candidate, Department of Oral Medicine, University of Southern California
Disclosure: Nothing to disclose.

Rebecca Cheng, University of California at San Diego
Disclosure: Nothing to disclose.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

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.

CME Editor

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, University Hospitals, Case Medical Center
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.

 
 
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