It’s summer time, time for frisbee in the park and ballet stepping around dog poop. Time for E. Coli closing beaches and going top down in the auto and topless whereever. It’s also time for the infamous “knocked out front tooth“, usually just post ortho.
I’d like to share a case and use the comments portion to have folks comment on a critical thinking treatment plan. As well, I’d like folks to send along other trauma cases and see if we can make this blog more interactive. It’s share and care time folks…let’s get busy.
CLICK ON ACCOMPANYING VIDEO FIRST – then read
Case One posted on the ROOTS discussion forum
The left central was avulsed, placed in a paper cup and the patient dribbled saliva into the cup until they arrived at the office. The time
out of the mouth/socket was less than 30 minutes. The patient was anesthetized, the tooth was assessed to be clean of dirt/debris, then rinsed with saline, CHX, saline again and then reinserted in the socket. It was semi-stable at this time.
The adjacent teeth were stable and undamaged. Lip damage and blood evident, but otherwise no intraoral soft tissue damage. The
patient was put on peridex rinse, Augmentin/Clavulinate for you Canucks and Tylenol (NOT THE DREADED AND POINTLESS TYLENO 3). His tetanus shot was updated and the patient told to the father take him to update his tetanus told to lightly brush and keep the area as clean as possible
1. There was residual perio ligament and gum tissue visible on the root. Should I have scraped that off? or just the gum tissue? (there was not much gum tissue)
2. I could only bond to the adjacent central. Is that enough?
3. What next? When?
Never touch the tissue on the root surface if the tooth is dry for less than 60 minutes.