Podcast 810: Tooth Replantation - The Emergency Medical Minute

Podcast 810: Tooth Replantation

Contributor: Jarod Scott, MD

Educational Pearls:

  • There is a 1-hour window for tooth replantation in ED
  • Cold milk is often best transport media unless there is access to specialized solutions (Hank’s Balanced Solution)
    • Goal is to preserve periodontal ligament
    • Soaking in tap water should be avoided as it will lyse cells of periodontal ligament    
  • If oral surgeon is rapidly available, have them perform replantation
    • Do not delay replantation to wait for an oral surgeon to become available
  • Steps in tooth reimplantation
    • Disturb the socket as little as possible
    • Handle tooth only by crown, don’t touch root
    • Rinse tooth gently with tap water or saline, do not scrub it
    • Tooth should click back in place and remain stable
    • Don’t manipulate after reimplantation  
  • It may take weeks to determine if the tooth will survive 
  • Studies have shown that replantation performed within one hour has a significantly better prognosis than those taking place after a greater amount of time has passed

References

Alotaibi S, Haftel A, Wagner ND. Avulsed Tooth. In: StatPearls. Treasure Island (FL): StatPearls Publishing. Copyright © 2022, StatPearls Publishing LLC.; 2022.

Andreasen JO, Andreasen FM, Skeie A, Hjørting-Hansen E, Schwartz O. Effect of treatment delay upon pulp and periodontal healing of traumatic dental injuries – a review article. Dent Traumatol. 2002;18(3):116-128.

De Brier N, O D, Borra V, Singletary EM, Zideman DA, De Buck E. Storage of an avulsed tooth prior to replantation: A systematic review and meta-analysis. Dent Traumatol. 2020;36(5):453-476.

 

Summarized by Mark O’Brien, MS4 | Edited by John Spartz, MD & Erik Verzemnieks, MD

 

The Emergency Medical Minute is excited to announce that we are now offering AMA PRA Category 1 credits™ via online course modules. To access these and for more information, visit our website at https://emergencymedicalminute.org/cme-courses/ and create an account. 

Donate to EMM today!

 

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

 

Stay up to date by
joining our mailing list!