0071643192.pdf

HEAD, EYE, EAR, NOSE, AND THROAT

EMERGENCIES

TREATMENT

■ Replant tooth as soon as possible, if indicated.
■ Tips on transporting an avulsed tooth:
■ Touch the crown part only.
■ Gently rinse with tap water, no scrubbing(to avoid damaging the peri-
odontal ligaments).
■ Transport under tongue, in saliva, saline solution, milk, or in Hank’s
solution (best). Avoid dry storage.
■ Temporary stabilization of tooth may be achieved with Coe Pak or
other periodontal dressing or biting on a piece of gauze.
■ Immediate dental referral for splinting with adjacent teeth
■ Antibiotics
■ Te t a nu s
■ Soft diet postreplant

COMPLICATIONS

■ Replanted baby teeth can cause bone fusion and prevent permanent teeth
from erupting.

Fractured Teeth

ELLISCLASSIFICATION

See Figure 14.24.

CLASSI

Fracture of enamel

TREATMENT

Smooth edge with file and discharge with dental follow-up.

Do not reimplant baby teeth.

Baby teeth are naturally

replaced by adult teeth

between the ages of 6 and 12.

Ellis class I

Ellis class II

Ellis class III

Alveolar

fracture

FIGURE 14.24. Ellis classification of tooth fractures.

(Reproduced, with permission, from Tintinalli JE, Kelen GD, Stapczynski SJ. Emergency
Medicine: A Comprehensive Study Guide, 6th ed. New York: McGraw-Hill, 2004:1490.)