Wednesday, March 12, 2008

Vol 2:8 Answer

The Question
The answer is d.
The patient has an avulsed tooth, which is a dental emergency. When a tooth is missing from a patient, the possibility of aspiration or entrapment in soft tissues should be considered. Avulsed permanent teeth require prompt intervention. The best environment for an avulsed tooth is its socket. Replantation is most successful if the tooth is returned to its socket within 30 minutes of the avulsion. A 1% chance of successful replantation is lost for every minute that the tooth is outside of its socket. The tooth should only be handled by the crown as not to disrupt the root. If the patient cannot replant the tooth, then they should keep the tooth under his or her tongue or in the buccal pouch so that it is bathed in saliva. If that cannot be achieved, then the tooth can be placed in a cup of milk (e) or in saline. The best transport solution is Hank’s solution.

(a) The worst situation is to transport the tooth in a dry medium. (b) and (c) water and beer are less than ideal. Saliva, milk or saline are better solutions.

quizzER is a weekly contest consisting of a question selected from various areas of emergency medicine that are central to the education of medical students and residents in training. For more information please refer to the following link.

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