how to deal with traumatic dental injury in emergency room

if this gentle man presented to you in emergency room after street fight , head-tooth punch 



exam the teeth 

@if the tooth still in its place but movable , or displaced , return the tooth to its place by hand and hold it from the crown and gentle press it in its place , after that send pt to the dentist 

@if the tooth has fallen and pt brought it , hold the tooth from the crown (never touch the root) , and flush the tooth with cold normal saline for 15seconds , dont touch the tooth or rub it during washing (this can destroy the periodontal ligament)

keep the tooth moist all the time , by your mouth(inside mouth next to the check or pt saliva) or in milk , or emergency tooth preservation kit , or isotonic saline (not recommended)

and during maximum 30minutes , the pt should arrives to the dentist 

@if pt presented with absent tooth(or you discovered absent tooth in its place) , send for chest Xray , he might swallow it

give all pts anti tetanus toxin and prophylaxis antibiotics 

and finally , all traumatic dental injuries should reviewed by dentist , especially pediatric age group


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