AVULSED TOOTH TREATMENT OPTIONS

[drmithila]

 Perhaps this device could be useful for fractured teeth; broken teeth stabilized precisely may allow successful root canal treatment, especially with current perforation sealing techniques. I propose the hypothesis that sustained, apically directed pressure on the crown into the bony socket of a mid root fracture would more likely correctly align a fractured root than a dentist bonding a loose crown haphazardly to adjacent teeth with orthodontic wire.

DISCUSSION 

Many gaps exist in current treatment for successful reimplantation of avulsed teeth, even if the accident victim arrives to a medical professional within the narrow window of time needed. For example, general dentists see these cases so infrequently that they are often ill-suited to treat a screaming, bloody, ugly duckling child with no adjacent teeth to which to bond. They often refer them to an oral surgeon across town.
In car accidents with multiple avulsed teeth, medical per-sonnel are rarely prepared to handle anything dental. Even large trauma centers with around-the-clock general surgery, orthopedic, and cardiovascular residency coverage often call in oral surgeons to handle tooth avulsions. What if every paramedic had 3 sizes of the avulsed tooth stabilizing splint on board his vehicle and was trained to reimplant and insert the appliance even as a temporary means to stabilize? What if every emergency room physician/resident or general dentist had these appliances on hand ready to use?
Perhaps unconscious accident victims could be stabilized by reimplanting the teeth, selecting and fitting the appropriate appliance, relining the splint with cold care liquid gel polypropelene, and reinserting the appliance over avulsed teeth until the material was hardened and secure.

CONCLUSION

How many avulsed teeth are lost by holes in the healthcare system? How many avulsed teeth are lost by poor stabilization of multiple avulsed teeth with little to which to bond? How will prolonged, intermittent, apically directed biting force affect reimplantation success in the short term and long term? Can nondental, first-arriving healthcare professionals be trained to reimplant avulsed teeth with a preformed polypropylene mold? Will mid root fractures have a greater chance of success if the broken fragments are compressed over each other for 7 to 10 days? Will this device help other dental injuries such as subluxation and tooth loosening?
The answers to these questions won’t be known for perhaps years. However, how many thousands of avulsed teeth are failing currently? Failure to reimplant an avulsed tooth correctly can doom a young child and the family to a long emotional, financial, and aesthetic tragedy. This article has discussed a new treatment ap-proach that the author feels has promise for stabilizing avulsed teeth and for certain other dental trauma situations as well. Additional clinical experience is needed to determine how successful this approach will be.