Tooth Injury Present

Action

1. Consult specialist as indicated (Class II)
2. Treat injury:
• Enamel injury: File or smooth as necessary. (Class II)
• Dentin injury:
1. Perform supraperiosteal infiltration;
2. Cover with calcium hydroxide paste;
3. Arrange follow-up care within 24 hours with dentist. (Class I)
• Pulp injury: Same as dentin except with immediate dental consultation in the ED. (Class I)
• Avulsion*:
1. Replace if <1 hour of dry time since avulsion. Consider chest x-ray/panoramic x-ray if tooth whereabouts unknown;
2. Splint with periodontal paste, self-cure composite, or bonding materials;
3. Prescribe doxycycline or penicillin. (Class I)

*Do not replace avulsed tooth if alveolar ridge fractures are present. *Do not replace avulsed primary teeth.

• Intrusion: X-ray if necessary to find intruded tooth. (Class I)
• Subluxation/luxation: If significant mobility, splint as above. (Class I)

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