Tuesday, January 23, 2024

Pt. calls you with avulsed tooth an hour ago. Best transfer medium.. Cold milk

Pt. calls you with avulsed tooth an hour ago. Best transfer medium:


Patient with avulsed tooth they call u what to do, u told them to come immediately to replant the tooth, what is the best medium:

  • A. Saliva Under tongue.
  • B. Water.
  • C. Cold milk.
  • D. put inside pt. mouth.

If a patient calls you with an avulsed tooth (knocked-out tooth) an hour ago, the best transfer medium and course of action will depend slightly on the specific situation.
Here's a breakdown of the options you provided:

Scenario 1: Prioritizing immediate replantation (you tell the patient to come in)

In this scenario, time is of the essence for maximizing the chances of successful replantation. Ideally, the tooth should be replanted within 60 minutes of being avulsed. Therefore, the best course of action is for the patient to come to your dental clinic immediately.
While they are on their way, the best medium to store the avulsed tooth for immediate replantation is:

- Cold milk:

Studies have shown that milk is a good temporary storage medium for avulsed teeth due to its isotonic properties and nutrient content, which can help maintain the viability of the periodontal ligament cells.

- Hank's balanced salt solution (HBSS):

This is another acceptable option, particularly if milk is not readily available. HBSS is a sterile solution that mimics the electrolyte composition of human blood, helping to keep the tooth hydrated.

Important tips:

  • Do not: store the tooth in water, as it can damage the cells due to its hypotonic nature.
  • Do not: wrap the tooth in gauze or tissue, as this can dry it out.
  • Instruct the patient to: handle the tooth by the crown (the white part) and avoid touching the root surface.
  • Encourage the patient to: keep the tooth cool, but not freezing. They can place the container with the storage medium in their cheek pocket or hold it under their tongue.

Scenario 2: Delay in replantation (patient calls an hour after the incident)

Storage options for an extracted tooth:

If an hour has passed since the avulsion and immediate replantation is not possible, the best storage medium for the avulsed tooth becomes more crucial. In this case, the following options can be considered:
  • Cold milk: As mentioned before, milk remains a good option due to its properties.
  • Hank's balanced salt solution (HBSS): Similar to the immediate replantation scenario, HBSS is a viable alternative if milk is unavailable.
  • Commercial tooth preservation solution: If available, a commercially available tooth preservation solution specifically designed for avulsed teeth might be the optimal choice. These solutions are formulated to provide the best possible environment for the tooth cells during extended storage periods.

Important notes:

Even with proper storage, the chances of successful replantation decrease significantly after 60 minutes.
Consult with the patient and assess the situation carefully to determine the best course of action.
Emphasize the importance of seeking professional dental care as soon as possible for proper evaluation and treatment.