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Paediatric dentistry

Prevention of delayed avulsion

British Dental Journal volume 235, pages 798–799 (2023)Cite this article

A seven-year-old child presented with their parent to an emergency dental clinic in London having been directed there by the NHS Service urgent care hotline (‘111' service). The parent was carrying the child's upper left central incisor in a pot of milk. Clinical history revealed the tooth had been avulsed following an injury at their gymnastics club two days earlier. The gymnastics club staff had not attempted any dental first aid, nor had they called the parents when the injury occurred, instead waiting for the routine collection time, where the tooth was handed to the parent having been placed in water. The parent then placed it in milk overnight, but no attempt at reimplantation was undertaken. The parent contacted their family GDP at the earliest opportunity the following morning and was offered an appointment at 3 pm on the same day. At this appointment, the dentist unsuccessfully attempted reimplantation and advised attendance at the local hospital emergency department, who were unable to provide treatment. They were then sent to an emergency dentist at 9 pm, where attempted reimplantation was once again unsuccessful.

On presentation to our emergency dental clinic, the injury was 38 hours old and clinical examination revealed a healing socket, into which the tooth could not be reimplanted. Therefore, the patient had to accept loss of the tooth and an upper removable appliance was constructed to replace the tooth. The patient was subsequently discharged back to their GDP for ongoing care and management. Longer-term options for the space may consist of a resin-retained bridge or implant at a later stage of development. Dental first aid advice was provided to the parent in case of future traumatic dental injuries.

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References

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Authors and Affiliations

  1. Guy´s and St Thomas´ NHS Trust, London, United Kingdom

    I. Rashid, R. O’Rorke & M. Vaidyanathan

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  1. I. Rashid
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  2. R. O’Rorke
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  3. M. Vaidyanathan
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Correspondence to I. Rashid, R. O’Rorke or M. Vaidyanathan.

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Rashid, I., O’Rorke, R. & Vaidyanathan, M. Prevention of delayed avulsion. Br Dent J 235, 798–799 (2023). https://doi.org/10.1038/s41415-023-6563-5

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  • DOI: https://doi.org/10.1038/s41415-023-6563-5

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