Management of Traumatic Tooth Avulsion: When & How?

Traumatic tooth avulsion is a true dental emergency requiring immediate and structured management to optimize long-term prognosis. The success of reimplantation depends heavily on extra-oral dry time, handling of the periodontal ligament, and appropriate storage medium. Immediate reimplantation at the site of injury is ideal, while alternatives such as milk, saline, or saliva help preserve PDL cell viability when reimplantation is delayed. Clinical management includes gentle socket irrigation, proper repositioning, splinting for 1–2 weeks, and prompt initiation of systemic antibiotics. Pulp therapy is essential in most permanent teeth due to the high risk of necrosis. Timely intervention, patient education, and close follow-up remain critical to prevent complications such as root resorption and ankylosis.