Drop it like its hot

[busupshot83]

A woman came into the dental clinic I am shadowing at, and she had her son's tooth in a cup of milk. Supposedly, she said that the milk nourishes the tooth, and keeps it from turning grey (as tooths with no blood supply usually do). What do you guys thinK about that? Is that true?

Pce,

Bus.

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[larryt]

Originally posted by busupshot83
A woman came into the dental clinic I am shadowing at, and she had her son's tooth in a cup of milk. Supposedly, she said that the milk nourishes the tooth, and keeps it from turning grey (as tooths with no blood supply usually do). What do you guys thinK about that? Is that true?

Pce,

Bus.

Why didn't you ask your dentist at that time ? I wanna know more about this too.

 

[Bickle]

perhaps having the tooth in a calcium rich solution preserves it for a longer time?

 

[succedaneous32]

Yes it is true that if the tooth is dropped in milk that it can possibly stay vital. It usually has to be reinserted into the socket in about 30 minutes for it to be successful.

 

[bcDDS]

Milk is slightly basic and that's what you want.....something somewhat close to the body's pH. You can also tuck the tooth between the lip and gum area inside the vestibule until you reach the dentist for reinsertion. Don't scrape the tooth off with anything...It will give the periodontal ligament a chance to reattach when reinserted, but the tooth has pretty much no chance of staying vital with after being knocked out. It needs to be reinserted within a certain time frame to also decrease the chance of future root resporption. Because the tooth is no longer vital, a root canal will need to be done at some point.

 

[DcS]

Originally posted by succedaneous32
Yes it is true that if the tooth is dropped in milk that it can possibly stay vital. It usually has to be reinserted into the socket in about 30 minutes for it to be successful.

As bcDDS pointed out, once a tooth is knocked out of the mouth, it is no longer vital because the blood/nerve supply is severed. That tooth will never be vital again. If inserted rather quickly, there is a good chance with root canal therapy that the tooth will remain in the mouth. Pretty much echoing what bcdds already said.

 

[booshwa]

Milk is definetely an option. Ideally you should clean off the tooth and place it back within the socket (if that is possible)....then see a dentist. Although I'm sure that option really hurts.

They actually make solutions that are designed for avulsed teeth...I think it is HBSS (Hanks Balanced Salt Solution)-which anyone who has worked in lab has probably used.

The most important thing is time....the longer that the tooth is out of the socket, the less likely it can be implanted successfully. Milk works in this case because of its osmolarity (and possibly its pH). Water will work to keep the tooth moist, but is not desirable because of its osmolarity.

Here are some websites on the matter:
ncemi.org
or
emedicine

 

[dexterraz]

i knew all that jargin in bio 1 would come in handy for us pre-dents...hehe.

 

[aphistis]

Originally posted by booshwa
Ideally you should clean off the tooth and place it back within the socket (if that is possible)....then see a dentist.

Just to avoid confusion, "clean off the tooth" here means to just rinse it off under running water. As a couple previous folks mentioned, any sort of abrasive cleaning, no matter how light, will destroy the PDL and most likely render the tooth unsalvageable.

 

[Mudduck]

Uh..... yes doctor, I concur.

 

[booshwa]

Originally posted by aphistis
Just to avoid confusion, "clean off the tooth" here means to just rinse it off under running water. As a couple previous folks mentioned, any sort of abrasive cleaning, no matter how light, will destroy the PDL and most likely render the tooth unsalvageable.

Thank you for clarifying....its also important to hold the tooth only by the crown, and not to touch the PDL..

(this might be the first time I actually feel like I've learned something in D. School!!!)

 

[no2thdk999]

once a tooth is knocked out of the mouth, it is no longer vital because the blood/nerve supply is severed. That tooth will never be vital again.

True for teeth with a completely formed apex. Teeth with an immature apex have a reasonable chance of remaining vital if reinserted quickly.

Here is a good link to protocol for dental trauma:

http://www.iadt-dentaltrauma.org/Trauma/guide_opena.htm

Rob

 

[DcS]

Originally posted by no2thdk999
True for teeth with a completely formed apex. Teeth with an immature apex have a reasonable chance of remaining vital if reinserted quickly.

Here is a good link to protocol for dental trauma:

http://www.iadt-dentaltrauma.org/Trauma/guide_opena.htm

Rob

Thanks Rob, I was unaware of that possibility. Very thorough link I've bookmarked it for future reference.

 

[landrover77]

The best substance to place an avulsed tooth in is Hank's Balanced Salt Solution. This is tissue preveservative used in biology labs, and as has been discussed above, is isotonic and has the proper pH to reduced possible damage to the dental ligament. A commercial product example is Save-A-Tooth.

Here's a couple links with info:

http://www.save-a-tooth.com
http://www.sportsdentistry.com/tooth.html