If contaminated, the root surface and apical foramen should be cleansed with a stream of saline. Remove the coagulum from the socket with a stream of saline and then replant the tooth. If available, cover the root surface with minocycline hydrochloride microspheres (ArestinTM, OraPharma Inc, Warminster, PA, USA) to optimize pulp revascularization before replanting the tooth.
The aim of replanting developing (immature) teeth in children is to allow for possible revascularization of the tooth pulp. If that does not occur, root canal treatment should be performed.
Clean the area with water spray, saline or chlorhexidine. Do not extract the tooth if already replanted. Suture gingival lacerations if present. Verify normal position of the replanted tooth both clinically and radiographically. Apply a splint for 2 weeks.
Administer systemic antibiotics. For children of 12 years and younger: Penicillin V at an appropriate dose for patient age and weight.
If the injury occurred outdoors and the wound is contaminated with soil, tetanus prophylaxis should be considered.
- Soft diet for up to 2 weeks
- Brush teeth with a soft toothbrush after each meal
- Use a chlorhexidine (0.1%) mouth rinse twice a day for 1 week