- Past medical history
- Onset of pain / injury
- Trauma with "knocked out" tooth
- Location of tooth
- Whole vs. partial tooth injury
Signs and Symptoms
- Tooth missing or fractured
- Facial cellulitis
- Impacted tooth (wisdom)
- TMJ syndrome
- Myocardial infarction
Universal Patient Care Protocol
- Control bleeding with pressure
Tooth Avulsion ?
- Place tooth back in socket if feasible.
- Secure to surrounding teeth with tape
- Place tooth in milk or normal saline
- Notify Destination or Contact Medical Control
- Recommended Exam: Mental Status, HEENT, Neck, Chest, Lungs, Neuro
- Significant soft tissue swelling to the face or oral cavity can represent a cellulitis or abscess.
- Scene and transport times should be minimized in complete tooth avulsions. Reimplantation is possible within 4 hours if the tooth is properly cared for.
- All tooth disorders typically need antibiotic coverage in addition to pain control.
- Occasionally cardiac chest pain can radiate to the jaw.
- All pain associated with teeth should be associated with a tooth which is tender to tapping or touch (or sensitivity to cold or hot)
- DO NOT replace tooth if:
- obtunded patient
- Spinal Immobilization
- Multiple Teeth missing