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A 7 year old boy presents to the ED after falling off his bike and impacting his mouth against the handlebar and the ground. Bystanders reported to the parent that there was a tooth on the ground, and per paramedics the parent is on the way in and may or may not have the tooth. Exam reveals a grossly luxated tooth that is very loose, and two sockets of apparently missing teeth.
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February 5, 2019 at 6:27 pm
E) Primary incisors are yellower and have ridges on the bottom.
Permanent teeth start replacing primary teeth starting at age 5-6 years typically. The lower central incisors are usually the first to be lost and replaced, followed by the upper central incisors. A CXR is indicated to rule out a swallowed tooth in this case. Permanent teeth should be reimplanted, but primary teeth should not. Prophylactic antibiotics (typically doxycycline) are indicated after tooth reimplantation. Primary teeth are whiter and have smooth edged bottoms as compared to permanent teeth which are yellower and ridged.