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You are seeing a 3 year old who was running in the house, tripped and fell, hitting his mouth on the coffee table. On exam, his two upper central incisors are pushed up into his gums. None of his teeth, including those two, are loose. There was bleeding initially, but it has stopped spontaneously. He has no apparent pain and is climbing all over the gurney.
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September 26, 2023 at 1:14 pm
C) Place the patient on as-needed acetaminophen, soft-foods diet, and tell the parent to follow up urgently the next day with a dentist
Whereas avulsion injuries of primary teeth require no urgent treatment, intrusion injuries of primary teeth carry the risk of damaging the pulp, peridontium, and proximal permanent tooth above the socket. Thus, patients need to be evaluated by a dentist urgently. Radiographs will be needed. Although the dentist may elect to observe after full evaluation, and the teeth may re-erupt, the process must be monitored closely as complications are common. Prophylactic antibiotics are not indicated, and neither is emergent OMFS evaluation if not other significant injury is present.