Ellis class I
0.File down sharp edges, if necessary, with a dental drill or emery board.
1.Dental follow-up, as desired by the patient, is for cosmetic purposes only.
Ellis class II
1.Cover the exposed surface with a calcium hydroxide composition (eg, Dycal), a glass ionomer, or a strip of adhesive barrier (eg, Stomahesive). 2-octyl cyanoacrylate (Dermabond) has been shown to be an acceptable alternative in the setting of a dental fracture if no other materials are available.[3] The 2-octyl cyanoacrylate decreases tooth sensitivity and provides a protective barrier until dental follow-up.[4]
2.Provide pain medications.
3.Instruct the patient to avoid hot and cold food or drink.
4.Arrange for a follow-up appointment with a dentist within 24 hours.
5.Consider antibiotic coverage with penicillin or clindamycin.
Ellis class III
1.Cover the exposed surface with a calcium hydroxide composition (eg, Dycal) or a glass ionomer.
2.Provide immediate dental follow-up and analgesics as needed.
3.Initiate antibiotics with coverage of intraoral flora (eg, penicillin, clindamycin).
Dental avulsion
1.An avulsed tooth may be gently cleansed in either normal saline or sterile auxiliary solution (eg, Hank’s balanced salt solution).
2.Avoid scrubbing the tooth or any unnecessary delay before reimplantation.
3.The tooth can be returned to its original position by applying firm finger pressure.
4.Handle the tooth by the crown, and avoid trauma to the tooth root.
5.Stabilize the tooth with a temporary periodontal splint.
6.Provide early dental follow-up.
7.Initiate antibiotics with coverage of intraoral flora (eg, penicillin, clindamycin).
Dental subluxation
1.This type of injury may not require emergency treatment.
2.Very loose teeth should be pressed back into their sockets.
3.They should then be stabilized with wire or a temporary periodontal splint (eg, Coe-Pak).
4.Patients with dental subluxation should maintain a soft or liquid diet to prevent further tooth motion.
5.Provide early dental follow-up.
6.Initiate antibiotics with coverage of intraoral flora (eg, penicillin, clindamycin).
Dental intrusion
1.These injuries can be left alone and allowed to re-erupt.
2.Provide early dental follow-up.
3.Initiate antibiotics with coverage of intraoral flora (eg, penicillin, clindamycin
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