Tooth avulsion

#### What you need to know A 7 year old boy has tripped in the playground and knocked his front tooth out. He attends the emergency department with his mother, who has the tooth in her hand. He is stable and has no other injuries of concern. Permanent dental problems can be avoided by taking a simple dental history and doing a basic examination. The main question is whether re-implantation of the tooth is appropriate. Was this a primary (baby) tooth or a permanent (adult) tooth? At 6-8 years of age, the primary central incisors have usually fallen out and the larger, permanent incisors have erupted (fig 1⇓). The associated with avulsion injury of a primary tooth, such as disturbances in eruption and appearance of the developing permanent teeth, can be increased if a primary tooth is re-implanted.1 This is not advised, and monitoring of permanent tooth eruption is essential following injury.2 3 Fig 1 Diagram highlighting difference in size between primary and permanent incisors. The primary central incisor is approximately 16 mm in length, two thirds the size of its permanent successor ### History