Paging Dr. Google

Just ran a call where a six-year-old got a front permanent incisor knocked out.

The kid was in good spirits, smiling and laughing. The tooth seemed in good shape, too, despite it’s less-than-desirable storage receptacle of the mother’s lint-filled pocket.

So, I gently took the tooth from her, handling it by the crown only, and wrapped it in saline-soaked gauze while I called the local hospitals to get confirmation on what I already suspected.

None of the local hospitals have the capability of re-implanting a dislodged tooth, and none of the local dental clinics that take Medicaid answer their emergency numbers, or even have emergency numbers, for that matter.

So, I whipped out my smartphone for a consult to Dr. Google, to refresh my memory on just how long a dislodged tooth is viable for reimplantation.

I learned a couple of things:

1. Milk* is still the best preservative if you don’t have a Sav A Tooth kit. I had been taught that milk had fallen out of favor as a tooth preservative.

2. The fibroblasts on the root of the tooth that are the “glue” that make reimplantation possible start dying after 30 minutes.

Our little girl’s fibroblasts were already dead, buried, and the remaining fibroblasts in her socket were having a rollicking Irish wake.

Looks like our patient will be channeling her inner hockey player for a while, until a dentist can fit her with an artificial implant.

* I asked Siri, “Does the milk have to be Pasteurized?” and she answered, “No, just deep enough to cover the tooth should be sufficient.”**

** Not really. I’ll be here all week, folks. Try the veal, and be sure to tip your server.