It is not unusual for the pediatrician to be the recipient of a phone call from a frantic parent or from school personnel regarding an accident involving a child with a permanent tooth that has been totally avulsed. Successful reimplantation of avulsed teeth, while difficult to predict, is dependent on maintaining the vitality of the remaining periodontal ligament fibers and cementum surrounding the root of the tooth. A pediatrician who is consulted immediately after an accident involving an avulsed permanent tooth should give the following advice: The tooth should be gently rinsed of gross debris using tap water. It should not be scrubbed since scrubbing will remove and further damage the periodontal ligament fibers and cementum.

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