<Tr> <Td> </Td> <Td> This section contains content that is written like an advertisement . Please help improve it by removing promotional content and inappropriate external links, and by adding encyclopedic content written from a neutral point of view . (January 2018) (Learn how and when to remove this template message) </Td> </Tr> <P> Dental avulsion is a real dental emergency in which prompt management (within 20--40 minutes of injury) affects the prognosis of the tooth . The avulsed permanent tooth should be gently but well rinsed with saline, with care taken not to damage the surface of the root which may have living periodontal fiber and cells . Once the tooth and mouth are clean an attempt can be made to re-plant in its original socket within the alveolar bone and later splinted by a dentist for several weeks . Failure to re-plant the avulsed tooth within the first 40 minutes after the injury may result in a less favorable prognosis for the tooth . If the tooth cannot be immediately replaced in its socket, follow the directions for Treatment of knocked - out (avulsed) teeth and cold milk or saliva and take it to an emergency room or a dentist . If the mouth is sore or injured, cleansing of the wound may be necessary, along with stitches, local anesthesia, and an update of tetanus immunization if the mouth was contaminated with soil . Management of injured primary teeth differs from management of permanent teeth; avulsed primary tooth should not be re-planted (to avoid damage to the permanent dental crypt). </P> <P> Although some dentists advise that the best treatment for an avulsed tooth is immediate replantation, for a variety of reasons this can be difficult for the non-professional person . The teeth are often covered with debris . This debris must be washed off with a physiological solution and not scrubbed . Often multiple teeth are knocked - out and the person will not know which socket an individual tooth belongs to . The injured victim may have other more serious injuries that require more immediate attention or injuries such as a severely lacerated bleeding lip or gum that prevent easy visualization of the socket . Pain may be severe and the person may resist replantation of the teeth . People may, in light of infectious diseases (e.g. HIV), fear handling the teeth or touching the blood associated with them . If immediate replantation is not possible, the teeth should be placed in an appropriate storage solution and brought to a dentist who can then replant them . The dentist will clean the socket, wash the teeth if necessary, and replant them into their sockets . He will splint them to non-knocked - out teeth for a maximum of two weeks for teeth with normal alveolar process and bone support . Properly handled, even replantation of periodontally compromised permanent teeth in older patients under good maintenance have been reported, with splinting extending for over 4 weeks due to the reduced support structure for the root due to periodontal disease . One week to ten days after the replantation, the dental pulps of the replanted teeth should be removed and a root canal treatment completed within two months . </P> <P> In addition, as recommended in all dental traumas good oral hygiene with 0.12% chlorhexidine gluconate mouthwash, a soft and cold diet, and avoidance of smoking for several days may provide a favorable condition for periodontal ligaments regeneration . </P>

When should an avulsed tooth in a 35-year-old patient be optimally reimplanted