Imaging/Clinical — MCQs

Question 11: A 27-year-old man is witnessed falling off his bicycle. The patient rode his bicycle into a curb and hit his face against a rail. The patient did not lose consciousness and is ambulatory at the scene. There is blood in the patient's mouth and one of the patient's teeth is found on the sidewalk. The patient is transferred to the local emergency department. Which of the following is the best method to transport this patient's tooth?

• A. Wrapped in gauze soaked in normal saline
• B. Submerged in normal saline
• C. Submerged in milk (Correct Answer)
• D. Wrapped in sterile gauze
• E. Submerged in water

Explanation: ***Submerged in milk*** - **Milk** is the ideal solution for transporting an avulsed tooth because it has a pH and osmolality that is compatible with the **vitality of the periodontal ligament (PDL) cells**. - Its nutrient content also helps to sustain these cells, increasing the likelihood of successful **replantation**. *Wrapped in gauze soaked in normal saline* - While **normal saline** can keep the tooth moist, its osmolality is not optimal for maintaining the **viability of PDL cells** for an extended period. - Wrapping in gauze may also cause the tooth to dry out if not kept adequately saturated, which can damage the **periodontal ligament**. *Submerged in normal saline* - Submerging in **normal saline** is better than dry storage but is still **suboptimal** compared to milk. - The tonicity and pH of normal saline are not as beneficial for the **long-term survival of PDL cells** as milk. *Wrapped in sterile gauze* - **Sterile gauze** alone does not provide moisture or nutrients, leading to **rapid desiccation and death of PDL cells**. - A dry environment dramatically reduces the chances of successful **replantation** and increases the risk of **ankylosis** or **resorption**. *Submerged in water* - **Water** is a **hypotonic solution** that can cause **lysis of PDL cells** due to osmotic pressure differences. - This significantly compromises the tooth's viability and success of **replantation**.