TABLE 105.2 SEQUENCE OF PRIMARY TOOTH EXFOLIATION If the avulsed tooth was a permanent tooth it should be first gently rinsed with saline, taking care to hold the crown of the tooth and not the root The tooth should then be inserted into the socket in its normal position Until splinting is achieved, the tooth may extrude slightly due to pressure from the blood in the socket Avulsed primary teeth are generally not reimplanted because of the complex treatment needed to preserve the tooth and potential damage to its developing succedaneous tooth If on-site reimplantation of an avulsed tooth is not possible, the tooth should be placed in a storage medium that preserves the vitality of the PDL of the root surface ViaSpan or Hanks balanced salt solution is an ideal cell culture for this purpose A commercial product such as the 3M Savea-Tooth™ Emergency Tooth Preserving System (Smart Practice, Phoenix, AZ) containing Hanks solution is available to place the tooth into during transportation to the dental office If none of these products are available, cold milk is an excellent alternative transport medium Although saliva or saline is not