ADC Practice Question — First Aid & PDL Cell Viability

Ranking only the three options available (water, saliva, saline) — which is best?

Dental trauma questions test protocol-level decisions — splint type, duration, follow-up timing — where one wrong detail means a wrong answer. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

A basketball player's tooth is avulsed on court. No milk is available. The coach has bottled water, the player can spit into a cup, and the first-aid kit has sterile saline. The tooth was dry on the floor for about 2 minutes before being picked up. Ranking only the three options available (water, saliva, saline) — which is best?

A. Water — it is always preferable because it is the cleanest and most readily available option
B. Saliva — it ranks above saline in the IADT hierarchy of preferred storage media for avulsed teeth
C. Saline — it is isotonic and always ranked higher than any biological fluid for storage
D. All three are equivalent — the guideline makes no distinction between these three media

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Sources cited

Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more

Show the answer and cited explanation

Correct answer: B

IADT hierarchy: milk > HBSS > saliva > saline > water. Among the three available here, saliva ranks highest, then saline, then water. Saliva's osmolality better matches PDL cell needs despite its bacterial content. SOURCE — Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 2, item 6

Source: Fouad AF et al. IADT Avulsion Guidelines, Dent Traumatol 2020;36:331-342, Section 2

Remy's study tip — Trauma questions hinge on: tooth maturity (open vs closed apex), time out of mouth, storage medium, and fracture type.

Exam preparation FAQ

How should I prepare for Dental Traumatology in the ADC exam?

Build competence across all topics. The exam tests application of guidelines to clinical scenarios, not memorisation.

How do I approach an unfamiliar First Aid & PDL Cell Viability vignette?

Extract key clinical data from the stem before reading options. There are usually 3–4 critical variables that determine the correct answer.

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Ranking only the three options available (water, saliva, saline) — which is best?

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