Ranking only the three options available (water,…
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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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
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