Immediate replantation at site of accident is the treatment of choice. The tooth should be
picked up by the crown, washed for no more than 10 seconds under cold running water,
then placed back into the socket.

If replantation is not possible, tooth should be transported in osmolality balanced transport
media like Hank’s balanced storage medium (HBSS) or saline if available. Physiologic
storage media like milk or patient’s own saliva in a clean container are other options for
transport. These storage media preserve periodontal ligament (PDL) cells. Water, with its
low osmolarity, causes PDL cell disruption and should be avoided for use to transport
avulsed teeth.

Prognosis is related to viability of PDL cells. The PDL cells are nonviable if total extra-oral dry
time is more than 60 minutes or the tooth has been stored in nonphysiologic storage medium.