HEAD AND NECK INJURIES - Medicine for Mountaineering and Other Wilderness Activities - page 108

Individualsonshortoutingsshouldseekimmediatedentalcare.Individualsonmoreex-
tended expeditions may have to tolerate the injured tooth for a prolonged period. Two to
three weeks are required for healing, and eating may be problematic.
Lost Teeth
An injury in which a tooth is totally removed from its socket is termed an avulsion. The
tooth frequently can survive if replaced in its socket promptly, preferably within one hour,
and an effort should be made in the field to do so. The tooth should be held by its crown
and gently rinsed with saline or disinfected water. It should not be scrubbed, and the roots
should not be touched. The tooth must not be allowed to dry. (If prompt restoration of the
tooth is not possible, it can be kept in liquid for delayed restoration by a dentist. Liquids in
which the tooth can be stored are, in order of preference, whole milk, saline, the person's
saliva, sports drinks, and water.) The individual then should be evacuated for definitive
treatment as quickly as possible.
Dental Care After Trauma
Following traumatic injuries, individuals should eat a soft diet for ten to fourteen days.
They should brush their teeth gently with a soft toothbrush after every meal. They should
rinse their mouths twice each day, preferably with a chlorhexidine-containing mouthwash
but with a warm salt solution if nothing else is available.
EAR INJURIES
Earinjuriesareuncommon.Mostaresimpleskininjuriesandshouldbetreatedlikesimilar
injuries located anyplace else. More severe injuries are often associated with severe head
or brain injuries.
One important cause of ear injuries is cleaning the external canal with long narrow ob-
jects, such as match stems. The admonition “Never put anything in your ear smaller than
your elbow” is wise, particularly in a remote area. If an accumulation of wax, a foreign
body, or a small insect causes problems, it should be removed by irrigating the ear with
lukewarm water, preferably with a soft rubber bulb designed specifically for this purpose.