1) Administer local anaesthetic buccally and palatally/lingually
2) Irrigate the tooth and surrounding tissues as there will likely be dried blood which will compromise bonding
3) Reposition/re-implant the tooth if required. Try to ensure it is positioned at the same height as the adjacent teeth and in line with them. If you are unsure about what the normal position is, reposition the tooth and show the patient in a mirror to confirm/adjust
4) Measure the length of your wire – it should extend across 3-5 teeth i.e. the injured tooth and 1-2 teeth either side. Cut the wire to the desired length
5) Ensure the tooth surface is dry and proceed to etch, prime and bond the teeth. Light cure for 15-20 seconds
6) Apply composite on the labial surface of the injured tooth and push the wire into the composite to submerge it. Light cure for 20 seconds. Apply further composite over the wire to secure it
7) Repeat step 6 for the adjacent teeth and ensure the sharp ends of the wire are covered with composite to prevent soft tissue injury.
8) Advise the patient regarding pain relief and to book an appointment with his/her own dentist for a review as the splint must be removed in 2-4 weeks [4].
Important: Never re-implant a deciduous (baby) tooth. If baby teeth are loose and pose an airway risk or causing discomfort, they should be removed. If trauma to deciduous teeth occurs, parents should always be warned of damage to permanent dentition and this should be followed up by the dentist.