A 5-year-old is brought to the emergency department after a fall. An upper PRIMARY incisor has been completely avulsed, the lip is lacerated, and the permanent tooth germ appears radiographically normal. What is the MOST appropriate management of the avulsed tooth?

Correct answer: C. Do NOT replant it; manage the soft tissue injury and the remaining dentition

• A. Replantation is contraindicated regardless of subsequent pulp therapy.
• B. Rigid splinting is inappropriate for primary teeth and replantation itself is contraindicated.
• C. Correct. An avulsed PRIMARY tooth is NEVER REPLANTED. The developing permanent tooth germ lies immediately palatal to and above the primary root apex, and the act of replanting risks direct mechanical damage plus the ongoing risk of infection and ankylosis — producing enamel hypoplasia, crown dilaceration or eruption disturbance in the permanent successor. Management is to control haemorrhage, suture the lip laceration (after excluding retained tooth fragments in the lip), and treat the remaining injured teeth on their own merits.
• D. Extracting uninjured or salvageable teeth is unnecessarily destructive.

Note: Always radiograph a lacerated lip after dental trauma with a missing tooth — fragments embedded in the lip are commonly missed and cause chronic infection.