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牙齒突然掉了一顆怎麼辦？｜證據鏈

km 編輯部2026-08-13閱讀約 45 分鐘
#證據鏈#牙醫KM#台灣#牙冠

本頁是〈牙齒突然掉了一顆怎麼辦？〉的事實單元帳：每一條主張對應的來源、證據等級、地域與期間、原文引句與限制，逐條攤開。

牙齒突然掉了一顆怎麼辦？｜證據鏈

F-Units（事實單元帳）

  • F1｜confidence: verified｜basis: internal_dataset｜period: 2025-03 至 2026-08 GSC｜geo: TW｜span: backlog #30「牙齒掉了怎麼辦」等 6 詞項合計曝光 112,586，全部集中於單站｜caveat: 曝光為屬性級數字，非去重流量；本條發布時剝除
  • F2｜confidence: 結構性整理（編輯框架，非外部事實宣稱）｜basis: editorial_framework｜period: 2026-08-06｜geo: universal｜span: 「四路分流（外傷恆牙／乳牙／自然鬆脫／非真牙）」與「紅旗清單」的編排，為本站依 F3 至 F31 各來源整理的溝通用架構｜caveat: 非診斷工具，不取代臨床判斷
  • F3｜confidence: verified｜basis: clinical_guideline（IADT 2020 指引二，Dent Traumatol 2020;36(4):331-342，DOI 10.1111/edt.12573；PubMed 條目見來源清單第 1 條）｜period: 2020 現行版｜geo: universal｜span（取自 Wiley 開放取用全文第 1 節，2026-08-06 以 ego-browser 實測取回；PubMed 摘要不含此段）: 「the prognosis is very much dependent on the actions taken at the place of accident and promptly following the avulsion」／「There are also individual situations when replantation is not indicated (eg, severe caries or periodontal disease, an uncooperative patient, severe cognitive impairment requiring sedation, severe medical conditions such as immunosuppression, and severe cardiac conditions) which must be dealt with individually」／「However, not replanting a tooth is an irreversible decision and therefore saving it should be attempted」／「The IADT does not, and cannot, guarantee favorable outcomes from adherence to the Guidelines」｜caveat: 共識指引，非隨機試驗結果
  • F4｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 2 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「An avulsed permanent tooth is one of the few real emergency situations in dentistry」／「Dentists should be prepared to give appropriate advice to the public about first aid for avulsed teeth」／「Also, instructions may be given by telephone to people at the emergency site」／「Immediate replantation of the avulsed tooth is the best treatment at the place of the accident」｜caveat: 屬指引對現場處置的總述，非個別病例建議
  • F5｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 2 節現場步驟清單）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「If a tooth is avulsed, make sure it is a permanent tooth (primary teeth should not be replanted) and follow these recommended instructions」／「Keep the patient calm」／「Find the tooth and pick it up by the crown (the white part). Avoid touching the root. Attempt to place it back immediately into the jaw」／「If the tooth is dirty, rinse it gently in milk, saline or in the patient's saliva and replant or return it to its original position in the jaw」／「Once the tooth has been returned to its original position in the jaw, the patient should bite on gauze, a handkerchief or a napkin to hold it in place」｜caveat: 指引原文未列刷洗、擦拭或消毒浸泡等步驟，本卡據此不寫該類動作
  • F6｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 2 節保存介質段）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「place the tooth, as soon as possible, in a storage or transport medium that is immediately available at the emergency site」／「This should be done quickly to avoid dehydration of the root surface, which starts to happen in a matter of a few minutes」／「In descending order of preference, milk, HBSS, saliva (after spitting into a glass for instance), or saline are suitable and convenient storage mediums. Although water is a poor medium, it is better than leaving the tooth to air-dry」｜caveat: 偏好順序為指引敘述，非統計排名
  • F7｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 2 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「The tooth can then be brought with the patient to the emergency clinic」／「See a dentist or dental professional immediately」｜caveat: 台灣的就醫路徑（急診或牙醫院所）依當地可近性而定
  • F8｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 3 節細胞狀態分層）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Minimizing the dry time is critical for survival of the PDL cells. After an extra-alveolar dry time of 30 minutes, most PDL cells are non-viable」／「The PDL cells are most likely viable. The tooth has been replanted immediately or within a very short time (about 15 minutes) at the place of accident」／「The PDL cells may be viable but compromised. The tooth has been kept in a storage medium (eg, milk, HBSS (Save-a-Tooth or similar product), saliva, or saline, and the total extra-oral dry time has been <60 minutes)」／「The PDL cells are likely to be non-viable. The total extra-oral dry time has been more than 60 minutes, regardless of the tooth having been stored in a medium or not」｜caveat: 指引三層皆以「口外乾放時間」表述；本卡不把它換算成「離開嘴巴到就診的時間」
  • F9｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 3.1.3 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Delayed replantation has a poor long-term prognosis. The periodontal ligament becomes necrotic and is not expected to regenerate. The expected outcome is ankylosis-related (replacement) root resorption」／「Therefore, the decision to replant a permanent tooth is almost always the correct decision even if the extra-oral dry time is more than 60 minutes. Replantation will keep future treatment options open」／「decoronation or other procedures such as autotransplantation might be necessary later if the replanted tooth becomes ankylosed and infra-positioned」｜caveat: 指引同段寫明沾黏與吸收的發生率變異大且不易預測
  • F10｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 3.1.1 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Verify the correct position of the replanted tooth both clinically and radiographically」／「If the tooth or teeth were replanted in the wrong socket or rotated, consider repositioning the tooth/teeth into the proper location up to 48 hours after the traumatic incident」｜caveat: 48 小時為指引對牙醫師的處置窗，不是民眾可自行操作的期限
  • F11｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 3.1.1 與第 11.1 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Stabilize the tooth for 2 weeks using a passive flexible splint」／「Replanted teeth should be monitored clinically and radiographically at 2 weeks (when the splint is removed), 4 weeks, 3 months, 6 months, one year, and yearly thereafter for at least five years」｜caveat: 合併齒槽骨或顎骨骨折時指引另有較長的固定期；開放根尖者追蹤更密集
  • F12｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 9 節病人指示）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Avoid participation in contact sports」／「Maintain a soft diet for up to 2 weeks, according to the tolerance of the patient」／「Brush their teeth with a soft toothbrush after each meal」／「Use a chlorhexidine (0.12%) mouth rinse twice a day for 2 weeks」｜caveat: 屬指引對醫師的衛教清單；實際用法須由牙醫師依個別狀況指示，本卡不作用藥建議
  • F13｜confidence: verified｜basis: clinical_guideline（同 F3 來源，第 8 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Although most people receive tetanus immunization and boosters, it cannot be assumed that this is always the case. Refer the patient to a physician for evaluation of the need for a tetanus booster」｜caveat: 指引寫的是轉介醫師評估，不是直接施打；台灣的接種時程另見 F31
  • F14｜confidence: verified（指引記載已逐字取回；IADT 網站入口 2026-08-06 實測 200、標題為 International Association of Dental Traumatology）｜basis: clinical_guideline（同 F3 來源，第 2 節）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「available in multiple languages: Arabic, Basque, Bosnian, Bulgarian, Catalan, Czech, Chinese, Dutch, English」／「This educational resource can be obtained at the IADT website」／「for mobile phones, is another useful source of information for patients, providing instructions on what to do in an emergency situation after a dental injury」｜caveat: IADT 網站首頁內容為動態載入，海報與應用程式的下載路徑與現行內容未逐字驗證；本卡僅記錄其在指引中的存在與定位
  • F15｜confidence: verified｜basis: clinical_guideline（IADT 2020 指引三，Dent Traumatol 2020;36(4):343-359，DOI 10.1111/edt.12576；PubMed 條目見來源清單第 2 條）｜period: 2020 現行版｜geo: universal｜span（取自 Wiley 開放取用全文第 1.10 節，2026-08-06 以 ego-browser 實測取回；PubMed 摘要不含此段）: 「An avulsed primary tooth should not be replanted. Reasons include a significant treatment burden (including replantation, splint placement and removal, root canal treatment) for a young child as well as the potential of causing further damage to the permanent tooth or to its eruption. However, the most important reason is to avoid a medical emergency resulting from aspiration of the tooth」｜caveat: 乳牙與恆牙的處置方向相反，本卡在四處分開陳述以防混用
  • F16｜confidence: verified｜basis: clinical_guideline（同 F15 來源，Table 12 乳牙脫出）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「The location of the missing tooth should be explored during the trauma history and examination, especially when the accident was not witnessed by an adult or there was a loss of consciousness」／「While avulsed teeth are most often lost out of the mouth, there is a risk that they can be embedded in soft tissues of the lip, cheek, or tongue, pushed into the nose, ingested or aspirated」／「If the avulsed tooth is not found, the child should be referred for medical evaluation to an emergency room for further examination, especially where there are respiratory symptoms」｜caveat: 原文脈絡為乳牙齒列；本卡在紅旗節引用時保留「找不到牙齒＋呼吸道症狀」的原始條件
  • F17｜confidence: verified｜basis: clinical_guideline（同 F15 來源，Table 12 乳牙脫出）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Avulsed primary teeth should not be replanted」／「To encourage gingival healing and prevent plaque accumulation, parents should clean the affected area with a soft brush or cotton swab combined with an alcohol-free 0.1%-0.2% chlorhexidine gluconate mouth rinse applied topically twice a day for 1 wk」／「Further follow up at 6 y of age is indicated to monitor eruption of the permanent tooth」｜caveat: 追蹤時程原文為 6-8 wk 之臨床檢查；影像追蹤僅在臨床發現提示病理變化時才建議
  • F18｜confidence: verified｜basis: clinical_guideline（同 F15 來源，第 1 節導論）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「For children, aged 0-6 years, oral injuries account for 18% of all physical injuries and the mouth is the second most common area of the body to be injured」／「A recent meta-analysis on traumatic dental injuries (TDIs) reveals a world prevalence of 22.7% affecting the primary teeth」／「They most commonly occur between 2 and 6 years of age」｜caveat: 為指引引述之他人統合分析數字，非台灣本地資料
  • F19｜confidence: verified｜basis: clinical_guideline（同 F15 來源，第 1.7 節與恆牙發育影響段）｜period: 2020 現行版｜geo: universal｜span（同上取回方式）: 「Clinicians should check whether the history of the accident and the injuries sustained are consistent or match. In situations where there is suspicion of abuse, prompt referral for a full physical examination and investigation of the incident should be arranged」／「Intrusion and avulsion injuries are most commonly associated with the development of anomalies in the permanent dentition」｜caveat: 轉介流程依各地規定，指引明寫超出其範圍
  • F20｜confidence: verified｜basis: clinical_guideline（IADT 2020 指引一，Dent Traumatol 2020;36(4):314-330，DOI 10.1111/edt.12578；PubMed 條目見來源清單第 3 條）｜period: 2020 現行版｜geo: universal｜span（取自 Wiley 開放取用全文，2026-08-06 以 ego-browser 實測取回；PubMed 摘要不含後一句）: 「Crown fractures and luxations of these teeth are the most commonly occurring of all dental injuries」／「back into the tooth socket under local anesthesia」｜caveat: 本卡僅用於指出「未完全脫出的移位屬另一份指引、且復位是牙醫師在局部麻醉下的處置」，不引用其個別術式建議
  • F21｜confidence: verified｜basis: peer_reviewed（PMID 37194850）｜period: 2017-01 至 2021-12 追蹤，2023 刊出｜geo: universal｜span: 「Sixty-two permanent replanted teeth were retrospectively assessed」／「Thirty-one teeth (50.0%) remained in their sockets and 31 (50.0%) were lost due to external root resorption. Of the 25 (40.3%) teeth replanted within one hour, 16 (64.0%) remained in their sockets, and 9 (36.0%) were lost. Twenty-two (71.0%) of all 31 lost teeth had an extra-alveolar time of more than one hour」／「The extra-alveolar time of less than one hour was demonstrated to be important to keep the permanent tooth in its socket」｜caveat: 單一中心回溯研究、樣本 62 顆，屬研究層級比例，不可作個人預後估計
  • F22｜confidence: verified｜basis: peer_reviewed（PMID 30720860，Cochrane CD006542.pub3）｜period: 檢索至 2018-03-08，2019-02 刊出｜geo: universal｜span: 「Four studies, involving a total of 183 participants and 257 teeth were identified」／「All evidence was rated as being of very low quality due to problems with risk of bias and imprecision of results」／「there is insufficient evidence to support or refute the effectiveness of different interventions for avulsed and replanted permanent front teeth」｜caveat: 版本鏈已查（2010 pub2 PMID 20091594 → 2019 pub3 為現行版，PubMed 以 CD006542 檢索無更新版）；pubtype 不含 Retracted Publication
  • F23｜confidence: verified｜basis: peer_reviewed（PMID 30193009）｜period: 2018 刊出，納入 15 篇研究｜geo: universal｜span: 「In 15 selected studies, nine storage media (HBSS, tap water, DMEM, milk, saliva, 10% and 20% propolis, Gatorade, and Viaspan) were analyzed at six time points. For storage up to 2 hours, HBSS, DMEM, milk, 10% propolis, 20% propolis, and Viaspan conserved more than 80% of PDL viability」／「Milk remains the most convenient, cheapest, and readily available solution in most situations while also being capable of keeping PDL cells alive」｜caveat: 體外人類牙周韌帶細胞培養研究之合併結果，非臨床療效；原文形容詞為研究者評語，本卡以中性措辭轉述
  • F24｜confidence: verified｜basis: peer_reviewed（PMID 40792198）｜period: 檢索 2014 至 2024；線上先行發表 2025-07-31，卷期標示 2025 年 9-10 月｜geo: universal｜span: 「This systematic review and MA suggests that placentrex and aloevera could represent an alternative to HBSS. However, more studies are necessary to obtain a reliable conclusion」｜caveat: 事故簿第 9 條之時效查核用——本卡確認保存介質題已有 2025 年更新回顧，其結論未推翻指引的現場介質順序；pubtype 不含 Retracted Publication
  • F25｜confidence: verified｜basis: peer_reviewed（PMID 33648772）｜period: 2022 刊出，3 篇研究納入｜geo: universal｜span: 「Three studies (4396 extractions in total) could be included for the risk of bias assessment and qualitative data synthesis」／「The reported indications for tooth extraction on dental and medical grounds included caries with the proportion of all extractions ranging from 36.0% to 55.3%, periodontitis from 24.8% to 38.1%, trauma from 0.8% to 4.4%, periapical disease from 7.3% to 19.1%」｜caveat: 統計對象為「拔牙的適應症」，不是「自然脫落的原因」；納入研究僅 3 篇，作者亦寫明可靠估計仍缺乏
  • F26｜confidence: verified｜basis: peer_reviewed（PMID 29926495，2017 世界工作坊分期分級架構）｜period: 2018 刊出｜geo: universal｜span: 「Stage I to IV of periodontitis is defined based on severity (primarily periodontal breakdown with reference to root length and periodontitis-associated tooth loss), complexity of management (pocket depth, infrabony defects, furcation involvement, tooth hypermobility, masticatory dysfunction)」｜caveat: 分期屬臨床診斷架構，須由牙醫師依完整檢查判定，本卡不作分期判讀
  • F27｜confidence: verified｜basis: peer_reviewed（PMID 42131949）｜period: 線上發表日 2026-05-14（esummary epubdate 實查，早於本卡日期 2026-08-06）｜geo: universal｜span: 「Fifty articles comprising 55 population-based cohorts (287 750 participants from 37 countries) were included」／「Individuals with nonfunctional dentition had approximately twice the odds of impaired OHRQoL compared with those with functional dentition」／「odds ratio (OR) = 2.08; 95% CI 1.72-2.52」｜caveat: 納入研究多為橫斷面設計，屬關聯性證據，不能推論因果或個人結果
  • F28｜confidence: verified（同 #28 卡錨）｜basis: peer_reviewed（PMID 30155575）｜period: 2019 刊出｜geo: universal｜span: 「The investigated haemostatics included gauze pressure」／「The interruption of antithrombotics prior to tooth removal because of the fear of bleeding or following postoperative bleeding increases the risk of thromboembolic events」｜caveat: 原研究情境為拔牙後出血，本卡僅引用止血措施類別與自行停藥的風險，不作外傷出血處置指示
  • F29｜confidence: verified（2026-08-06 ego-browser 實測全國法規資料庫頁面逐字比對，同 VERIFIED-FACTS 既有錨）｜basis: law｜period: 現行條文｜geo: TW｜span: 《全民健康保險法》第 51 條「十一、義齒、義眼、眼鏡、助聽器、輪椅、拐杖及其他非具積極治療性之裝具。」｜caveat: 個別給付以健保署現行公告為準，本卡不作給付判定
  • F30｜confidence: verified（2026-08-06 ego-browser 實測逐字比對）｜basis: law｜period: 現行條文｜geo: TW｜span: 《醫療法》第 81 條「醫療機構診治病人時，應向病人或其法定代理人、配偶、親屬或關係人告知其病情、治療方針、處置、用藥、預後情形及可能之不良反應。」｜caveat: 條文引述，非法律意見
  • F31｜confidence: verified（2026-08-06 ego-browser 實測取回，頁面標示之更新日期 2026/4/21）｜basis: official_statement｜period: 頁面現況｜geo: TW｜span: 衛生福利部疾病管制署「破傷風－疾病介紹」：「民眾若發現傷口有被土壤、塵土或動物及人類糞便污染，或生鏽器具割傷，需至醫院進行適當之治療，並於治療時告知醫師傷口有被污染。」／「完成基礎接種後，每隔10年應給予追加1劑減量破傷風、白喉、百日咳疫苗(Tdap)。」｜caveat: 該頁未針對牙外傷情境作專章說明；是否需要追加由醫師依個別接種史判斷
  • F32｜confidence: verified（2026-08-06 ego-browser 實測取回，下拉選單逐項讀取）｜basis: official_statement｜period: 頁面現況｜geo: TW｜span: 衛生福利部中央健康保險署「健保特約醫事機構查詢」頁（頁面標題逐字為「衛生福利部中央健康保險署-健保特約醫事機構查詢」），查詢條件含縣市、鄉鎮市、院所層級／特約類別，「已加入計畫」選項清單中包含「牙醫急診醫療不足區獎勵試辦計畫-醫院(牙醫急診試辦中心)」｜caveat: 該計畫名稱本身指向醫療資源不足地區之獎勵試辦，非全國牙科急診總表；實際可就診時段仍須逐一致電確認
  • F33｜confidence: verified（2026-08-06 ego-browser 實測，同 #9 卡錨 C3 家族）｜basis: official_statement｜period: 資料集現況（詮釋資料更新時間 2026-07-13）｜geo: TW｜span: 政府資料開放平臺資料集「臺北市醫療收費標準」，提供機關臺北市政府衛生局｜caveat: 單一縣市例證；其他縣市頁面放量前逐一補驗
  • F34｜confidence: n/a｜basis: editorial（結構性整理，非文獻導出）｜period: 2026-08-06｜geo: universal｜內容：家長在急症現場無法辨識乳牙或恆牙時的預設安全動作（不硬放回、置入保存介質、立即就醫由醫師判斷）。｜caveat：本條為本站依 IADT 恆牙與乳牙兩份指引之處置差異所做的保守整理，非指引原文條文，不得作為文獻證據引用。

來源清單

取用日期均為 2026-08-06。PubMed 條目以 E-utilities efetch 取得摘要原文並逐條對 span；IADT 三份指引為 Wiley 開放取用文章，以 ego-browser 開啟後取 innerText 逐字比對（其 span 不在 PubMed 摘要內，故對應 F-Unit 不標 PMID 前綴，避免機器閘門拿錯文本比對）；台灣法規與官方頁一律以 ego-browser 實載後逐字比對。

  1. Fouad AF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2020;36(4):331-342. PMID 32460393
  2. Day PF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol. 2020;36(4):343-359. PMID 32458553
  3. Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dent Traumatol. 2020;36(4):314-330. PMID 32475015
  4. Roskamp L, et al. Retrospective analysis of survival of avulsed and replanted permanent teeth according to 2012 or 2020 IADT Guidelines. Braz Dent J. 2023;34(2):122-128. PMID 37194850
  5. Day PF, Duggal M, Nazzal H. Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted. Cochrane Database Syst Rev. 2019;2(2):CD006542. PMID 30720860
  6. Adnan S, et al. Evaluation of periodontal ligament cell viability in different storage media based on human PDL cell culture experiments—A systematic review. Dent Traumatol. 2018;34(6):387-402. PMID 30193009
  7. Kumar S, et al. The evaluation of periodontal ligament cell viability for an avulsed tooth using various storage media: A systematic review and meta-analysis. J Oral Biol Craniofac Res. 2025;15(5). PMID 40792198
  8. Broers DLM, et al. Reasons for Tooth Removal in Adults: A Systematic Review. Int Dent J. 2022;72(1):52-57. PMID 33648772
  9. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. J Clin Periodontol. 2018;45 Suppl 20:S149-S161. PMID 29926495
  10. Tooth Loss and Edentulism Are Associated With Poorer Quality of Life: A Systematic Review and Meta-Analyses. J Periodontal Res. 2026. PMID 42131949
  11. Ockerman A, et al. Local haemostatic measures after tooth removal in patients on antithrombotic therapy: a systematic review. Clin Oral Investig. 2019;23(4):1695-1708. PMID 30155575
  12. 全民健康保險法 第 51 條（全國法規資料庫）
  13. 醫療法 第 81 條（全國法規資料庫）
  14. 衛生福利部疾病管制署：破傷風－疾病介紹
  15. 衛生福利部中央健康保險署：健保特約醫事機構查詢
  16. 政府資料開放平臺：臺北市醫療收費標準（提供機關：臺北市政府衛生局）
  17. 內部數據：`analysis/reports/km-dental-backlog.md` #30 附錄（詞×站×曝光逐筆可對帳）
  18. 編輯框架：本站四路分流與紅旗結構（無外部來源，標示為結構性整理）

內部引用鏈

  • 掉下來的是牙冠或假牙、不是真牙時：假牙牙套（牙冠套）是什麼？缺牙能做牙套嗎？（KM-DENTAL-23）
  • 牙冠重做的費用怎麼問、報價單怎麼讀：做一顆牙冠（假牙牙套）要多少錢？（KM-DENTAL-11）
  • 牙齒保不住之後補不補、怎麼決定：臼齒拔掉可以不補嗎？會怎樣？（KM-DENTAL-34）
  • 牙齦腫痛與該就醫的分級：牙齦腫痛怎麼快速消？什麼情況要就醫？（KM-DENTAL-05）
  • 蛀牙拖著不處理會怎樣：蛀牙可以拖多久？會自己好嗎？（KM-DENTAL-15）
發布閘門提醒：本卡為 draft。四語（zh-Hans／en／ja）未產前不得進 km_entries；本卡為症狀分級卡且含急症紅旗判準，依 ANK-DENTAL-SPEC 審核鏈第 5 層需 GM 第三意見專審（紅旗完整性／分級一致性／時間分層端點）後才進發布流程。F14 的 IADT 網站資源下載路徑未逐字驗證，該句維持「記錄其在指引中的存在」定位，不得改寫成資源導引。

FAQ

什麼情況要立刻就醫、不能等？
找不到牙齒且有呼吸道症狀、曾失去意識或出血止不住時，本站建議直接掛急診或撥打 119 [F2]。
どのような場合に直ちに受診し、待ってはいけませんか？ — 歯が見つからず呼吸器症状がある、意識を失ったことがある、または出血が止まらない場合、本サイトでは救急外来へ直接行くか 119 に電話することを勧めます [F2]。
When should I seek immediate care rather than wait? — For a missing tooth with respiratory symptoms, a prior loss of consciousness, or bleeding that will not stop, this site advises going directly to an emergency department or calling 119 [F2].
掉下來的牙齒可以泡在水裡嗎？
**指引把水列為不好的介質，但仍寫明它比讓牙齒風乾好。** 偏好順序由高到低是牛奶、HBSS、唾液、生理食鹽水 [F6]。體外研究的系統性回顧則顯示，保存 2 小時以內時 HBSS、DMEM、牛奶等可保留超過八成的牙周韌帶細胞存活率 [F23]。順帶一提，2025 年有一份新的系統性回顧與統合分析（檢索 2014 至 2024 年）比較各種介質與 HBSS，結論是 placentrex 與蘆薈可能是替代選項，但需要更多研究才能得到可靠結論 [F24]——也就是說，現階段現場能拿到的牛奶，仍排在指引偏好順序的前端 [F6][F24]。
落ちた歯を水に入れてよいですか？ — **ガイドラインは水を不適切な媒体に挙げますが、歯を乾燥させるよりは良いと明記しています。**優先順は牛乳、HBSS、唾液、生理食塩水です [F6]。in-vitro 研究のシステマティックレビューは、2 時間以内の保存では HBSS、DMEM、牛乳などが歯根膜細胞生存率を八割超で保ち得ると示しました [F23]。さらに 2025 年の新しいシステマティックレビューとメタ解析（2014 から 2024 年を検索）は、各媒体を HBSS と比べ、placentrex とアロエベラは代替候補になり得るが、信頼できる結論にはさらなる研究が必要と結論づけました [F24]。したがって現場で手に入る牛乳は、現在もガイドラインの優先順の前方にあります [F6][F24]。
Can a tooth that fell out be put in water? — **The guideline lists water as a poor medium, but expressly says it is still better than letting the tooth air-dry.** The order of preference is milk, HBSS, saliva, and saline [F6]. An in-vitro systematic review found that, for storage up to 2 hours, HBSS, DMEM, milk, and others could conserve more than eighty percent periodontal-ligament-cell viability [F23]. In addition, a new 2025 systematic review and meta-analysis (searching 2014 through 2024) compared media with HBSS and concluded that placentrex and aloe vera might be alternatives, but more studies are needed for a reliable conclusion [F24]. Thus, milk that is available at the scene still sits near the front of the guideline’s preference order [F6][F24].
已經超過一小時，還有必要把牙齒帶去嗎？
**有。** 指引寫的是：即使口外乾放時間超過 60 分鐘，決定把恆牙放回去幾乎仍是正確的決定，因為再植可以保留後續的治療選項，牙齒之後仍可視需要拔除 [F9]；而不把牙齒放回去是一個不可逆的決定 [F3]。長期預後會比較差（牙周韌帶壞死、沾黏性牙根吸收）[F9]，但這件事由牙醫師評估，不該在現場就先放棄。
すでに 1 時間を超えています。それでも歯を持って行く意味はありますか？ — **あります。**ガイドラインは、口腔外乾燥時間が 60 分を超えていても、永久歯を再植する判断はほとんど常に正しく、再植は将来の治療選択肢を残し、歯は後で必要に応じ抜歯できると述べます [F9]。歯を戻さないことは不可逆的な判断です [F3]。長期予後はより悪くなります（歯根膜壊死、強直関連歯根吸収）[F9]が、これは歯科医師が評価することであり、現場で先に諦めるべきではありません。
It has already been over one hour. Is it still worth bringing the tooth in? — **Yes.** The guideline says that even when extra-oral dry time is over 60 minutes, deciding to replant the permanent tooth is almost always correct because replantation keeps future treatment options open; the tooth can still be extracted later if needed [F9]. Not replanting it is an irreversible decision [F3]. Long-term prognosis is poorer (periodontal-ligament necrosis and ankylosis-related root resorption) [F9], but a dentist should assess this rather than the tooth being abandoned at the scene.

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引用本文

km 編輯部・《牙齒突然掉了一顆怎麼辦？｜證據鏈》・IDAEO 知識庫・2026-08-13・https://km.idaeo.ai/reports/dental-tooth-lost-evidence

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更新 2026-08-13T14:17:38.533Z · server-rendered · four-language · IDAEO 知識庫