Milk storage of an avulsed permanent tooth,
does it really help with Improved long-term survival and functional replantation success versus tap water, saline, or dry storage?
research showsThe grade is D. For the clinical subclaim, a retrospective cohort of 576 patients and 767 replanted teeth associated milk versus dry storage with adjusted HR 0.56 (95% CI 0.25–0.89), P=.015. Separately, the surrogate-endpoint claim rests on a 33-study review in which milk preserved extracted-tooth periodontal-ligament cells better than saline or tap water, with low to very low certainty. Long-term clinical superiority over water or saline was not directly established, giving D with 34 points.
ads claimA real finding that milk preserves ligament cells should not be converted into clinically proven superiority over water or saline for replantation success. The most direct current message is to avoid dry storage.
Useful facts when choosing a product
- Laboratory studies found better periodontal-ligament cell preservation in milk than in saline or tap water.
- The crown, not the root, should be handled, and the root should not be scrubbed or disinfected.
- Primary teeth should not be replanted; this verdict concerns avulsed permanent teeth only.
What the research actually shows
Clinical subclaim: Coste retrospectively followed 576 patients with 767 replanted permanent teeth from 1994-2018 and reported 50% survival at 5.5 years and adjusted HR 0.56 (95% CI 0.25–0.89), P=.015, for milk versus dry storage. This is a nonrandomized clinical association and not an adjusted clinical comparison of milk with water or saline. Surrogate-endpoint claim: De Brier screened 4,118 records and included 33 studies covering 23 comparisons, mostly using 3-38 extracted human teeth per group. The pooled cell-viability result favored milk over saline, but certainty was low to very low because of design limitations, indirectness, and imprecision.
Why this is classified as D (34)
Cell-preservation evidence is consistent, but direct clinical survival evidence is limited to a retrospective milk-versus-dry cohort while water and saline comparisons remain surrogate-based, giving D with 34 points.
Counterpoint. D does not mean milk should be avoided in an emergency. If immediate replantation is impossible and a dedicated medium is unavailable, milk is preferable to letting the tooth dry while seeking urgent dental care.
Rejudgment record. Cross-check applied — We separated cell viability from actual tooth survival and cross-checked comparators, analyzed scale, adjusted modeling, and funding against the De Brier review and Coste clinical cohort.
| Endpoint | S | Surrogate marker - laboratory or imaging measures |
| Replication | R1 | Single confirmatory trial |
| Independence | I2 | Decisive evidence is publicly or non-profit funded |
| Effect size | E+ | Meets the clinically important threshold |
The formula derives C while the verdict assigns D. Clinical survival evidence for milk versus dry storage comes from one retrospective cohort, while the broader claim of better replantation success than water or saline relies on extracted-tooth cell-viability surrogates and is one level less direct.
Sub-claim grades by effect
This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.
| Effect (sub-claim) | Grade | Basis |
|---|---|---|
| Milk storage is better than dry storage for replanted-tooth survival. | C | A large retrospective cohort found an adjusted association with lower tooth loss. |
| Milk improves replantation success versus water or saline. | D | The evidence is dominated by extracted-tooth cell viability rather than direct clinical superiority. |
Cross-check — Codex and Claude
Evidence Table
| Study | Design | Sample | Funding | Endpoint | Result | Weight |
|---|---|---|---|---|---|---|
| Study 1 | Systematic review and meta-analysis | 23 | Supported by the Belgian Red Cross scientific research foundation; authors reported Belgian Red Cross employment and no other funding | Periodontal-ligament cell viability and limited clinical replantation success | Saline versus milk cell viability SMD -4.35 (95% CI -7.55 to -1.14); low to very low certainty | Key surrogate synthesis for water and saline comparisons |
| Study 2 | Retrospective clinical survival cohort with multivariable Cox analysis | 767 | Public and university grants from CNPQ, PRPq-UFMG, and MEC-PROExt | Functional retention of the replanted tooth in the mouth | 50% survival at 5.5 years; milk versus dry storage adjusted HR 0.56 (95% CI 0.25–0.89), P=.015 | Direct clinical supporting evidence for actual tooth survival |
Receipt — 2 References
All 2 cited sources were verified for existence at the original page (as of 2026-08-14).
Reviewed and approved: Chamgap Editorial Team · Approval date: 2026-08-14 · Corrections: none
Cite this verdict
[Chamgap] Milk storage of an avulsed permanent tooth x improved replantation success — Evidence Grade D·34. 2 cited sources checked. Source: https://chamgap.com/en/verdicts/general/avulsed-permanent-tooth-milk-storage-replantation-success/ · CC BY 4.0CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.
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