The guiding principle in managing trauma to the primary dentition is potential sequelae to the permanent tooth. If the risk to the permanent tooth is great, the primary tooth should be removed. If esthetics are a concern to the parent, a number of appliances can be fabricated to temporarily manage this issue. It is important that parents realize that the desire to maintain optimum esthetics by maintaining a significantly injured primary tooth can, in many cases, cause more damage to the permanent tooth. Where avulsions have occurred, the old adage "when in doubt, leave it out" is still perhaps the most reliable advice.