Dental Emergencies

Pain

Dental pain can be caused by trauma, severe decay, eruption (wisdom teeth), previous placed deep restoration (crowns), food impaction, and developing an abscess related to teeth or gums. You may also experience pain from diseases or oral cancers.

Before taking any medication, follow these steps:

1. Try to localize the area (tooth, gum, etc.).
2. Establish the duration of how long the pain has been experienced (20 minutes, 3 hours, overnight, etc.)

After this, ask yourself the following questions:

1. Is pain is spontaneous or caused by stimulation (i.e. hot or cold, biting pressure)?
2. What helps relieve the pain (i.e. hot or cold)?
3. Do you notice any unusual occurrences besides pain (lost filling, broken teeth, red gums, blisters)?
4. Do you have any swelling or fever?

After you gather all of this critical information, contact the office and explain your findings. An appointment will be booked based on the severity of your symptoms.

Lost Filling or Crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown or filling has dropped out of the mouth, make a dental appointment as soon as possible. An appointment will be booked based on the severity of the incident.  Keep the crown in a safe place, because there is a possibility that the dentist can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage, and will require further treatment.

Cracked or Broken Teeth

The teeth are strong, but they are still prone to fractures, cracks and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme.  Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting.  If a tooth has been fractured or cracked, there is no alternative but to call the dentist as quickly as possible and explain the nature of the concern.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

1. Retain the broken segment (it might provide some important information)
2. Call the dentist.
3. Rinse the tooth fragment and the mouth with lukewarm water.
4. Be gentle when chewing in that area of the mouth, and avoid extreme temperatures

The nature of the break or fracture will limit what the dentist is able to do.  If the fracture is above the gum line, it may require simple restoration or future crown or root canal treatment. If a fracture or crack extends into the root, salvaging the tooth may prove difficult. The tooth may require root canal treatment, periodontal (gum) surgery, or, in some situations, an extraction may be the only possible option.

Avulsed (Knocked Out) Tooth

We’re all at risk for having a tooth knocked out.  More than 5 million teeth are knocked out every year!  If we know how to handle this emergency situation, we may be able to actually save the tooth. Before addressing any dental concerns, assessing the medical condition (such as loss of conscience, severe neck or head injury, etc.) of the patient is critical.  Teeth that are knocked out may be possibly reimplanted if we act quickly, yet calmly, and follow these simple steps:

1. Locate the tooth and handle it only by the crown (chewing part of the tooth), NOT by the roots.
2. DO NOT scrub or use soap or chemicals to clean the tooth.  If it has dirt or debris on it, rinse it gently with your own saliva or whole milk.  If that is not possible, rinse it very gently with water.
3. Get to a dentist within 30 minutes.  The longer you wait, the less chance there is for successful reimplantation.

Ways to transport the tooth

• Try to replace the tooth back in its socket immediately.  Gently bite down on gauze, a wet tea bag or on your own teeth to keep the tooth in place.  Apply a cold compress to the mouth for pain and swelling as needed.
• If the tooth cannot be placed back into the socket, place the tooth in a container and cover with a small amount of your saliva or whole milk.  You can also place the tooth under your tongue or between your lower lip and gums.  Keep the tooth moist at all times.  Do not transport the tooth in a tissue or cloth.
• Consider buying a “Save-A-Tooth” storage container and keeping it as part of your home first aid kit.  The kit is available in many pharmacies and contains a travel case and fluid solution for easy tooth transport.

The sooner the tooth is replaced back into the socket, the greater the likelihood it has to survive and possibly last for many years.  So be prepared, and remember these simple steps for saving a knocked-out tooth.

You can prevent broken or knocked-out teeth by:

• Wearing a mouthguard when playing sports
• Always wearing your seatbelt
• Avoiding fights
• Avoid chewing hard items such as ice, popcorn kernels, hard breads, etc.

Dislodged/Loose Teeth

If a tooth has been dislodged or loose from trauma, try to position the tooth as quickly as you can. If you are unable to do so, contact the office as quickly as possible, and explain the situation in detail. Meanwhile, take over-the-counter medication to relieve pain (if accessible).

The dentist will try to position the tooth to the previous location (if possible), along with taking proper radiographs (x-rays), and explain your future prognosis. In most situations, a splint (metal wire) is placed to stabilize the tooth as a temporary measure. In the future, the tooth may require root canal treatment, however, this is difficult to determine in the initial emergency appointment (and this also depends on the age of the patient).