EMERGENCY DENTAL EXPLAINED

Dental Emergency

Dental Emergency

A knocked-out tooth is a dental emergency that requires urgent attention. If the appropriate emergency steps are followed immediately after the tooth has been knocked out, the chances are very good that the tooth can be reinserted and preserved by a dentist.

Loose Tooth, Tooth Out of Alignment

If you have a tooth that is loose or out of alignment, you should call your dentist for an emergency appointment right away. In the meantime, you can try to put the tooth back in its original position using your finger with very light pressure. Do not try and force it. You can bite down to keep the tooth from moving. Your dentist may want to splint the tooth to the adjacent teeth (the teeth on each side) to keep it stabilized.

Chipped, Cracked or Fractured Teeth

If a tooth is chipped and doesn’t hurt, this usually does not constitute a dental emergency and you can wait a few days to see a dentist. However, it is important to be careful while chewing so as not to chip it more. Your dentist may simply be able to smooth the chip out, or add some composite filling material to repair the tooth.

A cracked or fractured tooth is a serious issue constituting a dental emergency. Fractured or cracked teeth usually suggest that damage has occurred to the inside of the tooth as well as to the outside. Severe fractures are so extreme that the tooth cannot be saved. If you suffer a fractured tooth, call your dentist immediately for an emergency appointment and follow these steps:

An X-ray will be needed in order for your dentist to properly diagnose the condition of your tooth. If the soft tissue inside of the tooth (the tooth pulp) is damaged, your tooth may need a root canal. If the pulp is not damaged, the tooth might only need a crown.

Some dentists make some of their permanent crowns in-office and place them in the same day; other dentists use an outside laboratory to make the crown. In this case you will have to wear a temporary crown while the laboratory makes a permanent crown. If the tooth cannot be saved, your dentist will inform you of the various alternatives for replacing missing teeth, such as implant-supported restorations and bridges.

Tissue Injury and Facial Pain

Any type of injury inside the mouth, such as puncture wounds, lacerations and tears to the lips, cheeks, mouth and tongue, are considered tissue injuries and a dental emergency. If you experience any type of tissue injury, it is important to clean the area immediately with warm water. If the bleeding is coming from the tongue, gently pull the tongue forward and place pressure on the wound using gauze. You should get to an oral surgeon or nearby hospital emergency room as quickly as possible.

To alleviate any type of facial pain associated with tissue injury, you can take acetaminophen as directed on the packaging label. Never take aspirin or ibuprofen for a dental emergency because they are anticoagulants, which can cause excessive bleeding.

Other Dental Emergencies

Basically, any dental problem that requires immediate treatment in order to save a tooth, stop ongoing tissue bleeding or alleviate severe pain is considered a dental emergency.

A severe infection or abscess in the mouth can be life-threatening and should be dealt with immediately. Your dentist might be able to perform the first stage of a root canal, or will refer you to an endodontist (root canal specialist) to open and drain the tooth and allow the abscess to drain. If your dentist can’t be reached, seek hospital emergency room care.

Problems with Temporary Restorations

Having a temporary dental crown come off is not a dental emergency. However, it is important to put it back in place so that the tooth stays in its original position until you can see your dentist.

A temporary crown can easily be put back onto your tooth by placing Vaseline, toothpaste, Chapstick or even a very small amount of denture adhesive into the temporary and placing it onto your tooth. Try putting your crown in first and note how it fits into place. Once you are comfortable with the fit, apply adhesive into the temporary and place it properly on your tooth. Bite down firmly onto a dry washcloth, applying even pressure to the temporary. After a few minutes, clean off any excess adhesive you can see. You should see your dentist within the next few days to have it properly re-cemented.

Is it a Dental Emergency?

Smoothing a chipped tooth, re-cementing a crown that is not causing pain and composite bonding to repair a tooth are not dental emergencies. Typically, such problems can be dealt with during your dentist’s regular office hours.

If you are not sure whether or not you are having a true dental emergency, answer the following questions:

If you answered yes to any of these questions, you might be having a dental emergency and should call your dentist immediately. It’s important to describe to your dentist exactly what has happened and what you are feeling.

If you experience extreme pain caused by hot or warm foods or beverages, try drinking ice water. It might relieve the pain. Sip on ice water and hold some in your mouth until you see the dentist.

If you are having sensitivity to cold or if it causes pain to breathe in air, avoid cold foods and beverages. Breathe through your nose and call your dentist’s office.

If you experience pain in a tooth when biting down, it might indicate an abscess. This is an emergency and you should call your dentist’s office.

How to Avoid a Dental Emergency

Many dental emergencies can be easily avoided by having routine check ups with your dentist to ensure that your mouth and teeth are healthy, strong and free from decay.

Wearing a mouth guard during sports activities will help to prevent teeth from being chipped, knocked out or broken. Avoid chewing on ice and hard foods that may break or fracture your teeth. If you are planning to travel out of the country or leaving for an extended vacation, during which you may not have ready access to dental care, it is important to see your dentist for a routine check up before you leave. Your dentist can make sure that you don’t have any loose crowns or teeth, decay close to the nerve of a tooth that could cause you pain or develop into an abscess or other problems that could be easily fixed before becoming a dental emergency later.

Being Prepared for a Dental Emergency

Because a dental emergency can happen at any time and place, the best thing to do is be prepared and don’t panic. Pack and keep with you a small dental first aid kit containing the following:

Author
Dr. Yohan Kim Dr. Kim graduated from University of Pennsylvania School of Dental Medicine Top of the Class and extended his training in General Practice Residency at Bellevue Hospital Center. He has been a faculty at AIC implant training center and lectured in US and Canada for the past 7 years. He has been part-time clinical instructor at NYU Implantology program as well as at GPR program at Bellevue hospital center. He truly believes that education and better knowledge empower patients. He maintains a private practice in Manhattan, New York focusing on comprehensive digital dentistry.

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