Before an Emergency ever occurs:
Make sure that your dentist has after hours coverage meaning
that he/she or a partner is available to take care of
dental emergencies. Keep your dentist's emergency number
readily available (carry it in your wallet or organizer,
for example)
If you're not sure if a
dental problem is an emergency, we offer this advice:
If you have pain, it's an emergency. This is because
even injuries that seem small or superficial can affect
the living tissues inside the tooth.
Even if you aren't in much pain, any structural
damage to a tooth — from a sports injury, for
example — should be considered an emergency. Chips
or fractures can affect the living tissue inside the
tooth, causing more problems in the future. Your dentist
can prevent the damage from getting worse.
The same is true of a lost filling or crown. Even
if you don't have any symptoms, the tooth has lost its
support and it could easily become weaker. Pieces could
break off or crumble, and you would need more extensive
treatment. If you see your dentist right away, there's
a good chance he or she will be able to repair the damage
with minimal treatment. Quick treatment improves the
odds of saving injured or damaged teeth.
The most common dental emergencies include
1. Tooth/teeth knocked out
2. Partially dislodged (extruded) tooth
3. BROKEN/ FRACTURED /CHIPPED TOOTH OR FILLING
4. SWOLLEN JAW
5. Severe Toothaches
6. Wisdom teeth erupting
7. Possible Broken Jaw
8. Bitten Tongue or Lip
9. Something Caught Between Your Teeth
10. BLEEDING AFTER AN EXTRACTION
11. BROKEN DENTURE, Temporary bridge OR PLATE
12. Injury to the soft tissue in the mouth
13. Lost filling
14. Dislodged crown/cap/bridge
15. Pus from the gums
It is important to know what to do in case of
an emergency
These general tips and guidance are NO substitute
for seeking professional, personal advice from your
Dentist or Doctor immediately.
1. Tooth/teeth knocked out
All teeth, even baby teeth, are important. Many
parents are under the false impression that baby teeth
are less important because they will eventually be replaced.
This is absolutely not true. Baby teeth serve
several important functions including, acting as spacers
creating enough room in the jaw so that permanent teeth
can come in, aiding in proper speech development, and
serving to help build self-esteem in the newly independent
child. For a parent, seeing a child lose a tooth in
an accident is always difficult. Such injuries often
result in bleeding in the mouth and can be anxiety provoking
for the child as well. Knowing how to prevent dental
injury and what to do in case an accident occurs can
save your child's teeth.
• Time is the enemy when a tooth is knocked
out. If a dentist is seen within
one hour after an accident,
chances are good that the tooth
can be re-implanted and saved. If the
tooth is put back in place within
10 minutes, it has a fair chance of taking root again.
After 2 hours, the chances are
poor.
• Make sure that you do not touch the root
of the tooth with your hands.
The root is the portion of the
tooth embedded in the gum and
not normally seen. The tooth should
be picked up by the crown only
and must not be allowed to dry.
• Rinse the tooth off very gently to make
sure it is clean. Do not scrub
the tooth or remove any
tissue that is attached to it. Be sure to
place a towel or wash cloth in the sink
so that it does not go down
the drain.
• When the tooth is clean, tuck it between
the cheek and gum or, preferably,
gently place the tooth
back into its own socket. Make sure
it's facing the right way. . Ask the
patient to hold the tooth in place
If this is not possible or if you are afraid that the
tooth might be swallowed, place
it in a glass containing either saliva or milk.
The tooth has a better
chance of surviving if it's kept in its natural
environment. Another option
is to put the tooth in a container
of milk, or spit into a cup and place the
tooth in the cup with the saliva.
The most important thing is to keep the tooth moist.
Use a cup of water if nothing else is available.
• You will need to take the tooth with you
and get to your dentist immediately.
If greater than 24 hours
has passed, then there is little
chance at all of re-implantation working.
2. Partially
Dislodged (Extruded) Tooth
What You Can Do
When a tooth is partially loosened or dislodged from
its socket, dentists call it an extruded tooth. As long
as the nerve and blood vessels remain intact, an extruded
tooth may be saved without root-canal treatment, depending
on how displaced it is. If the tooth is pushed out of
place (inward or outward), it should be repositioned
to its normal alignment with very light finger pressure.
Do not force the tooth into the socket. Hold the tooth
in place with a moist tissue or gauze. It is vital that
a dentist see the injured individual as quickly as possible.
You can apply a cold pack or ice to relieve pain until
you reach the dental office.
What Your Dentist Will Do
Your dentist will clean the area and then put
the tooth back in the right position. He or she may
use a plastic splint or orthodontic wire brackets to
keep the tooth stable until it has a chance to heal.
If the nerves or blood vessels were damaged, your
dentist may recommend root canal treatment to prevent
the tooth from becoming discolored or developing an
abscess, which is an infection. The dentist should do
a series of tests to determine if the nerve has been
damaged. These tests also may have to be done at follow-up
appointments because the tests may not be accurate right
after the tooth is injured.
3. Broken/Fracytured/Chipped/
Tooth or Filling
Teeth are remarkably strong,
but they can chip, fracture or break. Teeth usually
break as a result of trauma — from biting down
on something hard, for example, or from a blow to the
face. A child may fracture a tooth falling off a bike
or curb during play. Cavities that have weakened the
tooth also can cause chipping or fractures.
If your tooth breaks, the first thing you should
do is contact your dentist immediately. You should also
clean your mouth out by rinsing thoroughly with water.
Apply a cold compress to the area to minimize any swelling.
Quick action can save the tooth, prevent infection and
reduce the need for extensive dental treatment. Find
the broken tooth fragments and bring the pieces with
you, they may be able to be "cemented" back
together. Follow your doctors instructions. If your
child is experiencing pain or sensitivity in the affected
tooth, it may indicate that the tooth nerve may be injured.
The dentist can perform a root canal or other necessary
procedure to save the tooth. Afterwards, The tooth may
also need to be restored with a composite filling. This
tooth may need a full permanent crown to protect if
from further breakage and tooth loss
4. Swollen Jaw
A swollen jaw may have several reasons. When associated
with an accident, it may indicate a fracture of the
jaw. When it is in connection with a decayed tooth,
a swelling indicates an infection. Sometimes a swellingof
the jaw following an extraction may mean that the extraction
wound is infected. In any case, DO NOT APPLY HEAT TO
THE AREA. Do not put a heating pad, a hot water bottle,
or any other source of heat on your jaw. Heat will make
things worse instead of better. Apply a cold compress
instead by taking some ice in a plastic bag or handkerchief.
Call the dentist immediately.
5. Severe Toothaches
Remember, pain is often a poor health signal as
it's usually a LATE sign of trouble!
Never put any pain killers, including aspirin,
on the gum because it can burn the gum tissue. Clean
your mouth out by rinsing thoroughly with warm water.
Gently floss around the tooth to remove any food particles
that may be caught there. If your tooth continues to
hurt, you should call your dentist as soon as possible.
A toothache can result from several dental problems.
The more the tooth is bothering you before you go to
the dentist the more difficult it is for the dentist
to treat you comfortably. Regular dental check ups and
dental cleanings can help prevent toothaches.
6. Wisdom teeth erupting
When only part of the tooth has erupted into the
mouth, it can create a flap of gum tissue that easily
holds food particles and debris and is a hotbed for
bacteria. Pericoronitis or infection and swelling also
can occur around a wisdom tooth that has not erupted
at all and is still under the gums.
Symptoms
Symptoms include:
• Painful, swollen gum tissue in the area of the
affected tooth, which can make it difficult to bite
down comfortably without catching the swollen tissue
between your teeth
• A bad smell or taste in the mouth
• Discharge of pus from the gum near the tooth
More serious symptoms include:
• Swollen lymph nodes near the chin
• Muscle spasms in the jaw
• Swelling on the affected side of the face
Pericoronitis can be managed with antibiotics and warm
salt water rinses, and the condition should go away
in approximately one week. However, if the partially
erupted tooth fails to completely enter the mouth and
food debris and bacteria continue to accumulate under
the flap of gums, pericoronitis will more than likely
return.
Prevention
You can help to prevent pericoronitis by practicing
good oral hygiene on any erupting wisdom tooth to make
sure that food particles and bacteria do not accumulate
under the gums. However, if these steps do not work
and pericoronitis returns, it may be necessary to have
the overlying flap of gum tissue removed. In some cases,
the wisdom tooth may need to be extracted.
Treatment
Pericoronitis can be tricky to treat because the flap
of gum tissue won't go away until the wisdom tooth emerges
naturally or until the tissue is removed.
Your dentist will clean the area thoroughly to remove
damaged tissue or pus. If the area is infected, you'll
be given oral antibiotics.
Your dentist will give you instructions for keeping
the area clean, which is the best way to prevent the
problem from returning. This usually involves brushing
and flossing daily and rinsing your mouth with water
several times a day. This will help prevent food particles
from accumulating in the area.
In some cases, your dentist may suggest you have your
tooth extracted once pericoronitis is under control.
If your dentist thinks the tooth may erupt fully into
the mouth without problems, he or she may leave it alone.
However, if pericoronitis recurs, the tooth may be extracted.
Pericoronitis that causes symptoms should be treated
as soon as possible. If you are experiencing symptoms
of pericoronitis, make an appointment to see your dentist.
If your wisdom teeth are coming in, visit your dentist
at least twice a year for regular checkups. During those
visits, he or she can check on the progress of your
wisdom teeth.
7. Possible Broken Jaw
If your jaw hurts when it is moved or you cannot
close your mouth in a normal manner and this is accompanied
with pain and swelling, your jaw may be broken. If you
suspect you or someone else has a broken jaw, do not
move it. The jaw should be secured in place with a handkerchief,
necktie or towel tied around the jaw and over the top
of the head. Cold compresses should be used to reduce
swelling. Go immediately to a hospital emergency room,
or call your dentist.
8. Bitten Tongue or
Lip
If you have bitten your tongue
or lip, gently wipe the area clean with a cloth. Apply
a cold compress to the area to stop bleeding and minimize
any swelling. If the bleeding will not stop, you should
contact your dentist. If the wound is large, it may
require stitches.
9. Something Caught
Between Your Teeth
The longer a food particle stays trapped between the
gum and tooth, the greater the chance the gum will become
irritated and infected and the pain will get worse.
If you develop an infection, called an abscess, it can
become a serious health problem if left untreated.
Gently insert a piece of dental floss or a dental flosser.
Be very careful not to cut the gum tissue. If you are
unable to remove the object, contact your dentist. Never
use a sharp/pointed instrument object to try and remove
something that is stuck in between your teeth, it will
only cut the gum . If you can’t remove it, contact
the dentist
10. BLEEDING AFTER AN EXTRACTION
Slight bleeding after an extraction is normal. Clots
usually form within one hour if you follow doctor’s
post-op instructions. Apply pressure by biting on the
thick gauze pad over the extraction site. Avoid rinsing,
drinking or eating for at least one hour following the
extraction. Avoid sucking, spitting, and smoking All
of these activities will compromise healing and increase
the chances of infection.
11. Broken denture/bridge
Save all the parts of your broken
complete or partial denture or bridge. Call your dentist.
If it is possible it may be repaired or it may need
to be replaced as soon as possible. Temporary bridges,
plates and dentures can keep you comfortable until the
permanent one is repaired or replaced Always clean Dentures
over a towel or bowl of water etc, to prevent damage
if dropped.
12. Injury to soft
tissue in the mouth
These include tear, puncture
wounds or lacerations to the cheek, lips or tongue.
• Soft tissue injuries usually do not bleed a
lot, but when they do, the injury can seem worse than
it really is. When the blood mixes with saliva, it may
look like you are bleeding a lot. In most cases, the
bleeding should stop within a few minutes.
• Clean the area right away with water.
• If the bleeding continues, press a damp piece
of gauze against the injured area for 10 to 15 minutes.
If you don't have gauze, you can use a clean piece of
material that will soak up blood and saliva. Maintain
pressure on the area until you can be treated.
• To relieve pain, slow the bleeding, and reduce
swelling, hold ice to the area for five or 10 minutes.
• If the bleeding doesn't stop within a few minutes,
the injury may be serious and you will need to see a
doctor right away.
• If the wound has occurred due to the metal parts
of an orthodontic appliance, do not attempt to remove
any part that may be lodged in the tissue. Try to stop
the bleeding and take the patient to a dentist immediately.
• Bleeding from the tongue can be reduced by pulling
the tongue forward and using gauze to place pressure
on the wound area.
• Go to the doctor/hospital if the bleeding does
not stop or it is a large wound that may need stitches
13. Lost filling
If you lose a filling or a crown, the nerve inside the
tooth may be exposed, and you may feel severe pain when
air or hot or cold substances touch the uncovered part
of the tooth.
14. Dislodged crown/cap
Crowns are precision made and cemented on top of the
tooth. Occasionally, the crown comes off. This leaves
the tooth unprotected, and often sensitive. Try to snap
the crown back on and go to your dentist immediately.
Never wait more than a day to get a crown re-cemented.
You don't want to wait too long because the tooth will
be weak and could be damaged more if it is not protected
by the crown..Teeth move and shift very quickly without
the crown in place. If this happens your crown may no
longer fit. It s not possible to reuse the crown if
the teeth have shifted significantly, requiring the
dentist to have to make a new crown.
What Your Dentist Will Do
If the tooth is structurally sound and the crown still
fits properly, your dentist will clean the area and
then replace the crown.If the tooth has been affected
by decay, your dentist will need to prepare the tooth
again by removing the decay and then making a new filling
or crown to replace the old one.
15. Pus from the gums
Pus formation in the mouth can be detected by a bad
taste and foul odour from the mouth. Pus is a sure sign
of harmful bacterial activity. The pus may be formed
due to an infection in the gums or due to infected nerve
tissue in a tooth root. In both cases pus formation
will be seen in the gums. This may be accompanied by
pain in the area. If a small boil containing pus forms
and drains repeatedly in connection with a tooth, it
is usually a case of infected nerve tissue. Root canal
treatment will bring such a tooth back to its healthy
state. If ignored, such an infection spreads to neighbouring
teeth and infects them as well.
SMOKING WILL DELAY ALL HEALING
WHAT TO EXPECT AT THE DENTIST’S OFFICE
When you arrive at the dentist's office, he or she will
do an oral examination to see which tooth is bothering
you and then diagnose the source of the pain. Your dentist
may also want to take x-rays to help in the diagnosis.
Treatment can then begin to alleviate the pain and address
the problem.
Preventing Dental Injuries
• The best way to prevent a dental emergency is
to properly protect your teeth.
• If you play contact sports like football or
hockey, wear a protective mouth guard. Increasingly,
dentists are recommending that children engaged in sports
wear mouth guards. Not only do mouth guards protect
teeth but they also protect lips, gums, and cheeks.
Commonly there are two types of mouth guards: Semi-formable
mouth guards are available in sporting good stores and
in drug stores. Often these mouth guards can be boiled
to fit allowing them to sit snugly against the teeth.
Dentist made mouth guards are custom made. The dentist
creates a mold of the mouth which is used to create
the mouth guard. Consequently, these mouth guards fit
more securely against the teeth affording the best protection.
Another way to reduce the risk of dental injury is to
watch out for situations that commonly lead to injury.
These are some of the more common:Forks and Spoons -
Believe it or not, some injuries are self-inflicted
when people, not paying attention, crack or chip their
teeth with spoons or forks as they eat
• Don't chew ice, pens,
or pencils. never open a bottle cap by using teeth.
Trips and Falls - Falling into furniture and down stairs
often causes dental injury. This is most likely to occur
when children are first learning to stand using furniture
to maintain balance. Child proof your home Children
who are just learning to walk also have a tendency to
fall down - often onto household furniture or other
items. If you have an infant make sure to child-proof
your home before they become mobile, usually around
12 - 16 months.
• Brush with a fluoride toothpaste twice
a day.
• Floss daily.
See your dentist for regular dental cleanings and check-ups.
Make sure your children are belted safely in their stroller
and car seat. Wear helmets while biking, skateboarding
& roller blading
• Use seat-belts for the
entire family while traveling. Wear a custom made mouth
guard while in “school” sports and during
weekend sports and activities If you are away from home,
be sure to carry your doctor’s business card.
So if you have a problem you can call for a telephone
consultation so he can help you decide whether you need
to seek immediate dental care.
• Don't use your teeth to open paper clips or
function as tools.
• If you smoke a pipe, don't bite down on the
stem.
• If you grind your teeth
at night, ask your dentist if you should be fitted for
a bite plate to prevent tooth grinding.
• Always wear a seat belt when riding in a car.
• Avoid sucking on lemons
or chewing aspirin or vitamin C tablets. The acid wears
away tooth enamel.
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