What’s A Dental Emergency?
Injuries to the mouth may include teeth that are knocked-out (avulsed), forced out of position and loosened (extruded), or fractured. In addition, lips, gums or cheeks are often cut or traumatized. Oral injuries are often painful and should be treated by a dentist as soon as possible.
Avulsed (Knocked-Out) Teeth
If a tooth is knocked out, pick it up by the crown, so as avoid damaging any of the periodontal fibers on the root surface (these are what will help reattach it once it is reimplanted). The tooth may be placed back into the socket if possible, stored in a zip-lock bag filled with milk, or (as long as you don't swallow it) it can be stored in your mouth - between your cheek and gums. Survival rates for knocked out (avulsed) teeth drop sharply after 30 minutes. So, try to make it to your dental office within the first 30 minutes. Many parents and teachers could and should manage to push the tooth back into the socket. It doesn’t matter if they reimplant the tooth back to front, that can be corrected before the placement of the splint.
What To Do When A Tooth Is Knocked Out:
- Have someone call your dentist for an emergency appointment, while you look for the tooth.
- Gently rinse any debris off the tooth with cool water, but do not scrub or using anything on the tooth other than water.
- Don't touch the root surface, handle the tooth by its crown.
- Place the clean tooth back in the socket if possible, or in milk (wrap the tooth in gauze or a towel before immersing in milk), in your mouth between the cheek and gum in that order of preference.
- Get to the dentist as soon as possible. If you make it within 30 minutes, it may be possible to reimplant the tooth.
Extruded Teeth
If the tooth is pushed out of place (inward or outward), gently with light finger pressure reposition it back into its normal alignment. Do not attempt to force the tooth into the socket. Using a moist piece of gauze or tissue, stabilize the tooth. As with an avulsed tooth, it's vital that a dentist sees the tooth within 30 minutes.
What To Do When A Tooth Is Fractured:
- Rinse mouth with warm water.
- Use an ice pack or cold compress to reduce swelling.
- Use ibuprofen (not aspirin) for pain.
- Immediately get to your dentist, who will determine treatment based on how badly the tooth is broken. Only a dentist can tell how bad the break is.
Minor Fracture. Minor fractures can be smoothed by your dentist with a sandpaper disc or simply left alone. Another option is to restore the tooth with a composite restoration. In either case, treat the tooth with care for several days.
Moderate Fracture. Moderate fractures include damage to the enamel, dentin and/or pulp. If the pulp is not permanently damaged, the tooth may be restored with a full permanent crown. If pulpal damage does occur, further dental treatment will be required.
Severe Fracture. Severe fractures often mean a traumatized tooth with slim chance of recovery.
Injuries To Oral Soft Tissues
Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away with warm water, and the injured person taken to a hospital emergency room for the necessary care. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.
Sports Injuries
Mouthguards provide excellent protection and should be worn by all athletes. They act as shock absorbers for the teeth and jaws. There are three main types - they vary in effectiveness, comfort, and price. If you sustain any injury to either your jaw or your teeth, let your dentist know immediately (go to the emergency unit of the nearest hospital if necessary). A fractured jaw needs to be cared for immediately. You may experience difficulty and discomfort opening and closing your mouth - you may want to immobilize your jaw by tying a cloth around it; don’t attempt to open and close your mouth. Go directly to your dentist or local emergency room.
Lost Fillings
If the pain is due to a lost filling, the filling should be replaced as soon as possible in order to prevent the development of further decay from impacted food particles and bacteria in the filling space. Call your dental office to schedule an appointment. Remember, don't place aspirin directly on the gums to dissolve. Aspirin will burn the tissues if left in your mouth.
Temporary Crowns
Temporary crowns are designed to cover and protect the teeth for a short period of time while the permanent crown(s) are at the lab being fabricated. They may feel good and look good, but don't make the mistake of not completing your treatment - temporary crowns are made of a much more porous material than permanent crowns. If left for prolonged periods of time, you may require a root canal, additional tooth structure may need to be removed due to decay or gum recession, and/or your dentist may have difficulty seating your permanent crown. It's important that you follow through with the work within the amount of time recommended by your dentist. Because temporaries are cemented with temporary cement, they frequently become dislodged. Be sure to alert your dentist so that he may re-cement it for you.
We're out participating at educational conventions and seminars throughout the year and we'd like to use this blog as a dental resource for our community of Phoenix, AZ (and beyond). Of course, we welcome you to join the conversation. Suggest topics and ask those burning questions about dentistry that keep you up at night. Please feel free to contact me through the Morse Family Dental website. Remember, the advice provided here is intended to aid you in understanding some of the treatment options available. It is important to note that before beginning any course of treatment you should always see your dentist.