Dental Emergencies

dental emergency iconA dental emergency is when you have a broken tooth that is causing pain or swelling, you experience bleeding from trauma, or you have a tooth that has been knocked out of the socket. In these cases, you should contact a dentist immediately.

Tooth knocked out

CALL A DENTIST IMMEDIATELY! Gently rinse off the tooth and try to re-implant it yourself immediately. If a tooth is left out of the socket for more than one hour, the likelihood that it will ever grow back properly drops significantly as time goes on. Even if it is re-implanted immediately, there is still only about a 50/50 chance of long term tooth survival. A dentist can x-ray the tooth to be sure it is in correctly and perhaps bond it in place to help stabilize the tooth. DO NOT SCRUB the tooth, as this will destroy the attachment fibers that are needed to help the tooth re-implant. If you don’t feel comfortable trying to replant the tooth and you can get in to an office quickly, rinse the tooth gently and put the tooth either in the patient’s mouth to keep the tooth moist, OR put it in a small cup of milk to help keep it from getting dehydrated.

Cut lip or trauma to the face

If it looks like you may need to have sutures in your face, going to a medical doctor first may be the best. After he/she has taken care of the medical condition, a dentist can look at the teeth to be sure they are ok. (If a tooth is knocked out of the socket, it needs to be repositioned immediately, however.) Usually, a cold wet clean wash cloth applied to the area with pressure will stop any bleeding. If the cut is deep, apply the compress and go to a hospital emergency department.

Suggestions for Home Remedies

Rinse the area lightly with warm water. If you don’t have sensitivity to PRESSURE or it’s not bleeding, or COLD air doesn’t send you “through the roof”, then it’s probably not very deep and it should either be smoothed off or at your earliest convenience, see the dentist to make sure there are no sharp edges or exposure of the pulp.

These come in a variety of styles. It can be hot or cold sensitive, pressure sensitive, percussion sensitive, sharp or dull, only hurt when stimulated, or last for either a short time (less than 30 seconds), or last for a long time (over 5 minutes.) If it’s dull achy feeling, it’s probably gum related and you’ll need to schedule a cleaning. If it’s sharp and brief feeling, then a filling may have come out and exposed a root, or a big chip on the tooth occurred. If it’s a slowly getting better, than it could be the nerve or something poked under the gums.

Often you can save yourself a trip to the office if you can simply clean the inside of the temporary off and reposition it back in place. Be sure to lightly rinse off the area where the temporary crown was and orient the temporary back on the tooth. Generally a temporary is only protecting the prepared tooth and this is not urgent, however, it should be replaced. Do NOT let a tooth go more than a couple days without a temporary back over it, as leakage can occur and you risk reinfection. Dental adhesive powder or even a small amount of toothpaste works well to help hold it in place until you can make it to the office.

If the pain only lasts for a few seconds, then it is often related to a small exposure close to the root. In this case, avoiding hot and cold, and even placing some Vaseline over the area can protect the tooth for a short while until you can get in to have us look at it. If the pain persists more than one minute after it is exposed to hot or cold, it often means that the nerve have been infected. This could mean that we will need to do a root canal to save the tooth. If Advil or Tylenol won’t take away the pain, then this is probably what we will need to do to get you out of pain. Never put aspirin on the tissue in your mouth directly. It can easily burn the tissue.

If the pain only lasts for a few seconds, then it is often related to a small exposure close to the root. In this case, avoiding hot and cold, and even placing some Vaseline over the area can protect the tooth for a short while until you can get in to have us look at it. If the pain persists more than one minute after it is exposed to hot or cold, it often means that the nerve have been infected. This could mean that we will need to do a root canal to save the tooth. If Advil or Tylenol won’t take away the pain, then this is probably what we will need to do to get you out of pain. Never put aspirin on the tissue in your mouth directly. It can easily burn the tissue.

This generally requires a visit to replace the filling and is usually NOT an emergency. Most fillings are not deep enough to cause any problem if they are left untreated for a couple days. This can vary from case to case, so use your judgment and call us for advice if you are unsure. Sometimes putting a little wax, gum or Vaseline over the area will protect it temporarily until you can come in. The pharmacy even sells a small tube of thick ointment that can be mixed up to be placed in the opening to block food from entering.

This is a common trauma and it can sometimes be helped by “rounding” off the corner of the opposing teeth so they can’t pinch the tissue in between the teeth. Placing a cotton roll or gauze in the cheek area will help push the cheek away so that you can let the area heal without additional trauma.

First, try using dental floss, very gently and carefully, to remove the object. If you tie a small knot in the middle of the floss and pull that through the contact area, often you can dislodge most small pieces of food or debris. Do not poke between your teeth with a pin or similar sharp, pointy object; it can cut your gums or scratch the tooth surface. If you can’t get the obstruction out, see your dentist.

For further information, please visit Dental Emergencies at the Mouth Healthy website

Brought to you by the American Dental Association