What to Do When Dental Emergencies Occur and How to Prevent Them

Before going into the steps in remedying dental emergencies, what can be classified as such?

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

• Are you bleeding from the mouth?
• Are you in severe pain?
• Do you have any loose teeth?
• Have you been hit in the face or mouth?
• Do you have any swelling in the mouth or facial area?
• Do you have any bulges, swelling or knots on your gums?

If you answered yes to any of these questions, you might be having a dental emergency and should call your dentist immediately. It is important to describe to your dentist exactly what has happened and what you are feeling. Most dentists set aside time for emergency procedures. Be sure to keep your dentist's after hours contact information ready at all times. It is important to remember that with some dental emergencies, seeing a dentist within 30 minutes or less can mean the difference between saving, or losing your tooth.

Your teeth can fall out, chip away, or loosen any time. You can wake up in pain because of tissue problems in your mouth. You never know when a dental emergency can happen. Keep in mind these following tips can help you manage your dental emergency until you can get to the dentist. Listed below are the kinds of dental emergencies, and how to deal with them.

Knocked-Out Tooth

A knocked-out tooth is a dental emergency that requires urgent attention. Following these steps immediately after the tooth has been knocked out can increase your chances to have the tooth be reinserted and preserved by a dentist.

1. Pick up the tooth by the top (crown) of the tooth. Do not touch the root(s) of the tooth.
2. Rinse the tooth off very gently to ensure that it's clean. Do not scrub the tooth or remove any tissue attached to it. Be sure to place a towel or washcloth in the sink so that the tooth does not go down the drain.
3. Gently place the tooth back into the socket if you can. Hold it gently in place while trying to bite down. If not, put the tooth in a small container or in a cup of milk. Note that the latter is preferable.

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 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 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:

1. Clean your mouth out by gently rinsing thoroughly with warm water.
2. If the fracture is caused by facial trauma, apply a cold compress to the area to minimize any swelling.
3. Take pain relievers according to the packaging directions to alleviate pain.

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 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 temporary crown comes off, this is not a dental emergency. Despite this, it is still 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, 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 crown. After a few minutes, clean off any excess adhesive you can see. See your dentist within the next few days to have it properly re-cemented.

If the tooth cannot be saved, your dentist should 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. These injuries are dental emergencies. 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. Try to go to an oral surgeon, or a 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

Stopping ongoing tissue bleeding, or alleviate severe pain are considered as dental emergencies.

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 to open and drain the tooth and allow the abscess to drain. If your dentist can't be reached, seek hospital emergency room care.

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:

• Small container with a lid
• Name and phone number of your dentist
• Acetaminophen
• Gauze
• Handkerchief 

How to Avoid a Dental Emergency

Many dental emergencies can be 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 mouthguard during sports activities can 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. Your dentist can also ensure no decays are present.

Reference

Guide to Dentistry by S. Lerch, DDS