Please call our office for any dental emergency. Dental emergencies can be traumatic. Generally, local emergency rooms do not do dental work and one must find a dentist to care for dental emergencies. In the meantime however, it’s important to minimize the damage that could be caused by handling the situation irresponsibly.
With children, the most common dental emergencies include a chipped/broken tooth or a knocked out tooth (hopefully a baby tooth, however the roots of the adult teeth are not fully formed and are easily knocked out as well). If a tooth is knocked out completely, it might be possible to save it if the proper steps are taken carefully and quickly enough. Do not handle the tooth by the root, but contact only the top part (crown) that would show in the mouth, the whiter part. If possible, reinsert the tooth into the socket it was knocked out of (if the tooth did not fall on the ground or in dirt/gravel etc.) and have the child bite on a gauze pad to hold teeth in place. If necessary, rinse tooth gently; do not scrub, scrape or use alcohol to remove dirt. If it’s not possible to reinsert the tooth into the mouth, place it in a glass with a neutral pH liquid, such as milk or water. Contact a Dentist as soon as possible.
If a tooth is chipped/broken, it might not need immediate attention, but still should be inspected by a Dentist as soon as possible. A problem that appears benign might become more complicated if left unchecked, or could cause other problems. Often, the trauma causing the tooth to chip/break will also bruise or cut the face, lips tongue or cheek. The soft tissue trauma can bleed a lot and look much worse than it actually is, and often needs to be, and should be, treated first by a medical office. After the soft tissue trauma is treated, rinse the broken/chipped tooth area with warm water. Keep a cold compress over the facial area of the injury. Recover any broken tooth fragments and bring them with you to the dental office.
CUT OR BITTEN TONGUE, LIP OR CHEEK
Ice can be applied to any bruised areas (never to a swelling due to infection or abscess, only trauma). For bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the bleeding does not stop with pressure, is gushing like a faucet fully open or continues after 15 minutes, go to an emergency room.
BROKEN BRACES AND WIRES
Remove a broken appliance only if it comes out easily. If it is lodged or painful to remove, cover any protruding edges with wax, cotton balls, gauze or chewing gum. DO NOT REMOVE any wire caught in the gums, cheek or tongue; see a dentist immediately. Emergency attention is usually not required for loose or broken appliances that cause no discomfort. Call your Orthodontist as soon as possible.
KNOCKED OUT PERMANENT (ADULT) TOOTH
Recover the tooth, making sure to hold it by the crown (top of the tooth that shows in your mouth, the whiter part) and not the root end. Rinse with milk, but do not clean or handle the tooth more than necessary (do not scrub, scrape or use alcohol). Reinsert the tooth in the socket and hold it in place using a clean piece of gauze or cloth. If the tooth cannot be reinserted, carry it in a cup containing milk, water or saliva. Because time is essential, Contact a Dentist as soon as possible.
Begin by cleaning around the sore tooth meticulously. Using warm salt water, rinse the mouth to displace any food trapped between teeth. UNDER NO CIRCUMSTANCES should you place aspirin on the aching tooth or on the gum. In the event of facial swelling, do NOT apply a cold or hot compress to the area. For temporary pain relief, acetaminophen or ibuprofen is recommended. See a Dentist as soon as possible.
Other Emergency Conditions:
POSSIBLE BROKEN JAW
In the event of jaw injury, tie the mouth closed with a towel, tie or handkerchief if possible. Go to an emergency room immediately.
BLEEDING AFTER A BABY TOOTH FALLS OUT
Fold a piece of gauze and place it (tightly) over the bleeding area. Have the child bite down on the gauze for 15 minutes; if bleeding continues after that, see a Dentist.
COLD OR CANKER SORES
Over-the-counter medications will usually provide temporary relief. If sores persist, visit your Dentist. Never place an aspirin on these sores.
Other emergency dental procedures are necessitated not by sudden trauma, but by sudden manifestation of a long-standing problem. These can occur in children or adults:
For example, cavities are not painful at first. Only when a cavity, which is a bacterial infection of the tooth, reaches the center of the tooth, the pulp/nerve, can pain and/or swelling occur. Often times, there may only be some mild sensitivity or nothing at all, until the infection travels through the tooth into the jaw and establishes there. These infections can become abscesses, which is why cheeks, faces and necks (possibly dangerous here) can swell. It is extremely important NEVER to place heat or ice on a dental infection, especially in the lower jaw!
The same is true for gum ailments, or “gum disease”. The gums, known in the dental industry as periodontal tissue, can become infected more easily than teeth, and must be regularly cleaned at home and by a professional dental hygienist. Brushing is usually not enough – floss is the recommended line of defense. A lack of flossing, or improper flossing technique, can lead to receding gums, bleeding and infection. If left unchecked, these can reach emergency status. Brushing and flossing are also usually not enough, as the professional cleaning cannot be duplicated at home, regardless of what the toothpaste, tooth brush and mouth wash commercials tell us! Gum disease is the silent tooth taker; it rarely causes pain or swelling until the teeth are beyond treatment and need to be taken out. Once the bone and gum recede, they will never grow back. (see our information on gum disease in our patient education section).
Once a tooth is abscessed and is causing pain and/or swelling, antibiotics are needed to quell the infection in order to perform comfortable treatment. If the swelling is in certain areas of the mouth or a certain size, an oral surgeon may be needed to drain it as part of the treatment. It is for this reason that new patients need to be seen during normal business hours, as we can only phone in prescriptions for current patients of record (those seen a year or less ago). If you are not a current patient, please call our office and leave a detailed message. If Dr. Del Presto can, he will come in to the office to diagnose and prescribe the proper treatment and medicine. If he is not available at that time, a local emergency room or emergency care clinic can get you the necessary medicine until you can be seen in our office.
FILLINGS/CROWNS/CAP FALLING OUT
If possible, re-insert with toothpaste or denture adhesive, but NEVER use super glue!