Dental Emergency

General Dentistry
Most people have a problem with their mouth or teeth at some point in time. It can be difficult to know if a problem is deadly serious or is just a minor irritation.

If the dental office is open, the first choice is to call the office. Set up an appointment to discuss the problem with a dentist. If it is after hours, the following guideline may help you decide your course of action.

What is 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. Oral injuries are often painful and should be treated by a dentist as soon as possible.

How soon should I see a dentist?
Immediately getting to a dentist with 30 minutes can make the difference between saving or losing a tooth.

When a tooth is knocked out:
Immediately call your dentist for an emergency appointment. Handle the tooth by the crown, Not the root. Touching the root (the part of the tooth below the gum) can damage cells necessary for bone re-attachment.
Gently rinse the tooth in water to remove dirt. Do Not scrub. Do Not try to replace the tooth into the socket, but place the clean tooth in your mouth between the cheek and gum to keep it moist. It is important not to let the tooth dry out If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk.

When a tooth is pushed out of position:
Attempt to reposition the tooth to its normal alignment using very light finger pressure, but do Not force the tooth. Bite down to keep the tooth from moving. The dentist may splint the tooth in place to the two healthy teeth next to the loose tooth.

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.

1. Minor fracture:
   Minor fractures can be smoothed by your dentist with a sand- paper 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.
2. Moderate fractures
   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.
3. Severe fracture:
   Severe fractures often mean a traumatized tooth with slim chance of recovery.

When tissue is injured:
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.

Swelling:
If you have a swelling that makes it difficult to swallow or breathe, you should go to the emergency room immediately. All swellings should be evaluated by a dentist. If the swelling is minor, moist heat will many times stabilize the swelling until the office reopens. Hot, salt-water holds may help relieve swelling in the mouth.

• Hot Salt-Water Hold
  1 teacup hot water (the temperature you normally drink tea or soup)
  1 teaspoon salt
  Stir salt into hot water. Take a sip of saltwater and hold it on the swollen or painful area until it is mouth temperature. Repeat until gone. Use as often as you like.
  Swelling is usually caused by infection. If the swelling is more than minor, an antibiotic may be needed. Call the dentist.

Sensitivity:
Sensitivity is a sharp pain that stops immediately. Teeth can be sensitive to cold, hot, sweets, touch (such as a toothbrush), biting tooth to tooth, biting on food. Sensitivities are not emergencies. However, sensitivity is many times the first warning of future trouble. Have it evaluated by a dentist.

Aches and Pains:
An ache is a deep pain that may throb and that usually lasts for long periods. An ache may be a sign of a serious problem. Over the counter painkillers (aspirin, acetaminophen, ibuprofen, etc) may be used until the office reopens. Use the one that works best for you, but do not overdose. A Hot Salt-water Hold may help relieve the pain. Do not ignore aches and pains; have them evaluated before they get worse.

Broken Tooth or Filling Came Out:
This is not an emergency, but should be evaluated at the first available appointment. Keep the tooth clean. If the edge is sharp or the tooth is sensitive, the hole may be filled with wax or cotton.

Crown Came Off:
Do not loose the crown. If you are comfortable with the crown off, leave it off until you can visit the dentist. If this is not an option, place the crown back on the tooth. A little toothpaste or denture adhesive will help hold the crown in place. Be very careful not to swallow or aspirate the crown.

ORTHODONTICS

True orthodontic emergencies are very rare, but when they do occur we are available to you. As a general rule, you should call the office when you experience severe pain or when you have a painful appliance problem that you can’t take care of yourself. We’ll be able to schedule an appointment to resolve the problem. You might be surprised to learn that you may be able to temporarily solve many problems yourself until you schedule an appointment with our office. When working with your appliances, you need to know the names of the parts of your appliances so you are able to identify what part is broken or out of place. After alleviating your discomfort, it is very important that you still call our office as soon as possible to schedule a time to repair the problem. Allowing your appliance to remain damaged for an extended period of time may result in disruptions in your treatment plan.

The following solutions may help you relieve your discomfort:

Poking Wire
Using a pencil eraser, push the poking wire down or place wax on it to alleviate the discomfort.

Loose Bracket or Band
If your bracket or band is still attached to the wire, you should leave it in place and put wax on it. If the wire comes out entirely, wrap the bracket with a tissue.

Loose Wire
Using a tweezers, try to place your wire back into place. If doing this and using wax doesn’t help, as a last resort use a small fingernail clipper to clip the wire behind the last tooth to which it is securely fastened. If your discomfort continues, place wax on it.

Loose Appliance
If your appliance is poking you, place wax on the offending part of your appliance.

General Soreness
When you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for three to five days. This can be relieved by rinsing your mouth with a warm salt water mouthwash. Dissolve one teaspoonful of salt in 8 ounces of warm water and rinse your mouth vigorously. Placing Orabase on the affected area may help; this can be found in a pharmacy. If the tenderness is severe, take ibuprofen or whatever you normally take for headache or similar pain.

The lips, cheeks, and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces. You can put wax on the braces to lessen this. We’ll show you how!