Dental Emergencies

Post by: Gerarda on 09 Sep 2019

Broken front teeth, tooth pain, knocking out a tooth (avulsed tooth), bleeding gums and tooth sensitivity have all been covered in previous blogs. Below are many other types of dental emergencies that patients have.

Realigned your teeth after a fall
Once your permanent teeth grow in your teeth should never be loose. If you fall and hit your mouth and move teeth out of position, they will become loose and need immediate treatment. A trauma so severe as to move teeth needs emergency room treatment at a hospital to determine if you have had a concussion or a broken jaw. Your first stop though should be your dentist as the sooner the teeth are realigned the better chance they will survive the trauma.

Under some conditions it is possible to move teeth back into place. The dentist administers a local anesthetic, repositions the teeth and then uses composite to bond them to the neighboring teeth for support. This keeps them in place until they heal back into the bone. Depending on the extent of the injury the bonding will have to remain in place for up to 3 months. The longer the teeth are left untreated the harder it will be to move them back into position. Teeth that have moved and caused bone damage will most likely need to be extracted.

Root canal treatment will need to be done on the injured teeth as the nerve will die from the trauma and will cause infection; therefore, the canals have to be cleaned, disinfected and medication placed in the canals or the teeth will start to go dark, a sure sign the nerve is dying.

The teeth stand a better chance of long term viability the sooner they are treated. Seek immediate dental treatment.

Infections
Infections can result in varying degrees of pain and sometimes they can have no pain at all, but all have one thing in common. There is something wrong in your mouth and it needs to be treated sooner rather than later. Whether it is a tooth abscess, cavity, injury, prior dental work or poor oral hygiene, left untreated will only become more serious.

Idiopathic ulcers or canker sores
While idiopathic ulcers are not life threatening, they are very painful and make eating and talking difficult. They develop on the soft tissue or at the base of the gum and are small, oval in shape with a red edge. Most go away in a week or so. Their cause is unknown but researchers believe they develop after a mouth injury such as an accidental cheek bite, hard teeth brushing, food sensitivities or stress to name a few. Contact your dentist if it doesn´t heal or it gets progressively worse.

Abscess
There are three types of abscesses, a periapical abscess, a periodontal abscess, and a gingival abscess. Abscesses occur at different regions of the tooth and for different reasons. Essentially, an abscess is a pocket of pus that is caused by a bacterial infection. Either way you slice it, the abscess need to be treated. The abscess has to be drained to get rid of the infection. At times a root canal treatment is required and if that is not possible then the tooth would need to be pulled. Infection causes bone destruction so it is important for it to be treated in a timely manner. It also can result in serious and sometimes life-threatening complications if left untreated.

Swelling
Swelling in the oral cavity is a common dental emergency and depending on the reason for the swelling is one that needs immediate attention. Usually the swelling doesn´t go away on its own. Swelling of any kind is never a good sign and can indicate that you have a serious dental infection.

A swelling has many causes including:
Gum disease
Gum inflammation (gingivitis)
Using a dental device such as braces
Having a sharp or broken tooth
Reaction to certain foods or medication
Biting your tongue or cheek
Cancer treatment such as chemotherapy or radiation
Taking medication for rheumatoid arthritis, epilepsy or antibiotics
Autoimmune diseases such as lupus, Crohn´s disease or Bechet’s disease

It is not pleasant realizing that you have something wrong in your mouth and it is difficult to examine yourself. You are left wondering if this will go away on its own. Can I look after this myself? How long do I wait before calling my dentist? Many times people have favorite home remedies that can help, but at other times you need to call your dentist immediately.

1. Broken front teeth from diving into a pool or from falling down
Remember while it might be irritating and unattractive, a broken tooth is usually not life-threatening. Depending on how much of your tooth is broken and the angle it is broken at, the treatment could range from doing a composite repair for a chipped tooth to doing a root canal treatment and a crown if the tooth is broken off at the margin of the gum. If the tooth is chipped then schedule an appointment at your convenience; if however, the tooth has broken off or you have pain then see a dentist immediately.

2. Tooth pain
Usually a dental emergency will have a degree of pain attached. It just depends on the level of pain and the kind of pain how your dentist deals with it. If it is sensitive to both cold and hot temperatures, chances are it is a grinding problem. If it is only sensitive to cold, many times, but not always, it could be a nerve problem. It could be that the nerve has been irritated and is crying out for attention. If that is the case you need to call your dentist immediately. It doesn´t get better by itself. If it hurts when you bite down, it could be a broken tooth, it could also mean that you have been grinding your teeth or it could be a sign that you have an abscess. Either way, you need to have it treated by a dentist.

3. You´ve knocked out your tooth
If for whatever reason your tooth gets knocked out, put it back in. Yes put it back in the socket. And hold it there until you see a dentist. Make sure though when you pick it up you only touch the crown of the tooth, the part that is used to chew and not the root. Also important is to put it back in the correct position. If there is any debris on the tooth when you pick it up rinse it in a cup of lukewarm tap water for no more than 10 seconds. Any longer than that can kill the cells on the root surface that help reattach it. If you are looking at your tooth between your fingers then most probably you´re in shock, but if you want to save the tooth then you have to remain calm and think. If you can´t put it back correctly, then put it in a glass of milk. If milk is not an option, then put it in your mouth between the cheek and the gum to keep it moist. Do not swallow it as you only have about 2 hours for it to be reimplanted correctly. The sooner the better, otherwise, the likelihood of success becomes less. You need to make a very quick trip to a dentist.

For most dental emergencies you need to go to a dental clinic not a hospital. Hospitals rarely have a dental department and if they do it is even rarer that there would be someone on call. A doctor in an emergency room can only give you pain medication or antibiotics. In some cases, they will schedule an x-ray or scan depending on the severity of the trauma. They will still suggest you see your dentist.