We’re very lucky that in dentistry there are very few true dental emergencies. Generally, facial trauma and infections are the two situations where urgent attention is needed. Here’s a compiled list of some of the issues you may encounter at home, and what we recommend you do about them.
Significant facial trauma: trauma to the face can result in fractured teeth and/or bones. If this situation occurs, your best bet is being seen in the hospital setting to be critically assessed. The emergency department will be able to triage, and put you in contact with Oral and Maxillofacial Surgeons who are typically on-call at the major hospitals in the city. They will be able to evaluate and treat appropriately.
Facial trauma resulting in tooth avulsion: Tooth avulsion is the dislodging of a tooth entirely from the jawbone. It is a rare, but significant, event that needs to be dealt with promptly. In children, especially, it is important that permanent teeth are handled appropriately. If a tooth is avulsed, it should immediately be placed in Saline or Milk. Storage in these media helps maintain the tooth’s ability to rejoin with the jaw. If our office is open, you will be scheduled immediately, as treatment is ideally completed within an hour of the accident. If our office is unavailable, an emergency department is the next best bet. Typically, oral surgeons will be consulted and re- implantation will be done in the ER.
Infection: Dental infections are generally well-contained in the mouth, but can spread and become systemic infections. These will present with symptoms like fever, malaise, aches, swelling, pus, etc. If these symptoms are present and our office is closed, an urgent care center can evaluate and prescribe an antibiotic to reduce bacterial load. You should know, however,
that infections do not resolve completely without treatment (typically a root canal or extraction) so these issues need to be assessed in our office at the earliest opportunity.
Lost restorations: If the restoration is a provisional (or temporary) crown, it should be recemented to the tooth. Pharmacies will typically sell “temporary dental filling” or “cement” materials that can be used to replace it. To do so will require trying in the crown to make sure you know the proper orientation, then fill the inside of the crown before pushing it into place. Gently biting on the crown will help seat it fully. If the crown is not a provisional, it will need to be cleaned and recemented in our office. An appointment will be provided the same or next day. Patients often have little to no discomfort when restorations dislodge, and will postpone recementation. This can create potential issues as teeth will sometimes shift, making the crown difficult to re-seat, or the gum tissue will grow over the tooth, making anesthesia necessary and further treatment to re-isolate the tooth. Our advice, call us and get in ASAP.
If the restoration was a filling, provisional or otherwise, a prompt evaluation and replacement of the restoration should be completed. This will reduce sensitivity and exposure of the tooth to the mouth and bacteria.
Broken tooth or teeth: Prompt evaluation by a dentist to evaluate the extent of the broken teeth. Some broken teeth are little chips, and can be fixed with a small tooth-colored filling. Other broken teeth require root canal therapy and crowns or veneers. An x-ray will be taken and an exam completed, and we will discuss your restorative options from there.
Jaw pain/locking: The majority of jaw pain is related to an acute event or muscle activity. Immediately, you should attempt to minimize the extent of your jaw opening (be careful yawning!), apply an ice pack to the area to reduce inflammation, take NSAIDs like Tylenol, Advil, or Motrin to reduce inflammation, and start on a soft diet. Intermittent gentle stretching, by opening the jaw slowly to your fullest most-comfortable position can be done as well. Contact our office for an exam with the doctors to discuss if an appliance like the deprogrammer
