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Ultimate guide to dental emergencies

Today, I want to talk about dental emergencies that we see in the dental office every day and how to best manage them. I get a lot of calls from patients especially over the weekend that they cracked a tooth or are experiencing a toothache. These situations can be stressful for patients so it is good to know some basic home remedies to deal with these situations and also learn how to prevent dental emergencies.

Any trauma to the mouth that may cause bleeding and lacerations to the gums, and dislodge or fracture teeth, and may require immediate medical attention. Whether the result of an accident or biting on a piece of food that’s too hard, mouth injuries can cause teeth to become cracked, broken, or knocked out/dislodged. It is important to see a dentist because if left untreated, a dental emergency can lead to serious complications.

What are the different types of dental emergencies?

There are various types of dental emergencies like broken tooth, painful teeth, painful gums, avulsed teeth, mouth ache, etc.

• Broken teeth: Broken teeth may need root canals to stabilize the tooth and prevent further damage. Crowns can be used to protect the tooth.
• Painful teeth: Teeth can become painful for many reasons, including loose fillings, cavities or abscesses. Prompt care can help prevent complications ranging from abscesses to lost teeth.
• Painful gum: Healthy gums should be firm, pink and pain-free. Gums that hurt may be infected, abscessed or irritated by food stuck between the teeth or under the gum-line. If a salt-water rinse and careful brushing and flossing do not alleviate the pain, patients should seek dental emergency care as soon as possible.
• Avulsed teeth: A tooth that is knocked out is an absolute emergency and must be treated as soon as possible. The tooth's root should not be touched, and the tooth should be placed in a glass of milk or a tooth preservation kit as soon as possible.
• Mouth ache: Several things can lead to a mouth ache, including TMJ, bruxism and soft tissue damage. If conservative at-home care does not resolve the symptoms, emergency care may be needed to rule out more serious problems and identify the underlying issue.

What should I do if a tooth breaks?

Teeth are remarkably strong, but they can chip, crack (fracture) or break. This can happen in several ways: 1) Biting down on something hard, 2) Being hit in the face or mouth trauma, 3) Falling, 4) Having cavities that weaken the tooth, or 5) Having large, old amalgam fillings that don't support the remaining enamel of the tooth.

What You Can Do?

To resolve dental emergency problems will depend on the problem. For example, for cracked (or fractured) tooth: There is no way to treat a cracked tooth at home. You need to see a dentist right away. Sometimes the tooth looks fine, but it hurts only when you eat drink. If your tooth hurts all the time, it may have a damaged nerve or blood vessels. This is a serious warning sign. However, for broken tooth: If you have a broken tooth, see your dentist as soon as possible. Your dentist can figure out if the break was caused by a cavity, and if the tooth's nerve is in danger. A damaged nerve usually will require root canal treatment.

Until you get to the dentist's office, make sure that you rinse your mouth well with warm water. Apply pressure with a piece of gauze on any bleeding areas for about 10 minutes or until the bleeding stops. If this doesn’t work, use a tea bag with pressure on the area to stop the bleeding. Then, apply a cold pack to the cheek or lips over the broken tooth. This will help reduce swelling and relieve pain.

If you can't get to your dentist right away, cover the part of the tooth that is in your mouth with temporary dental cement. You can find this at a drugstore. You can also take an over-the-counter pain reliever if you need relief.

What should I do in case of a toothache?

Toothaches occur when the extremely sensitive central portion of the tooth (called pulp), becomes inflamed. This can happen for a variety of reasons: cavities, a blow to the tooth, or an infection of the gums.

• Take a painkiller. Non-steroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and Ibuprofen, which provide quick, effective relief for most minor toothaches, like Tylenol.
• Apply a cold compress using an ice pack. Do not apply the ice directly to the tooth. This will increase the pain, especially since teeth inflamed by toothaches are often quite sensitive to hot or cold temperatures.
• Numb the area. Buy an over-the-counter tooth and gum numbing gel to help ease the throbbing for a few hours. These gels are applied directly to the affected area and usually work for several hours.
• Clean your mouth thoroughly. Sometimes toothaches are caused by small pieces of food that have gotten lodged in the tooth and are exacerbating the pain of cavities or gingivitis. When this is the case, thoroughly cleaning your mouth can go a long way toward eliminating the pain and making the problem go away.
• Floss around the tooth. I know that most of my patients hat to floss, but make sure you do. Sweep it back and forth across the tooth so that it picks up any particles that have lodged there.
• Brush the area. If your ache is caused by gingivitis, this is one of the best ways to ease the pain. Brush your teeth for several minutes, concentrating on the painful area. Keep brushing until the area no longer feels as sensitive. Finish the cleaning by using mouthwash to rinse away dislodged particles.

Use this routine twice a day, every day, and keep using it after the pain subsides. You can use a sea salt rinse. A toothache caused by a blow to the tooth or a mild infection might go away on its own. To help it along, make a rinse with warm water and a spoonful of sea salt. When the salt dissolves, gargle the water in your mouth, making sure it splashes around the affected area. Repeat several times daily until the pain subsides. If it still is not going away and you feel like it is a dental emergency, then do call
emergency dentist nearby.

What should I do with a lip or gum injury?

Trauma to the lips, tongue and the inside of the mouth is quite common. The soft flesh of the lips and their exposed location make them vulnerable to injury. A blow to the face can crush your lips against your teeth, causing bruising or cuts. Your teeth can cut the inside of your lip or puncture your skin. A fall or blow may cause you to bite your tongue.

Symptoms include bruising, swelling, bleeding or cuts on the lips or tongue. Your dentist or physician will ask about what happened to cause your recent trauma and do a thorough physical exam of the area. If the lips are injured, he or she will check the teeth and bone for damage, and look for pieces of chipped tooth.

Many lip and tongue injuries occur during sports. They often could be prevented through the use of a safety mouth guard. Preformed guards are available in sporting goods stores. A dentist can create a custom-fit guard. Routinely using seat belts and car seats can reduce the risk of trauma as a result of car accidents.

To clean cuts inside the mouth, rinse with salt water or a hydrogen peroxide solution (one-part hydrogen peroxide and one-part water). Be sure not to swallow this peroxide rinse. If your lip is swollen or bruised, apply a cold compress. If there is bleeding, apply pressure with a clean cloth for at least five minutes. Using ice can help limit swelling, bleeding and discomfort. Wrap crushed ice in clean gauze or a clean piece of cloth and hold it on the area affected.

Certain injuries will require treatment by an oral surgeon or plastic surgeon. It is particularly important to have an experienced surgeon stitch cuts that cross the gums. Small puncture wounds in the tongue usually heal without any treatment other than cleansing with antiseptic or hydrogen peroxide rinses. Large cuts may require stitches. The mouth contains many bacteria. For this reason, an antibiotic often is prescribed after a cut to the lip or tongue to prevent infection.

When to call a Dentist?

Seek medical care if:

• The bleeding cannot be controlled with pressure and a cold compress
• You have a deep cut that crosses the border between the lip and facial skin
• The lip is punctured— Signs of any infection usually will be evident about four days after the injury. Signs include:

How can I avoid a dental emergency?

There are a number of simple precautions you can take to avoid accident and injury to the teeth. You can wear a mouth guard when participating in sports or recreational activities. You can also avoid chewing on ice, popcorn kernels and hard candy, all of which can crack a tooth. Avoiding these foods can help you avoid seeing an emergency dentist.

Final words:
Remember, time means everything during a dental emergency. The quicker you can get a hold of your dentist, the better chance you’ll have to minimize damage and reduce pain.

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