Dental Emergencies

Your dentist should be the first person you call if you have a dental emergency. Most dentists set aside time for emergency procedures. Be sure to keep your dentist's after hours contact information readily available at all times.Whether at home or traveling, the following tips can help you manage a dental emergency until you can get to the dentist. It is important to remember that with some dental emergencies, seeing a dentist within 30 minutes or less can mean the difference between saving or losing your tooth.

A knocked-out tooth is a dental emergency that requires urgent attention. If the appropriate emergency steps are followed immediately after the tooth has been knocked out, the chances are very good that the tooth can be reinserted and preserved by a dentist.

• Pick up the tooth by the top (crown) of the tooth. Do not touch the root(s) of the tooth.
• Rinse the tooth off very gently to ensure that it's clean. Do not scrub the tooth or remove any tissue attached to it. Be sure to place a towel or washcloth in the sink so that the tooth does not go down the drain.
• If you can, gently place the tooth back into the socket. Hold it gently in place while trying to bite down. 
• If you can't place the tooth back in the socket, put the tooth in a small container or in a cup of milk. Note that the latter is preferable.
• Call your dentist immediately, since getting to the dentist quickly with your tooth – in addition to following the steps above – is critical for saving the knocked-out tooth. The longer you wait to re-implant the tooth in its socket, the less chance you have of the tooth "taking" and remaining viable.

If you have a tooth that is loose or out of alignment, you should call your dentist for an emergency appointment right away. In the meantime, you can try to put the tooth back in its original position using your finger with very light pressure. Do not try and force it. You can bite down to keep the tooth from moving. Your dentist may want to splint the tooth to the adjacent teeth (the teeth on each side) to keep it stabilized.

If a tooth is chipped and doesn't hurt, this usually does not constitute a dental emergency and you can wait a few days to see a dentist. However, it is important to be careful while chewing so as not to chip it more. Your dentist may simply be able to smooth the chip out, or add some composite filling material to repair the tooth.A cracked or fractured tooth is a serious issue constituting a dental emergency. Fractured or cracked teeth usually suggest that damage has occurred to the inside of the tooth as well as to the outside. Severe fractures are so extreme that the tooth cannot be saved. If you suffer a fractured tooth, call your dentist immediately for an emergency appointment and follow these steps:

• Clean your mouth out by gently rinsing thoroughly with warm water.
• If the fracture is caused by facial trauma, apply a cold compress to the area to minimize any swelling.
• Take acetaminophen (not aspirin) according to the packaging directions to alleviate pain.
• Never apply a painkiller to the gum because it can burn the gum tissue. This includes Orajel, which often is marketed for these types of procedures.

An X-ray will be needed in order for your dentist to properly diagnose the condition of your tooth. If the soft tissue inside of the tooth (the tooth pulp) is damaged, your tooth may need a root canal. If the pulp is not damaged, the tooth might only need a crown.Some dentists make some of their permanent crowns in-office and place them in the same day; other dentists use an outside laboratory to make the crown. In this case you will have to wear a temporary crown while the laboratory makes a permanent crown. If the tooth cannot be saved, your dentist will inform you of the various alternatives for replacing missing teeth, such as implant-supported restorations and bridges.

Any type of injury inside the mouth, such as puncture wounds, lacerations and tears to the lips, cheeks, mouth and tongue, are considered tissue injuries and a dental emergency. If you experience any type of tissue injury, it is important to clean the area immediately with warm water. If the bleeding is coming from the tongue, gently pull the tongue forward and place pressure on the wound using gauze. You should get to an oral surgeon or nearby hospital emergency room as quickly as possible.To alleviate any type of facial pain associated with tissue injury, you can take acetaminophen as directed on the packaging label. Never take aspirin or ibuprofen for a dental emergency because they are anticoagulants, which can cause excessive bleeding.

Basically, any dental problem that requires immediate treatment in order to save a tooth, stop ongoing tissue bleeding or alleviate severe pain is considered a dental emergency.A severe infection or abscess in the mouth can be life-threatening and should be dealt with immediately. Your dentist might be able to perform the first stage of a root canal, or will refer you to an endodontist (root canal specialist) to open and drain the tooth and allow the abscess to drain. If your dentist can't be reached, seek hospital emergency room care.

Having a temporary crown come off is not a dental emergency. However, it is important to put it back in place so that the tooth stays in its original position until you can see your dentist.A temporary crown can easily be put back onto your tooth by placing Vaseline, toothpaste, Chapstick or even a very small amount of denture adhesive into the temporary and placing it onto your tooth. Try putting your crown in first and note how it fits into place. Once you are comfortable with the fit, apply adhesive into the temporary and place it properly on your tooth. Bite down firmly onto a dry washcloth, applying even pressure to the temporary. After a few minutes, clean off any excess adhesive you can see. You should see your dentist within the next few days to have it properly re-cemented.

Smoothing a chipped tooth, re-cementing a crown that is not causing pain and composite bonding to repair a tooth are not dental emergencies. Typically, such problems can be dealt with during your dentist's regular office hours.If you are not sure whether or not you are having a true dental emergency, answer the following questions:

• Are you bleeding from the mouth?
• Are you in severe pain?
• Do you have any loose teeth?
• Have you been hit in the face or mouth?
• Do you have any swelling in the mouth or facial area?
• Do you have any bulges, swelling or knots on your gums?

If you answered yes to any of these questions, you might be having a dental emergency and should call your dentist immediately. It's important to describe to your dentist exactly what has happened and what you are feeling.If you experience extreme pain caused by hot or warm foods or beverages, try drinking ice water. It might relieve the pain. Sip on ice water and hold some in your mouth until you see the dentist.If you are having sensitivity to cold or if it causes pain to breathe in air, avoid cold foods and beverages. Breathe through your nose and call your dentist's office.If you experience pain in a tooth when biting down, it might indicate an abscess. This is an emergency and you should call your dentist's office.

Many dental emergencies can be easily avoided by having routine check ups with your dentist to ensure that your mouth and teeth are healthy, strong and free from decay.Wearing a mouth guard during sports activities will help to prevent teeth from being chipped, knocked out or broken. Avoid chewing on ice and hard foods that may break or fracture your teeth. If you are planning to travel out of the country or leaving for an extended vacation, during which you may not have ready access to dental care, it is important to see your dentist for a routine check up before you leave. Your dentist can make sure that you don't have any loose crowns or teeth, decay close to the nerve of a tooth that could cause you pain or develop into an abscess or other problems that could be easily fixed before becoming a dental emergency later.For more information about safe care in the event of a dental emergency while traveling, contact the Organization for Safety and Asepsis Procedures (OSAP), or the International Association for Medical Assistance to Travelers (IAMAT).

Because a dental emergency can happen at any time and place, the best thing to do is be prepared and don't panic. Pack and keep with you a small dental first aid kit containing the following:

• Small container with a lid
• Name and phone number of your dentist
• Acetaminophen (not aspirin or ibuprofen because they can act as a blood thinner and cause excessive bleeding during a dental emergency).
• Gauze
• Handkerchief