When you have a dental emergency — whether it’s caused by a sudden accident or chronic disease — your teeth and/or the tissues of the mouth that surround them need to receive proper care right away. As with any type of medical emergency, it’s important to be aware, before you’re actually in the situation, of what you can do to ensure the best outcome.
Traumatic Dental Injuries
Dental injury.A knocked-out permanent tooth requires quick thinking and immediate action. You’ll increase the chances that the tooth can be saved if you pick it up without touching the root, gently clean it off with water, and put it back in its socket facing the correct way. Hold it in place with gentle pressure as you rush to the dental office or emergency room. If you can’t replant it immediately, tuck it between the patient’s cheek and gum, or carry it in a container of cold milk.
For a more traumatic injury such as a tooth that has been moved or loosened, treatment needs to occur within six hours. However, if there is uncontrollable bleeding, go immediately to the ER. Fortunately, other dental injuries that happen most frequently are less severe. The most common traumatic dental injuries are chipped teeth. If a tooth is chipped, try to find any pieces that have come off, as it might be possible to reattach them. Make an appointment for an office visit as soon as possible, and bring the pieces with you.
Acute or persistent tooth pain always signals a need for an urgent visit to the dental office. The most common cause of dental pain is tooth decay, a bacterial infection that can spread through many parts of the tooth, and even into the gum tissue. Sometimes, tooth pain indicates that you may need a root canal treatment — a procedure that not only relieves the pain of an infection deep inside the tooth, but also can keep the tooth from having to be removed. Other times, pain may be caused by a loose filling or sensitive tooth. The only way to know for sure what’s causing your tooth pain is to make an appointment at the dental office right away.
Injuries and infections involving the soft tissues of the mouth may also require emergency treatment. The tissues of the gums, tongue, or cheek lining can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses. A periodontal (gum) abscess is a pus-filled sac caused by an infection and is usually quite painful. Abscesses require immediate attention at the dental office.
Any injury to the soft tissues of the mouth should be rinsed with dilute salt water. If there is visible debris, it should be cleared. Bleeding can usually be controlled by pressing a clean, damp material to the area for 10-15 minutes. If this does not work, go to the emergency room immediately.
A foreign body lodged beneath the gum line can sometimes be gently worked out with dental floss or a toothpick. But if this can’t be accomplished easily, make a dental appointment so the area does not become damaged and/or infected.
Although there can be discomfort associated with orthodontic treatment, there are only a few true orthodontic emergencies. They include trauma or injury to the teeth, face or mouth. Infection or swelling of the gums, mouth or face, and severe, unmanageable discomfort or pain in these areas can also be orthodontic emergencies. In any of these situations, seek immediate care from the dental office or emergency room — whichever is your best option. For loose, broken or irritating pieces of orthodontic hardware, please call the dental office for advice.
When dental emergencies and pain occur, our attention is often focused on diseases and injuries related to the teeth. However, it’s important to remember that the soft tissues of the mouth — the gums, tongue, lips and cheek lining — may also be affected. While they are tough enough to stand up to the oral environment, these tissues can be damaged by accidental bites, falls, sports injuries, and scalding liquids. They may also suffer injury from foreign bodies that become lodged below the gum line, and they can develop painful and potentially serious abscesses.
First Aid for Soft Tissues
Soft tissue injuries in the mouth don’t usually bleed excessively — although blood mixing with saliva may make any bleeding appear worse than it actually is. To assist someone with this type of injury, you should first try to rinse the mouth with a dilute salt water solution. If a wound is visible, it can be cleaned with mild soap and water; if that isn’t possible, try to remove any foreign material by hand, and rinse again.
Bleeding can usually be controlled by pressing damp gauze (or, if unavailable, another clean material) directly to the site of the injury, and keeping it there for 10-15 minutes. If the bleeding doesn’t stop, immediate medical attention will be needed. Try to see a dentist within 6 hours of the injury for evaluation and treatment. This usually involves determining the extent of the damage, performing initial restorative procedures, and occasionally suturing (stitching) the wound. An antibiotic and/or tetanus shot may also be given.
Occasionally, foreign objects may become lodged in the space between teeth and gums, causing irritation and the potential for infection. There are a few foods (such as popcorn husks) that seem especially prone to doing this, but other items placed in the mouth — like wood splinters from toothpicks or bits of fingernail, for example — can cause this problem as well.
If you feel something stuck under the gum, you can try using dental floss to remove it: Gently work the floss up and down below the gum line to try and dislodge the object. Light pressure from a toothpick may also help work it free — but avoid pressing too hard or pushing the object in deeper. If that doesn’t work, see a dentist as soon as possible. Special tools may be needed to find and remove the object, and you may be given medication to prevent infection.
Periodontal (Gum) Abscesses
Sometimes called a gum boil, a periodontal abscess is a pus-filled sac that may form between teeth and gums. It is caused by an infection, which may have come from food or other objects trapped beneath the gum line, or from uncontrolled periodontal disease. Because pressure builds up quickly inside them, abscesses are generally quite painful. Symptoms may include a throbbing toothache which comes on suddenly, tenderness and swelling of the gums or face, and sometimes fever. Occasionally, pus draining into the mouth through an opening in the sac relieves the pressure and pain, but may cause a strange taste.
If left untreated, abscesses can persist for months and cause serious health problems, including infections that spread to other parts of the body. That’s why it is important to see a dentist right away if you experience symptoms. He or she will find the location of the abscess and treat it appropriately. Treatment usually involves draining the pus and fluid, thoroughly cleaning the affected area, and controlling the infection.
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