Knowing What to Do If You Have a Dental Emergency

Dental emergencies are scary, but they don’t have to be permanent. Find out how to deal with cracks, fractures, and knocked out teeth with this handy guide.

Knowing what to do in a dental emergency

Image from Garry Knight on Flickr. 

The general attitude towards dental emergencies is a casual ‘It will never happen to me.’ Like so many aspects of healthcare, diet, and lifestyle, we have a tendency to hope for the best and be completely unprepared for the worse. Yet, around five million teeth (children and adult) are knocked out of place every single year.

So, there is a real need for people to get familiar with the emergency dental options available to them. This is something that should be done sooner rather than later. It’s not necessarily too late to fix a dental disaster, if you get in touch with a specialist as soon as possible following the incident, but the likelihood of a successful repair is much higher if you have a contingency plan in place already.

The most common ways to find yourself at the centre of a dental crisis are the crack, fracture, chipping, or complete loss of a tooth. This situation can occur for an endless variety of reasons. You might chip a tooth chewing on ice or hard candy. You could fall over and hit your mouth. You might even play sport and break a tooth while in the middle of a match. Our teeth are actually pretty strong, but like any part of the body, they can only withstand so much pressure.

When an unexpected dental emergency develops, the instinct can be to panic a little. After all, this is a piece of your body that has broken, a piece of your mouth. Even if there is no pain, the experience can be very distressing. However, it rarely poses an immediate threat to health. This means that, although a dentist should be contacted and made aware of the situation as quickly as possible, there is no need to panic.

It is especially important to remember this if a tooth is knocked out or a crack appears after hours at your local surgery. There are emergency numbers that you can call for immediate advice (your dentist should have given you this information at your very first appointment), but it might not be possible to see a specialist until the following day. As long as you keep the wound or broken tooth protected from further injury, this delay is nothing to worry about.

Recognising the Signs of a Dental Emergency

The term ‘dental emergency’ can be fairly subjective, as everybody has their own pain tolerance, response to crises, and ways of dealing with unexpected situations. But, generally speaking, a dental emergency is any kind of incident that needs to be handled sooner than a regular appointment can manage. For example, chipped, fractured, and cracked teeth, teeth that have been entirely knocked out of the socket, extreme toothaches, and oral traumas.

If you have attended a routine check-up and been informed that you need a treatment, this is not considered a dental emergency unless the specialist specifies otherwise. If there is no pain or risk of further injury to your teeth, you will be expected to schedule a future appointment in which to have this work performed. The vast majority of emergency incidents are completely unexpected, so the dentist and the patient must respond quickly.

While the most common dental emergencies remain cracked and knocked out teeth, you may be eligible for urgent treatment if your teeth have become so severely decayed that you are in extreme pain. A dentist will usually try to see a patient as soon as possible if they know that this is the case. In the interim, they are likely to prescribe powerful painkillers. In all circumstances, the first step should always be to call your dentist.

As aforementioned, you may not be able to get through to them immediately. This is likely to happen if your accident or emergency occurs late in the evening or early morning. You can either phone an emergency line (recommended for knocked out teeth) or you can wait until your own surgery opens for the day. If necessary, treatment for cracks and fractures can be delayed a little while. Knocked out teeth, however, require immediate treatment.

Determining If You Have a Dental Emergency

In cases where teeth have been knocked clean out, the patient is almost certainly going to know about it right away. There is likely to be a fair amount of pain and a moderate degree of bleeding from the wound. So, this is a difficult injury to miss. Cracks and fractures, however, do not involve pain unless the break has occurred very close to the gum tissue. This means that they can go unnoticed, especially if a person is not used to being aware of their teeth.

For example, it is easy to chip a tooth while chewing on something hard. You might notice right away or you might shrug the unusual sensation off as nothing to worry about. It may be a few hours before you next run your tongue over your teeth and find the missing segment. Once again, you should try not to panic. The one thing that makes a dental injury worse is stress and anxiety, particularly if it involves pain or bleeding.

You have to trust that your dentist, or the emergency specialist assigned to you, has the skill and know how to judge the situation properly. If you inform them of your symptoms and they know that an urgent response could save your tooth, they will arrange for treatment to be delivered as fast as possible. And the opposite is also true. If you have a chip and are not in any pain, a timely appointment is still needed, but it may not harm the tooth to wait.

If you are unsure about the severity of your dental emergency, check for bleeding and assess your current level of pain. If bleeding is present and/or you are in severe pain, you need to dial the emergency number given to you. This is also true for anybody with noticeable swelling to the face, gums, mouth or cheeks. If you have lacerations on the inside of your mouth, resulting from a cracked tooth, this is also considered serious enough for the emergency number.

Knowing How to Respond Quickly and Safely

The first step is to call your dentist. The second step is staying calm. This can be easier said than done if there is a bleed in the mouth, but remember that it is not life threatening. And, the faster your heart is racing, the more blood will rush to the wound. So, it really does help to respond as practically as possible.

The following section will outline the recommended responses for a number of the most common dental emergencies.

Knocked Out Teeth

After deep wounds to the mouth and gums, this is the most urgent dental emergency of all. It requires an extremely rapid response, so it may be best for a patient to visit the first surgery or clinic that they can make it to. If this is not the surgery that they are registered with, but a dentist there can deliver treatment faster, this is the superior option.

Things get trickier for people who lose teeth after hours. As already explained, emergency dental numbers are designed to help people in these situations and put them in touch with specialists who are available at unusual times. The problem is that this depends entirely on the location, the amount of surgeries in the area, and the number of dentists willing to attend after hours call outs.

If a knocked out tooth cannot be re-implanted within two hours, the chances of it at you can to seek dental attention fast. In the event that emergency care cannot be found, the tooth may be lost. However, your dentist will still be able to offer you a range of different repair options and treat the wound in your mouth.

If you lose a tooth and you manage to hold on to it, gently place it back into the empty socket. Hold it firm, but do not apply too much pressure. Bite down slowly, until you can feel the tooth fit back into the socket. If this is too painful or you cannot find the socket, the best chance of keeping the tooth healthy is to place it in a glass of milk. In either circumstance, touch only the crown of the tooth; do not touch the roots, because this will introduce bacteria.

The lost crown will need to be lightly rinsed if it left your mouth after it came loose.  Then, head to a dentist as soon as possible. As aforementioned, if you can get your tooth to a dentist within two hours, there is a good chance of it being successfully re-implanted. The likelihood of this happening is highest within the first half an hour of the loss, so make haste if you are keen to save your tooth.

Loose or Misaligned Teeth

For patients who have noticed loose or misaligned teeth, the first step is still to arrange treatment as soon as possible. In in the interim, the best thing to do is gently push the tooth back into its normal position and avoid biting down on it. You will have to be very careful about what and how you eat. You may have to chew on one side until you see the dentist.

In this situation, an emergency dentist may decide to splint the tooth. This involves fixing it to a healthy one, so that it does not become more damaged while you wait for proper treatment. A splint can buy a patient a little more time, especially if they are keen to have the work done by their own specialist.

Chipped, Cracked, and Fractured Teeth

The majority of dental chips are not actually emergency situations. If they do not involve pain or severe breaks, treatment can be safely delayed for a little while. It is still important to be very careful when eating, because a jagged edge is likely to be sharp against the mouth. Take care when chewing, biting, and talking fast.

The exception to the rule is if a crack or fracture has already caused a laceration to the mouth or gum tissues. If you have a deep cut or wound, the situation may be more urgent. You need to take it as clean as possible and consult a dentist for advice. It is important to realise that severe cracks are very rarely saved. If a full break has occurred, it may be impossible to fix the tooth without adding some kind of artificial replacement.

To reduce bleeding and stop the wound from getting infected, gargle with warm salt water. A cold compress can be pressed against the outside of the face if swelling develops and needs to be controlled. It should be fine to take an over the counter painkillers, but steer clear of aspirin. It thins the blood and this is precisely the opposite of what a dentist wants for patients during a treatment.

When you do get to see a dentist, they will likely perform an x-ray to assess the extent of the damage. If the soft tissue inside the tooth (pulp) has been affected, you may need to have a root canal procedure. This is a complex process that involves creating a channel through the tooth, in order to reach the root. Once there, the dentist removes the damaged pulp and any signs of infection. The tooth is then filled with gutta percha and a crown is added over the top.

Gum and Tissue Injuries

You might think that a dentist only deals with teeth, but injuries to the lips, cheeks, tongue, and inside tissues of the mouth are considered dental emergencies. If you have this kind of injury and you head immediately to an ER department, they may refer you to an emergency dental specialist. The most important part of the response to this kind of emergency is putting a stop to any bleeding in the mouth.

Once again, you can take standard painkillers, but always avoid aspirin. It is likely, especially in the case of severe lacerations, that stitches or surgery will be needed. Aspirin thins the blood and makes it much harder to carry out this treatment. For injuries to the tongue, the best response is to gently pull it forward and apply pressure with a clean handkerchief or piece of gauze. This should slow the bleeding and give you a chance to assess the damage.

The Value of a Quick and Sensible Response

The faster that you can arrange for dental treatment, the easier it will be for your mouth to fully recover. This is particularly true for knocked out teeth; a rapid response is vital here. Nonetheless, even if you do not manage to save a knocked out or cracked tooth, it is not the end for your dental health. There are a number of different repair options and you can discuss them with your specialist.

The thing to remember about replacement teeth, crowns, and fillings is that they are the best solution to missing enamel. This does not necessarily mean that they are an ideal one. For instance, fillings need to be replaced every 7-12 years. And crowns fitted after root canals are at risk of being removed, if a patient develops an infection. Once a tooth has been lost, for any reason, the mouth will always require special attention.

The gap between natural teeth prevents healthy crowns from being stimulated in the same way that they would if they were touching other natural teeth. This means that they do not grow as strong and can start to lean into the space where a tooth should be. The best way to avoid this is with a crown or bridgework piece, but the teeth will still need regular attention and frequent check-ups.

If a baby or infant experiences a dental emergency, and they have yet to develop their adult teeth, the injury will likely be temporary. This is almost always the case if there is no damage to the oral tissues or gums. However, emergency treatment should still be sought, because the child may be in pain. For lost and cracked teeth, the dentist will want to make sure that everything that has been damaged can be replaced when the adult teeth develop.

Meeting the Cost of Emergency Dental Care

The cost of emergency call outs will vary from surgery to surgery. If you do end up having to call a specialist out to help you late at night or in the early hours of the morning, you may be expected to pay a higher rate. This can tempt patients on low incomes to opt for routine ‘in hours’ care instead of emergency treatment, even if their injuries are severe.

This is very ill advised, however, and can lead to the mouth and teeth becoming even more damaged. If you are worried about the cost of an emergency call out, speak with your dentist or specialist before accepting treatment. As your wellbeing and the health of your mouth is the top priority, the dentist has a duty to help you meet payments.

Whether this means coming up with a personalised payment plan, deferring payment for a brief while, or helping you claim back the cost of treatment through an insurance plan, you have a right to be given sound advice. Nevertheless, it is always best to be prepared for an emergency. You can do this by registering with a reliable and affordable dental membership plan or care scheme.

The last thing that you should ever do is reject urgent treatment if you really do need it. You will only end up causing lasting damage to your mouth. The same rules apply to those with dental phobias. Yes, it will be hard to confront your fear, but once an emergency has occurred, this is the only viable option. Remember that your dentist is there to act as a resource and a hub of information and advice. If you are worried or scared, voice your concerns.

Hints and Tips for Avoiding Dental Emergencies

The best way to avoid emergency situations like the ones described above is no real surprise. For a start, you should never bite or cut things with your teeth. It may be quicker, but think of how much pain you could avoid by simply getting up and looking for a pair of scissors. This applies to opening bottles and unscrewing caps with your teeth too. This is not what your teeth were designed for; they are sturdy, but do not take them for granted.

While it is not always possible to avoid eating hard foods, things like chewing on ice and hard candies are particularly risky. You might want to avoid chewing on very hard foods if your teeth have experienced a past injury. They may be more vulnerable to cracks and factures. For those who play sport, dental emergencies are easy to prevent. All that you have to do is wear a high quality mouth guard. This like wearing a helmet on your head when you ride a bike; it is a natural part of this kind of physical activity.

Ultimately though, it is not always possible to avoid dental injuries. Accidents do happen and, sometimes, even taking the right precautions is not enough. The good news is that these instances are rare. So, protect your teeth in the right way and you are likely to never experience a crack, fracture, chip, or lost tooth. As oral health is a good indicator of overall physical health, it is very important to look after your adult teeth.

 

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