What to do in a dental emergency

Written by: Dr Shalini Ashwath | BDS | 1300SMILES Dentists Townsville City | November 9, 2020

Dental emergencies are unexpected and time-sensitive, so it’s best to know exactly what to do before you find yourself in the moment, whether that moment is on the hockey field with a distraught child or standing on the mountain bike trail with your own tooth in your hand.

WHAT IS A DENTAL EMERGENCY?

A dental emergency occurs when your mouth experiences trauma and presents with bruising, swelling or bleeding at your teeth and gums, a broken tooth or tooth that falls from the socket completely. Both adults and children can experience dental emergencies, so it’s less about the ‘who’ and more about the ‘how’. Activities like contact sports such as basketball and hockey, bike riding, skateboarding, rollerblading and playgrounds tend to be common culprits.

WHAT TO DO IN A DENTAL EMERGENCY

  1. Stay calm. No matter the emergency, the first step is always to try to remain calm so that you can manage the situation. 
  2. Phone your local dentist. Ask their advice on what to do, this will also allow them to prepare for your emergency treatment before you arrive at the clinic. 
  3. Act quickly. If the tooth has to be re-implanted, or has a large chip where you can see the red nerve inside the tooth, you need to seek dental treatment immediately. Getting to the dentist within 30 minutes to re-implant a tooth is ideal. You will more than likely need Root Canal Treatment after re-inserting the tooth. 
  4. Monitor the recovery. Following your emergency treatment, your dentist will need to monitor the area to determine the success of any treatment and how your mouth is recovering from the trauma.

COMMON EMERGENCY INJURIES

Lost tooth

If a tooth has completely removed from the socket, you may or may not need to try to re-insert it. If it is a child who has lost a baby tooth, don’t try to pop it back in. The mouth will heal as normal. If, in the stress of the moment, you can’t recall whether the tooth is your child’s baby or adult tooth, phone your dentist and he or she may ask you to send a photo.

If it’s an adult tooth that has been knocked out, store the tooth in some saline, if you have no saline use milk, if you have no milk store the tooth in the cheek to keep it in the saliva. Go to the dentist immediately and they can reimplant it. (Don’t leave the tooth in saline or milk overnight.)

 

“A knocked tooth isn’t as time-sensitive as a knocked-out tooth, but it is still traumatic to the bone.”

 

If you can’t get to the dentist right away, or are too far from a clinic, you can re-insert the tooth yourself. Hold the tooth by the crown end (the bit we see) and not the root as that’s where the nerves are, clean the tooth with some saline, and use gauze or a first aid kit to pop it back in – make sure the tooth is the facing the right way.

Knocked tooth

A knocked tooth isn’t as time-sensitive as a knocked-out tooth, but it is still traumatic to the bone. You should still go see your dentist as soon as you can so the dentist can numb the area and re-align the tooth. 

Broken tooth

If your tooth has broken during the trauma, treatment will depend on the severity of the chip. If it’s a superficial chip, we can bond the piece back on or fill the chip with a bond. If it’s a big chip and you can see red in the middle of the tooth where the nerve would be, you will need to see your dentist as soon as possible.

POST-TREATMENT MONITORING 

If your tooth has been reimplanted, you will need to ensure your tetanus vaccinations are up to date, and you will need to take antibiotics prescribed by your dentist. You will also need to be on a soft diet for 10-14 days as the ligaments will be bruised and the tooth will be a little loose. Your dentist will use follow-up appointments to monitor your recovery, ensure the tooth’s nerve is alive and there is no infection.

PREVENTION THROUGH PROTECTION

There are three types of mouthguards to protect your mouth from trauma while playing sports or doing high-risk activity.

  1. Stock mouthguards are not moulded to your teeth, will probably fall out while in use, and offer minimal protection. 
  2. Boil-and-bite mouthguards mould very slightly to your teeth, are better than the stock mouthguards but they still are hard to fit properly and don’t do a great job protecting your mouth.
  3. Custom fit mouthguards are fitted to your teeth and gums by your dentist taking an impression of your mouth. These are thick and offer the best protection.

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