Dental Emergencies you can address while the dentist is away

We don’t think about our mouths very often when we think about basic first aid, but dental emergencies are one of the most common urgent and emergent medical situations that happen after regular dental office hours. Dental emergencies are common in families with athletes of any age.

To dramatically decrease your odds of having a dental emergency, dentists suggest that everyone in the family who participates in contact sports wear a mouthpiece at all times (that is during practice and during competition). Also, never use the teeth to open containers of any type. In addition, don’t get in the habit of chewing ice or hard candies – these are not meant to be chewed. If you will be traveling to foreign countries that do not typically have accessible dental care, see your dentist to survey your mouth to see if any preventative maintenance should be done before you depart.

Luckily, most dental emergencies can be handled temporarily with these methods until you get to the dentist’s office (but remember, these methods are not meant to substitute for medical attention):

1) Tooth pain. The most common dental emergency is sudden and bothersome tooth pain and ache. This can come on suddenly, with or without visible swelling. First, gently use dental floss on the gums around the painful tooth to remove any debris that might be causing the discomfort, and then rinse gently with warm water. You can treat the pain and swelling with cold compresses and age-appropriate over-the-counter pain relievers until you can see the dentist. Avoid the use of aspirin, which thins the blood and therefore can cause bleeding to be more difficult to stop. Despite the persistent myth, do NOT apply aspirin directly to the gums – this can chemically burn the gum tissue and make the situation worse. Only apply cold compresses to areas of swelling, not hot or warm compresses.
2) Chipped/broken teeth. First, retrieve as many pieces of the damaged tooth as possible. Broken teeth typically bleed, so hold clean gauze unto the site and apply direct pressure to stop the bleeding (bleeding typically stops within 2-3 minutes). Make arrangement to see the dentist immediately, and use cold compresses on the outside of the mouth for pain relief until your dental appointment. Do not administer over-the counter pain relievers if you have a dentist appointment on the same day without the dentist’s prior approval.
3) Knocked out tooth. First, retrieve the tooth if possible. Only touch the tooth by the part that is normally exposed – do not touch the root. Rinse any visible dirt or contaminants off of the tooth. If it is possible to gently put the tooth back into the socket, do so. If the tooth cannot easily be reinserted, place the tooth into a small container of milk or warm salt water. Get to a dentist as soon as possible – teeth have the highest chance of being successfully replanted if proper medical attention is given within 1 hour of the incident. In children, a permanent tooth being knocked out is an emergency, but the loss of a baby tooth might not be. In the case of a knocked out baby tooth, stop any bleeding and call the dentist’s office to report the incident. The dental staff will then decide how urgent the matter is.
4) Lost fillings and crowns. When fillings and crowns fall out, you should see a dentist as soon as possible in order to avoid infect and injury to the exposed area. You do not need to keep the filling material. Typically the affected tooth will be painful. To help ease the pain, try ‘capping’ the affected tooth with some sugarless gum or dental wax until you can see the dentist.
5) Abscesses. Abscesses are localized infections of the tissue surrounding a tooth. Abscesses are painful and potentially serious, because left untreated, the infection can spread. Therefore, you should always see a dentist if you develop a pimple-like growth on your gums. Do not attempt to lance the abscess. Swish your mouth with warm salt water every few hours until you can get to the dentist’s office.
6) Damaged braces. Sometimes, the metal brackets connecting orthodontics break. This should be handled by the orthodontist and not by the dentist, unless one of the teeth has become loose or has been knocked out. If one of the teeth has become loose or knocked out, report to the dentist’s office first, and then the orthodontist. Apply dental wax to any areas that have become sharp (the orthodontist’s office will provide a little dental wax to have at home in case this happens), and call the orthodontist’s office. The orthodontist will decide over the phone whether the damage is an emergency requiring after-hours care, or whether dental wax will allow you to wait until regular office hours to be seen.

Sometimes, it is difficult for patients to decide whether their situation is an emergency, especially after regular office hours. Typically, the dentist wants to see patients with any of these situations, even if it is after regular hours:

● Bleeding in the mouth that is difficult to stop and requires many minutes of applied pressure.
● Pain that is severe and impairs your normal functions
● Teeth that come loose (adults only)
● Swelling in the mouth, jaw, or cheek area
● Injury to the mouth from a blow to the face
● Bulges, swelling or knots in the gums, especially with pain
● Sudden inability to open the mouth fully

If you or a family member engages in contact sports that carry a higher than average risk of dental emergencies, it is wise to assemble the materials for a dental first aid kit and keep it among the sporting equipment. A complete dental emergency kit consists of a clean container with a lid, a small bottle of water, a few packets of table salt, some sterile gauze, a clean handkerchief or bandana, and the phone numbers for the dentist’s office, including the phone number for emergencies.