Dental Emergencies

Any dental emergency can be potentially serious and should never be ignored. Ignoring a injury to your gums or teeth can increase your chances of permanent damage as well as requiring extensive and expensive treatment in order to repair the damage. Call us immediately to schedule an emergency appointment.


Broken braces wires

If an arch wire, brace wire, brakes or pops out of place, give us a call right away! Do not cut the protruding wire because you will run the risk of swallowing or inhaling the wire fragment. Take a pencil eraser and use it to reposition the protruding wire to stop it from causing irritation to your cheek, tongue, gum or soft tissues of your mouth. If you can not reposition the wire take some orthodontic wax, a cotton ball or a piece of gauze and apply it to the wire where it is coming into contact with your mouth. Reapply as needed until you are able to come into our office. If the protruding wire is causing irritation rinse your mouth with antiseptic rinse or warm salt water, “saline solution”. The rinse will prevent inflammation and the formation of any sore spots. If the irritation causes unbearable pain, pain relievers can be taken for relief.


Chipped or Broken Teeth

Chipped or broken teeth result from untreated fractures. Fractures can be caused by:

  • Cavities
  • Weak enamel
  • Weakened teeth due to a previous root canal treatment
  • Impact or trauma to the mouth

If there are signs of fracture lines, then the structure of the tooth has weakened. If left untreated, the pressures being applied to your teeth when biting can cause the tooth to break at the lines. It is recommended that, upon noticing fracture lines, schedule an appointment with us to prevent any further damages.

If the tooth has been broken or chipped, rinse your mouth with warm water to remove any debris. If your mouth is bleeding, apply pressure to the wound using gauze for approximately 10 minutes or until it stops bleeding. Apply a cold item to the outside of your mouth, cheek, or lip where the trauma happened to help keep the swelling and pain down. Immediately call our office to schedule an emergency appointment. Postponing treatment will increase the chances of making the situation worse.

Fractured teeth treatments include:

  • Use of materials to fill in the fractures
  • Root canal with a crown
  • Veneers
  • Extraction and replacement with an implant

Dental Abscess

When the inside of your mouth is injured or irritated, bacteria can enter and cause an infection. A dental abscess is the barrier that forms around the infection. There are two types of abscesses:

  • Gum Abscess (Periodontal abscess): This is caused by an infection in between the tooth and gum. The infection can be caused by food getting trapped between the gum and teeth. For people with severe periodontal disease, the buildup of bacteria can easily get under the gum and spread to other areas of the mouth quickly.
  • Tooth-Related Abscess (Periapical abscess): This occurs when the infection get inside the tooth. This normally happens when the nerves of the tooth are dead or dying. The abscess forms at the tip of the tooth’s root and can spread into the surrounding bone.

Abscesses are painful; they will not go away on their own. The pain is caused by a buildup of pressure inside the abscess. By draining the abscess, the pressure is reduced and thus the pain will subside. However, the infection still needs to be treated. If left untreated, the infection can damage the surrounding bone and teeth.

Treatments
The three main steps in treating abscesses are:

  • The area is thoroughly cleaned
  • The trapped pus is allowed to drain
  • The infection is treated

Fistula – A fistula is a hollow tunnel that is formed through the bone and skin to allow the abscess to drain. To treat a fistula, a flexible and thin piece of material is inserted into the fistula to trace the source of the infection. The material will appear on an x-ray, showing the trail of the fistula. Once the source of the infection is detected, it is cleaned and the fistula will close on its own.

Tooth-Related Abscess – Treating a tooth-related abscess starts by examining the damage to the tooth and determining how large the abscess is. For a small abscess, a small hole is made in the tooth to gain access to the inside and to allow the abscess to drain and be cleaned. Once the abscess has been cleaned, the tooth will undergo a root canal treatment, followed by the installation of a crown. If the abscess is large or the tooth is badly damaged, the tooth may need to be removed. In order to drain and clean the abscess, a hole is made in the gum through the bone.

After treatments, antibiotics are provided to help the healing process and to keep the infection from spreading.

If you believe you have an abscess, call us immediately to schedule an appointment.


Extruded tooth

Dental injuries are hard to avoid. These injuries can range from mild to severe. When a tooth gets knocked loose or becomes partially dislodged from its socket, it is called an extruded tooth. If you experience an extruded tooth, immediately call our office to schedule an Emergency Dental treatment.

Prior to the Emergency Dental treatment, do not attempt to pull out the extruded tooth because you can damage the attached nerves and tissue. To relieve pain and keep down the swelling, apply a cold compress to the outside of your mouth and cheek area. If the pain is unbearable, take an over-the-counter pain reliever such as Tylenol or Advil.

During an Emergency Dental treatment, your dental history will be reviewed to determine the best process to secure the extruded tooth back into its place. In general, the following steps will be taken to secure the extruded tooth:

  • Patient is anesthetized with local anesthetic.
  • Affected areas are thoroughly cleaned with water and antiseptics.
  • Dentist inspects the structures of the extruded tooth to ensure they are intact and that there are no signs of periodontal disease in the bone and surrounding structures.
  • The tooth is guided back into its socket.
  • An X-ray may be taken to verify root or bone damage that may affect healing. (If there is nerve or blood vessel damage, a root canal treatment to prevent discoloring and formation of an abscess will be performed)
  • Once the tooth is properly guided back into place, it will be secured to the surrounding teeth until it has enough time to heal.

The healing process can take around 7 – 10 days depending on the severity of the damage. It is extremely important to have a follow up appointment to verify that the tooth is healing correctly.


Knocked-out Tooth

A tooth is a living bone structure rooted in a socket in the jaw. If a tooth gets knocked-out, its support system of blood vessels and nerves are damaged. Call us immediately to schedule an emergency appointment. The faster you can get the tooth back into its socket, the higher the chances of saving the tooth. Knocked out teeth with the highest chances of being saved are those seen by us and returned to their socket within 1 hour of being knocked-out.

Prior to the emergency visit, you can attempt to reinsert the tooth back into its socket. When handling a knocked-out tooth, hold it by the crown and not the root. The crown of the tooth is the exposed part of the tooth that you see. Rinse the tooth with milk, do not scrub or remove any attached tissue fragments. If milk is not available, leave the tooth alone. Additional damage can occur if you try to wipe it. The tooth must be reinserted back into the socket in the same direction it originally was in, do not force it back in place. In many cases, it will slip right back into place. If you are unable to reinsert the tooth, put it in a small container of milk. If milk is not available, put the tooth in your mouth between your cheek and gum. For younger children, it is safest to store the tooth in a container of milk or have them spit into a container and store the tooth in saliva.

Once the tooth is reinserted back into the jaw, microscopic ligaments in the jaw bone will reattach to the root of the tooth. It usually takes about two weeks for the ligaments to firmly reattach. Once the tooth has reattached to the jaw, a root canal treatment will be performed to clean out the damaged nerves and to prevent the tooth from becoming infected or change colors.


Loose Brackets and Bands

A bracket or band can loosen from eating foods you should not have. Brackets are on your front teeth and bands are metal rings cemented to your back molars. To determine if you have a loose bracket or band, wiggle the bracket or band to see if it moves. If there is movement, schedule an appointment with us as soon as possible. When scheduling the appointment, be sure to inform the receptionist of the issue to ensure that the proper appointment time is allotted.

Prior to the appointment, you can temporarily reattach the loose bracket or band by using a small piece of orthodontic wax. To provide a cushion to your braces, you can place wax overtop of them. If the bracket or band has come completed off, wrap it in a tissue and bring it with you to the appointment. During the appointment, the affected area will be cleaned and the bracket or band will either be re-cemented in place or replaced within 30 minutes.

A loose bracket or band does not require immediate attention. But it you are in any pain, call us immediately and request an emergency appointment.


Lost Crown

A crown covers the top of a repaired tooth that previously had decay, damage, or root canal therapy. Sometimes, a crown can fall out or loosen due to new decay forming underneath the crown. The decay eats away at the bond between the crown and the tooth structure. As the bond weakens, the chances of the crown falling off increases.
A lost crown does not require an emergency appointment, but an appointment should be scheduled as soon as possible. Postponing your visit can result in:

  • More damage to your already weakened tooth
  • Pain due to tooth tissue exposed to temperature, pressure and air.
  • Teeth movement which can cause the crown to not fit.

Below are temporary solutions for a lost crown prior to your dental visit:

  • Apply an over-the-counter topical pain reliever to the sensitive area with a cotton swab to provide pain relief until the scheduled appointment.
  • If you still have the crown, you can attempt to reinsert it back on the tooth with temporary dental cement. Temporary dental cement can be purchased at your local drug store. Do not use any household glues (super glue) because they are not safe for your mouth and can cause more damage. Please remember to clean both the crown and your mouth with water prior to the application of the temporary dental cement.
  • If you have lost the crown, you can apply temporary dental cement directly to the top surface of the remaining tooth structure. The dental cement will protect and seal the tooth until the scheduled appointment.

Lost Filling

Losing a filling while eating can be a traumatic event. First, remove the fragments from your mouth to reduce the risk of swallowing it. If the filling material is either composite or amalgam, there is no need to save it. Remove the fragments from your mouth and discard them in the trash. If you had a gold filling or ceramic filling, try to save all the pieces for the dental appointment. Gold or ceramic fillings can sometimes be re-cemented back into place. Once all fragments are removed, give us a call and we will schedule an appointment as soon as possible.


Toothache

Toothache or tooth pain occurs when there is irritation to the nerves of a tooth. The most common causes of a toothache include:

  • Infection of gum tissue
  • Tooth decay
  • Abscessed tooth
  • Tooth fracture
  • Injury to mouth
  • Damaged filling
  • Tooth extraction
  • Teeth grinding

The symptoms of a toothache include, but are not limited to:

  • Sharp, constant, and throbbing pain
  • Swelling
  • Fever
  • Headache
  • Foul-taste from infected tooth drainage

However, radiating pain from other locations of the body can sometimes be mistaken for a toothache. The most common locations of radiating pain that are mistaken for as a toothache include: jaw, ear, and heart.

It is essential to see your dentist as soon as possible about your toothache if:

  • You have a toothache that lasts longer than 1 or 2 days
  • The pain is unbearable
  • You have a fever, earache, or pain upon opening your mouth
  • What treatments are available for a toothache?

Treatment depends on the cause. If a cavity is causing the toothache, the cavity will be removed and refilled or, if necessary, the tooth will be extracted. If the tooth’s nerves are infected, a root canal will be performed. An antibiotic may be prescribed depending on the severity of the pain and swelling. It is extremely important to prevent the infection from spreading to other parts of your face and bloodstream.

To prevent toothache and major dental problems is to practice good oral hygiene. Good oral hygiene includes:

  • Brushing regularly
  • Flossing daily to remove lodged food and plaque
  • Brushing with fluoride toothpaste
  • Professionally cleaning your teeth twice a year

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