Emergency Dental

What is a dental emergency?

Injuries to the head and or mouth may include teeth that are knocked out (avulsed), forced out of position and loosened (luxated) or fractured. In addition, lips, gums or cheeks are often cut. More extensive injuries may result in fractures of the bones of the face and jaws. Oral and facial injuries are usually quite painful and should be treated by a dental professional as soon as possible.

When a tooth is knocked out?

  • Immediately call your dentist for an emergency visit.
  • Handle the tooth by the crown (the part you see in the mouth), not the root. Touching the root (the part of the tooth below the gum) can damage cells necessary for bone re-attachment.
  • Gently rinse the tooth in water to remove dirt. Do not scrub.
  • Do not try to replace the tooth in the socket, but place the clean tooth in your mouth between the cheek and gum to keep it moist. It is important not to let the tooth dry out.
  • If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk.

Will this tooth I knocked out be with me for the rest of my life?

If there is any chance of re-implanting the tooth, your dentist will advise you that further treatment of it will likely be necessary, including root canal therapy, splinting and perhaps a permanent crown. Even though these treatments may all be successful, each individual’s immune system will determine whether the body accepts this re-implanted tooth, or rejects it, much the same as for organ transplants. Interestingly, it is possible for the body to initially accept the re-implanted tooth for a period of many years – perhaps even 20 – only to find that at some point in the future, the cells within the body’s immune system try to dissolve it (resorption). Attempts can be made to combat resorption, but if it continues, will lead to the eventual loss of the tooth. But be hopeful, even if this occurs, it can be decades later.

When a tooth is pushed out of position?

  • Attempt to reposition the tooth to its normal alignment using very light finger pressure, but do not force the tooth.
  • Bite down to keep the tooth from moving.
  • The dentist may splint the tooth in place to the two healthy teeth next to the loose tooth.
  • If the tooth has been pushed severely out of position, it will fall into the same classification as one that has been knocked out, although the prognosis will be better.

When a tooth is fractured?

  • Rinse mouth with warm water.
  • Use an ice pack or cold compress to reduce swelling.
  • Use ibuprofen, not aspirin, for pain.
  • Immediately get to your dentist, who will determine treatment based on how badly the tooth is broken. Only a dentist can tell how bad the break is.
  • Minor fracture: Very minor fractures, or chips, can be smoothed by your dentist with a handpiece and water spray, or can be simply left alone. Another option is to restore the tooth with a composite-restoration. In either case, treat the tooth with care for several days.
  • Moderate fracture: Moderate fractures include damage to the enamel, dentin and/or pulp. If the pulp is not permanently damaged, thetooth may be restored with a full permanent crown. If pulpal damage does occur, further dental treatment will be required.
  • Severe fracture: Severe fractures often mean a traumatized tooth with slim chance of recovery.

When Soft Tissue is injured?

Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away with warm water, and the injured person taken to the hospital emergency room for the necessary care. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.

Preparation for a dental emergency

In your first aid kit for home or car, include:

  • Your family dentist’s phone numbers (office and home)
  • Saline solution (the kind used for contact lenses is fine)
  • Handkerchief
  • Gauze
  • Small container with lid (at least 1.5 inches at it’s shortest dimension)
  • Ibuprofen (not aspirin- aspirin is an anti-coagulant, which may cause excessive bleeding in an oral emergency).