When dental emergencies happen we are highly concerned about the well being of the person having the issue, Contact our office right away to discuss options and appointments.  

Although dental injuries and dental emergencies are often distressing and often painful for both children and parents, they are also extremely common.  Approximately one third of children have experienced some type of dental trauma, and more have experienced a dental emergency. Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.

There are two peak risk periods for dental trauma - the first being toddlerhood (18-40 months) when environmental exploration begins, and the second being the preadolescent/adolescent period, when sporting injuries become commonplace.

Sometimes, teeth become fractured by trauma, grinding, or biting on hard objects.  In other cases, fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to contact our office immediately.  The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.

Types of dental emergency and how to deal with them:

Toothache

Toothache is common in children of all ages and rarely occurs without cause.  Impacted food can cause discomfort in young children, and can be dislodged using a toothbrush, a clean finger, or dental floss.  If pain persists, contact the pediatric dentist.  Some common causes of toothache include: tooth fractures, tooth decay, tooth trauma, and wisdom teeth eruption (adolescence).

How you can help:

1. Cleanse the area using warm water.  Do not medicate or warm the affected tooth or adjacent gum area.
2. Check for impacted food and remove it as necessary.
3. Apply a cold compress to the affected area to reduce swelling.
4. Contact the pediatric dentist to seek advice

Avulsed tooth (tooth knocked out)

If a tooth has been knocked-out of the child’s mouth completely, it is essential to see a Pediatric Dentist immediately. 
In general, pediatric dentists do not attempt to re-implant avulsed primary (baby) teeth, because the reimplantation procedure itself can cause damage to the tooth bud, and thereby damage the emerging permanent tooth.

When a tooth exits the mouth, tissues, nerves, and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Pediatric dentists always attempt to re-implant avulsed permanent teeth, unless the trauma has caused irreparable damage.  The reimplantation procedure is almost always more successful if it is performed within one hour of the avulsion, so time is of the essence!

Here are some steps to take:

1. Call our office.
2. Pick up the tooth by the crown and rinse it under warm water.  DO NOT touch the root.
3. For older children, insert the tooth into its original socket using gentle pressure, or encourage the child to place the tooth in the cheek pouch. For younger children, submerge the tooth in a glass of milk or saliva (do not attempt to reinsert the tooth in case the child swallows it) It is important to keep the tooth from drying out. Moisture is critically important for reimplantation success
4. Visit the pediatric dentist (where possible) or take the child to the Emergency Room immediately –time is critical in saving the tooth.

We will try to replace the tooth in its natural socket.  In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy might be necessary.

 Lost filling or crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that we can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When we are not immediately accessible, here are the steps to take:

1. Apply clove oil to the tooth to alleviate pain.
2. Clean the crown, and affix it onto the tooth with dental cement.  This can be purchased at a local pharmacy.
3. If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
4. DO NOT use any kind of glue to affix the crown.

We will check the crown to see if it still fits.  If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

Cracked or broken teeth

The teeth are strong, but they are still prone to fractures, cracks, and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain will be extreme.  Fractures, cracks, and breaks can take several different forms, but are generally caused by trauma, grinding, and biting.  If a tooth has been fractured or cracked, there is no alternative but to schedule an appointment as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

1. Call our office.
2. Rinse the tooth fragment and the mouth with lukewarm water.
3. Apply gauze to the area for ten minutes if there is bleeding.
4. Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
5. Cover the affected area with over-the-counter dental cement if you cannot see us immediately.
6. Take a topical pain reliever.

The nature of the break or fracture will limit what we are able to do.  If a fracture or crack extends into the root, root canal therapy is often the most effective way to retain the tooth. In the case of a complete break, your dentist will usually affix the fragment back onto the tooth as a temporary measure.

Dislodged/loose teeth

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it. If the tooth remains in the mouth still attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call our office immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain.  Your dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy might be required.

If you have questions or concerns about dental emergencies, please contact our office.