What a way to ruin your plans! You are about to attend an important event that has been months in the planning. You are under tremendous pressure, biting your nails, your lips and your favorite pen. All of a sudden a piece of your front tooth breaks off. It hurts when you breathe in and you look like Lloyd from the movie Dumb and Dumber. Fortunately a fast visit to the dentist fixes the problem quickly and comfortably, with amazing results.
A common problem
Dental emergencies are extremely common in North America. In one recent survey, 22 per cent of the general population had experienced mouth pain in the preceding six months, and 12 per cent experienced a toothache. In 1996, American students missed 1,611,000 school days because of acute dental problems.
There are various kinds of dental emergencies, such as chipped or cracked front teeth, broken back teeth, loosened (luxated) or knocked-out (avulsed) teeth, toothaches, swellings of the face and neck and damaged, loosened or lost dental work. Sometimes the problem is purely a cosmetic one; sometimes the emergency may be a sign of serious illness.
Chipped front tooth
If the chip is small, a dentist can usually fix it fairly easily by bonding colour-matched white filling material (composite resin). More extensive injuries may require the need for root canal treatment, placement of a post and likely a crown. For these more complex cases, your dentist would discuss both short- and longterm options to make your smile look and feel normal as quickly as possible.
Broken back teeth
Breaks in the back teeth are usually due to stress fractures in teeth weakened by large fillings or by large, growing cavities. The latter problem is usually more serious, because it means a toothache or abscess may occur in the near future. It is advisable to keep the area as cleans as possible and see a dentist within 24 hours, or within a few hours if the tooth is painful. Avoid chewing on the area. If the area is sensitive, covering the exposed area with a piece of sugarless gum may help. Your dentist may repair the problem immediately or elect to only smooth off any sharp, irritating rough edges and then discuss your options for treatment. Often a filling is an adequate solution, but sometimes onlays (similar to partial crowns) or crowns (caps) are more ideal. Root canal treatment may also be required to properly solve the problem and avoid loss of the broken tooth.
Swelling of the face or neck
These are advanced dental infections. If you cannot contact your dentist, then go to the nearest emergency room. If you also have a fever or if you are having any trouble swallowing or breathing you must go to the nearest hospital emergency room immediately. Do not drive yourself. If you are alone, call 911 and request an ambulance. This type of situation can quickly evolve into a condition in which you are unable to breathe and must be taken very seriously! Fortunately this situation is not very common and virtually unheard of in patients who get regular dental care.
Broken dental work
Just like broken teeth, contact a dentist right away. Beware of any loose pieces that could become choking hazards. If you have a denture with damage and you have an older denture, bring both to the dentist. While the new one is fixed by the lab, the old one could possibly be used as a temporary solution while the dental laboratory is repairing the problem. Other temporary solutions can be made by a dentist and are sometimes necessary.
See Part Two for more helpful tips and advice regarding dental-related emergencies.
IMPORTANT NOTE: In accidents where there is possible head or spine trauma, dental treatment should be secondary and patients should be rushed to a hospital emergency room
Steven Deskin is a Brantford Dentist in general practice.
