In my last article, I addressed matters concerning chipped front teeth, swelling of the face or neck, and broken dental work.Moving forward, I’ll now address some other common dental problems and what to do in the event that you are faced with one of them.
Knocked-Out Teeth
Avulsed teeth are the truest dental emergency. In the case of permanent teeth, time is of the essence. Immediate on-scene reimplantation is the preferred method of treatment. Best results are obtained when the knocked-out tooth is implanted within 10minutes!After one hour, the chances for success become dramatically reduced. If the tooth is visibly contaminated, it should be gently rinsed in cold running tap water and then reimplanted. Care should be taken not to touch, rub, or clean the root, which could remove fragile soft tissues and reduce the chance of successful reimplantation. The patient should then see a dentist immediately for bonding the tooth to its neighbour for stability.
If immediate on-scene reimplantation is not possible, the tooth should be transported in the patient’s cheek pouch,milk, or a specialized tooth transport container (available for purchase from many dental offices) to the dentist. Sterile contact lens saline solution can also be used. The dentist will reimplant the tooth and then bond it to the neighboring teeth. Careful followup by a dentist over the next few years is crucial. Root canal treatment will also be required. Baby teeth are never reimplanted, but an emergency visit to the dentist is essential… often adults assume that if the tooth is not visible, then it has been knocked out of the mouth. However,many times, x-rays will show that the tooth has been pushed into the jaw so deeply that it can no longer be seen. This poses a significant hazard to the nearby unerupted permanent teeth if the problem is not treated.
Teeth loosened or pushed out of place
A dentist should treat loosened or wobbly teeth quickly, especially if the patient cannot bite down. There is a need to determine if the tooth position has changed, and whether or not an adjustment is required. The majority of healthy teeth can be saved if they are quickly and firmly fixed to other nearby teeth. This treatment is called splinting and like broken bone splints or casts, is not permanent. Long-term follow-up is important. The dentist needs to carefully evaluate the situation over time and take x-rays to determine if the tooth is healing properly and determine the need for further measures, such as root canal treatment.
Toothaches
Toothaches comprise the majority of dental emergencies treated in my office. A true toothache is usually a dull ache or a throbbing pain. Sometimes the pain is steady, sometimes it is off and on, and in many situations it only occurs when triggered by temperature changes or chewing pressures. Toothaches are potentially serious if left untreated, but usually have a good outlook if attended to promptly. Therefore, a patient with a toothache must contact a dentist within one day! If there absolutely must be a delay in seeing the dentist, generic pain relievers can be very helpful when instructions are carefully followed. Start with acetaminophen and if this is not successful, try ibuprofen as long as you are sure a physician has cleared you to take ibuprofen or other non-steroidal anti-inflammatory drugs. It is extremely dangerous to take pain medication in combination with alcohol! Try to time your medication so that it will be mostly worn off by the time you see the dentist, so that the problem is not covered up, thereby making it more difficult to diagnose. Some people may delay treatments for toothaches, even though these procedures can be done with little or no discomfort.What these individuals should know is that not getting treatment can lead to a very serious spread of infection to other parts of the body which can in turn lead to serious illness, and even the occasional fatality.
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.
