Pain of any kind is the most obvious indication. Swelling which can accompany pain, or without pain, is another. A cosmetic situation can be an emergency – as in, your wedding is tomorrow and you just chipped off your front tooth. A tooth that has been knocked out or just out of position and any kind of significant trauma to the teeth, gums or mouth in general can be considered emergencies.
Our rule of thumb is simple. If you would drop virtually anything and everything you are doing and run straight to almost any dental office to seek help, there’s a pretty good chance that it is what we would call a ‘true emergency.’ When it comes to true emergencies we do our absolute best to accommodate you as quickly as possible. The same day is the rule (assuming we are in the office that day).
When a dental emergency strikes and you aren’t near our office or we aren’t available, what do you do? That depends, of course, on the nature of the emergency.
Let’s start with the big one: pain. In my experience, the single best pain medication for dental pain is Ibuprofen (assuming you can take it safely, and are not allergic to it). Is it the perfect solution? No. Nothing is. If you have an infection (abscess), the only thing that will ultimately help is antibiotics (prescription only). Please note: a typical sized adult should NOT exceed 800mg of Ibuprofen at a time in a 6 to 8 hour period. I mention this because I have had many a patient claim to have taken potentially harmful amounts of Ibuprofen when a toothache hits.
Swelling is also generally treated with antibiotics, so you need to be seen quickly. Please know this: an infection in your mouth is just as hazardous to you as an infection in any other part of your body. In some ways the infection in your mouth is more dangerous since swelling can lead to a closing of the throat, thereby making breathing difficult. If this should happen, it’s 911 time and the hospital ER.
I am often asked about putting ice or heat on the swollen area. Here is the general rule: you can put cold on at the very start of the swelling process (when it is just starting to swell). Avoid heat in the early stages as heat can actually make the swelling worsen by increasing blood flow to the area. The key is to get to the dentist NOW.
Chipped teeth without pain are generally not an emergency in the truest sense. Simply get to the dentist to see what options are available.
If a filling has come out, there are many products you can purchase at the drugstore that are made to temporarily fill a tooth. Remember it is just temporary and fillings usually come out because there is significant new decay under them.
If a crown comes off, you can place it back in place temporarily with denture adhesive or even a small piece of sugar free gum (chewed to soften). Then get the dentist to permanently recumbent or repair as needed.
Cuts on the gums or lips can be treated by rinsing with a light salt water solution, followed by pressure on any bleeding site with gauze or a tea bag. Cold compresses can be placed on the outside of the mouth for 5 to 10 minutes or so to prevent swelling, if you fell or were struck. Bleeding that cannot be adequately stopped needs to be treated by a dentist or physician possibly in the emergency room.
If you have a tooth that was completely knocked out of place, find and keep the tooth. If it is dirty, lightly rinse it off. Handle only the top of the tooth (the part you are used to seeing). If you can put it back in place then do so. Just make sure it’s facing the right way. Then see a dentist right away.
If you can’t get it back in properly, either place it in a cup of milk and take it to the dentist or ER quickly to be reseated. Even better, place the tooth in your mouth (assuming it’s your tooth) and keep it in your cheek.
Your dentist will try and put the tooth back in place and attach it temporarily to the teeth on either side of it to help stabilize it. A root canal on this tooth will likely be needed in the future if the tooth is successfully re-implanted.
If the tooth isn’t knocked completely out but just out of position, once again, seek a dentist’s help as soon as you can. Use the recommendations above concerning being struck.