Emergencies

STEPS TO SAVE A KNOCKED-OUT TOOTH

Wearing a custom-fitted mouthguard while participating in contact sports will help protect against painful and potentially expensive dental injuries. However, if an accident does occur remain calm and act quickly. The following steps should be taken immediately:

• Locate the tooth and, handling it gently by the crown, ensure it is clean. The crown is the smooth white part of the tooth that is normally visible in the mouth.
• If the root of the tooth is dirty, and the patient is calm and conscious, ask them to gently suck the tooth clean. Alternatively, rinse the entire tooth in milk or very briefly, in water.
• Immediately place the tooth back in the socket making sure it is facing the right way. Immediate replacement is essential and should ideally occur within 5-10 minutes of the tooth being knocked out.
• Hold the tooth in place by biting gently into a soft cloth or by using aluminium foil placed over the tooth and the teeth on either side to stabilise the tooth.
• If you are unable to replant the tooth back in the socket, keep it moist by putting it in a cup of milk, sealing it in plastic wrap or placing it in the conscious patient’s mouth, next to the cheek.
• Immediately Seek Dental Treatment! – Time is critical to prevent permanent damage.

EXTREME CARE SHOULD BE TAKEN WITH A TOOTH THAT HAS BEEN KNOCKED OUT.

Avoid the following:

• Do not handle the root of the tooth.
• Do not scrape or rub the surface of the tooth.
• Do not let the tooth dry out – keep it moist at all times.
• Do not put the tooth in hot water or ice.
• Avoid rinsing or storing the tooth in water for more than one or two seconds.
• Do not remove any soft tissue fragments from the tooth.

PROBLEMS WITH BRACES

Braces, bands or wires sometimes break or fall off. More often, one of the parts will come loose. This can cause some discomfort. Here are a few possible problems:

• Loose brace — The braces (also called brackets) are the metal or ceramic pieces that are glued to your teeth. They’re usually attached using a material called composite resin. It is similar to the tooth-coloured material used for some fillings. If you chew something hard or sticky, the resin can weaken or break. When that happens, a bracket can come loose. It may poke into your gums, tongue or cheek. When you first get your braces, your orthodontist will give you a special wax. You can put the wax over the bracket to keep it from poking you. This should provide some comfort until you can see your orthodontist.
• Loose band — Bands are the metal rings that are cemented around back teeth (and sometimes around front teeth). If a band becomes loose, call for an appointment to have it re-cemented or replaced. If the band comes off completely, do not try to put it back on. Save it and bring it to your appointment.
• Protruding or broken wire — This is a common problem. If a wire breaks or sticks out, it can hurt your cheek, tongue or gum. You can use the eraser end of a pencil to push the wire into a better position. If that doesn’t work, put a small piece of orthodontic wax over the end of the wire. Do not cut the wire. A cut wire can be accidentally swallowed or inhaled. If the wire has caused a sore, rinse your mouth with warm saltwater or an antiseptic rinse. This will keep the area clean and reduce discomfort. You can also use an over-the-counter pain reliever (such as Anbesol). This will temporarily numb the area. If the pain doesn’t get better or the sore seems to be getting worse, call your orthodontist.
• Loose spacer — Spacers or separators are rubber rings that are put between your teeth. They are left in place usually for a few days. They open a small space between your teeth so that orthodontic bands will slip onto your teeth easily. Sometimes springs or brass wire is used for this purpose. Sometimes, spacers can slip out of position or fall out. If this happens, make an appointment with your orthodontist to have them replaced.

BROKEN OR FRACTURED TEETH

Teeth are remarkably strong, but they can chip, crack (fracture) or break. This can happen in several ways:

• Biting down on something hard
• Being hit in the face or mouth
• Falling
• Having cavities that weaken the tooth

When a tooth chips or breaks, it may not hurt. You may not even notice the damage right away. Minor tooth fractures usually don’t cause pain, but if a large piece of the tooth breaks off, it can hurt. That’s because the nerve inside the tooth may be damaged, and if it is exposed to air, saliva, or hot or cold foods or drinks, it can be extremely uncomfortable.
Pain from a broken or cracked tooth may be constant or may come and go. Many people feel pain when they chew because chewing puts pressure on the tooth.

Cracked (Fractured) Teeth
There is no way to treat a cracked tooth at home. You need to see your dentist. Sometimes a tooth hurts only when you eat or when the temperature in your mouth changes (because you drank something hot or cold, for example.) If your tooth hurts all the time, it may have a damaged nerve or blood vessels. This is a serious warning sign.

Broken Teeth
If you have a broken tooth, see your dentist as soon as possible. Your dentist can figure out if the break was caused by cavities, and if the tooth’s nerve is in danger. Adults with a damaged nerve usually will require root canal treatment. In children, sometimes the damaged nerve can be saved if the dentist is able to treat the problem right away.

Until you get to the dentist’s office:

• Save the pieces. Your dentist may be able to cement the tooth back together.
• Rinse your mouth well with warm water. If you saved the pieces of the tooth, rinse them well.
• Put gauze on any bleeding areas for about 10 minutes or until the bleeding stops.
• Apply a cold pack to the cheek or lips over the broken tooth. This will help reduce swelling and relieve pain.
• If you can’t get to your dentist right away, cover the part of the tooth that is in your mouth with temporary dental cement. You can find this at a pharmacy.
• Take an over-the-counter pain reliever.