How to deal with a dental emergency

Dental Emergencies – Have you had an accident or suffer from the following?

Accidents and emergencies will happen and it is not uncommon for both adults and children to hurt their mouths, or chip a tooth or even knock it out completely (avulse it).

Do it yourself dental kits are available from pharmacists in Harrow, Wealdsone, Kenton, Hatch End and Stanmore and may be a useful addition to the family medicine cabinet.

Prevention is better than cure

Many dental accidents or emergencies are avoidable. Do not try to open bottles with teeth or bite or tear at resistant substances. Sports injuries are one of the commonest ways to damage teeth, so mouthguards are strongly advisable for both adults and children who play any kind of contact sports.

Chips and cracks

If the dentine or pulp is exposed, try to protect the tooth until you can get dental help. If you do not have a DIY dental emergency kit, chewing a piece of sugarfree gum and then placing it over the damaged tooth can make an effective temporary dressing.

Losing a filling

If a filling is cracked or drops out, a chewed piece of sugarfree gum can be packed into the cavity to protect it.

Knocking out a tooth

If a tooth is avulsed, provided it can be reinserted within an hour, there is a good chance of it re-implanting successfully into its socket, so it is essential to get to the dentist as quickly as you can. Try to touch it as little as possible. Do not wash it in water, because this washes away the cells that will enable it to reattach. Ideally put it back into its socket the right way round, having either licked it or wiped it round the inside of your mouth to clean it (the mouth it came from, not that of a parent or other person). If it is reinserted correctly, it will stay in place until you can get to the dentist to have it splinted and stabilised.

If it is not possible to put the tooth back into its socket, store it in a small container of milk or keep it in your cheek so it is bathed in your own saliva. Do not wrap the tooth in a tissue or handkerchief.

If a child under nine years of age avulses an adult tooth it is likely that the apex (the growing part of the root) will not have finished forming. The accident should be handled in the same way as for an adult, but the consequences are more uncertain.

Baby teeth should not be re-implanted. There is nothing to be done if a baby tooth is lost, but some parents may wish to consult a dentist for reassurance.

Loose teeth

If a tooth is knocked loose but remains in its socket, avoid chewing until you can get it properly stabilised.

Other tooth injuries

A knock to a tooth can sometimes cause the nerve (pulp) inside the tooth to die and the tooth may go darker in colour. If this happens, even if you have no pain, see a dentist as a dead tooth may cause an abcess to form unless the nerve is removed.

Injuries to gums, tongue, lips and inside cheeks

These are usually lacerations or cuts. Stop the bleeding by applying pressure with a warm compress such as cotton or linen handkerchief (not tissue or cotton wool). If dirty the wound should be cleaned with antiseptic mouthwash, e.g. Corsodyl, and an anti-tetanus injection is advisable.

A painkilling anti-inflammatory product, e.g. Difflam, can be applied by soaking a cotton bud in it and rubbing this on the affected area. It is also effective for the treatment of mouth ulcers.

Burns and scalds to the mouth

Apply ice or cold water to the burn as quickly as possible. An anti-inflammatory such as Difflam can help reduce the sting (this can de diluted up to 50% with water if it is too astringent).

Damage to dental work

If you break a crown, bridge, denture, etc, try and put it back together and into place until it can be mended professionally. secure the parts that are essential to help with your appearance using a denture fixative bought from a chemist, but do not try if there is a danger of swallowing or inhaling anything and always remove the parts before going to sleep. Do not try to bend distorted bridges or dentures back into shape as they may break.

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