How to avoid a mouthful of problems

Swati Uppal

‘A stitch in time saves nine’, goes the old saying. And nothing could hold true when it comes to dental problems, particularly emergencies. Please remember that with some dental emergencies, seeing a dentist within 30 minutes or less can mean the difference between saving and losing your tooth.

Following tips can help you manage a dental emergency until you can get to the dentist. 

Knocked-out tooth 

A knocked-out tooth requires urgent attention. If appropriate emergency steps are followed immediately, the tooth may be reinserted and preserved by a dentist.

• Pick up the tooth by the top (crown). Do not touch the root(s) of the tooth.
• Rinse the tooth under steady (slow) streamof water very gently to ensure that it’s clean. 
•  Do not scrub the tooth or remove any tissue attached to it. 
•  Do not use soap or chemicals.
•  Do not dry the tooth.
•  Place a towel in the sink so that the tooth does not go down the drain. But DO NOT wrap the tooth in a cloth or tissue.
• Gently place the tooth back into the socket. Hold it gently in place while trying to bite down. If you can’t do that, put the tooth in a small container filled with milk. In an event where no milk is available, put the tooth in the space between your cheek and teeth, or alternatively under your tongue. Be careful not to swallow it. Be sure to keep the tooth moist at all times.
• Call your dentist immediately. Getting to the dentist quickly with your tooth — in addition to following the steps above — is critical for saving the knocked-out tooth. The longer you wait, the less chance you have of saving the tooth.

Tissue injury and facial pain

Any type of injury inside the mouth, such as puncture wounds, lacerations and tears to the lips, cheeks, mouth and tongue, are considered tissue injuries and a dental emergency.

 If you experience any type of tissue injury, clean the area immediately with warm water. 

If the bleeding is from the tongue, gently pull the tongue forward and place pressure on the wound using gauze. 

Alternatively, if the patient is a child and gauze gets uncomfortable, make him/her suck on to ice or sugar continuously till you reach the dentist.

Similarly for any soft tissue tears (cuts), apply ice packs to control bleeding.

Go to an oral surgeon or nearby hospital emergency room immediately.

Never take aspirin or ibuprofen for a dental emergency because they are anticoagulants, which can cause excessive bleeding.

Lost filling

Make sure that the area is kept clean and no food lodgment is allowed in the now hollow portion of the tooth.

Do not fret as the filling cannot be put back and will have to be redone.

Avoid sticky foods and extremely hot or cold beverages/food. 

See your dentist as soon as possible.

Objects caught between teeth

First, try using dental floss to very gently and carefully remove the object. 

If you cannot get the object out, see your dentist. 

Never use a pin or other sharp object to poke at the stuck object. These instruments can cut your gums or scratch the tooth surface.

Chipped, cracked or fractured teeth 

If a tooth is chipped and doesn’t hurt, this usually does not constitute a dental emergency and you can wait a few days to see a dentist. However, it is important to be careful while chewing so as not to chip it more. 

A cracked or fractured tooth is a serious issue constituting a dental emergency. Fractured or cracked teeth usually suggest that damage has occurred to the inside of the tooth as well as to the outside. 

If you suffer a fractured tooth, call your dentist immediately for an emergency appointment and follow these steps:

• Clean your mouth by gently rinsing thoroughly with warm water.
• If the fracture is caused by facial trauma, apply a cold compress to the area to minimise any swelling.

An X-ray will be needed for your dentist to properly diagnose the condition of your tooth. If the soft tissue inside of the tooth is damaged, your tooth may need a root canal treatment.

If the tooth cannot be saved, your dentist will inform you of the various alternatives for replacing missing teeth. 

How to avoid an emergency

Many dental emergencies can be easily avoided by having routine dental check ups  to ensure that your mouth and teeth are healthy, strong and free from decay.

Wearing a mouth guard during sports activities will help to prevent teeth from being chipped, knocked out or broken. Avoid chewing on ice and hard foods that may break or fracture your teeth.

If you are planning to travel out of the country or leaving for an extended vacation, during which you may not have ready access to dental care, see your dentist for a routine check up before you leave. 

Your dentist can make sure that you don’t have any loose crowns or teeth, decay close to the nerve of a tooth that could cause you pain or develop into an abscess or other problems that could be easily fixed before becoming a dental emergency later.

Being prepared 

Because a dental emergency can happen at any time and place, the best thing to do is be prepared and don’t panic. Pack and keep with you a small dental first aid kit containing the following:

• Small container with a lid.
• Name and phone number of your dentist.
• Gauze
• Handkerchief. 
• Painkiller medicine (recommended by your dentist).

—The writer is a Chandigarh-based dentist

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  Is it a dental emergency?

Smoothing a chipped tooth, re-cementing a crown that is not causing pain and composite bonding to repair a tooth are not dental emergencies. Typically, such problems can be dealt with during your dentist’s regular office hours.

If you are not sure whether or not you are having a true dental emergency, answer the following questions:

•  Are you bleeding from the mouth?
•  Are you in severe pain?
•  Do you have any loose teeth?
•  Have you been hit in the face or mouth?
•  Do you have any swelling in the mouth or facial area?
• Do you have any bulges, swelling or knots on your gums?

If you answered yes to any of these questions, you might be having a dental emergency and should call your dentist immediately. It’s important to describe to your dentist exactly what has happened and what you are feeling.

If you experience pain in a tooth when biting down, it might indicate an abscess. This is an emergency and you should call your dentist’s office.

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Toothaches 

Toothache may result from causes such as decay, sensitivity, injury or infection. Below mentioned are some common symptoms and ways to tackle these before professional help is available.

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