ORAL SURGERY
Dental Emergencies

Dental Emergencies can be frightening and often painful.  Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.

Sometimes teeth become fractured by trauma, grinding or biting on hard objects.  In other cases, fillings, crowns and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to make an appointment with the dentist as quickly as possible.  The pain caused by dental emergencies almost always gets worse without treatment, and dental issues can seriously jeopardize physical health.

A few types of dental emergencies and how to deal with them are listed below:

Avulsed tooth (tooth knocked out)

If a tooth has been knocked completely out of the mouth, it is essential to see a dentist immediately.  When a tooth exits the mouth, tissues, nerves and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

  1. If possible, place it back into its socket – if not tuck it into the cheek pouch of the patient.
  2. If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort.  It is important to keep the tooth from drying out.
  3. Get to the dentist, quickly and safely.

The dentist will try to replace the tooth in its natural socket.  In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy may be necessary.  When the tooth is out of the socket for more than one hour, the chances of survival is low.  If the tooth is lost due to the trauma, or cannot be replaced in the mouth - a single dental implant can be done.


Lost filling or crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be very sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying, which causes the crown to no longer fit.

If a crown has dropped out of the mouth, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

When the dentist is not immediately accessible, here are the steps to take:

  1. Gently clean the remaining tooth structure and apply clove oil if needed to the tooth to alleviate pain.
  2. Clean the crown and affix it onto the tooth with dental cement.  This can be purchased at the local pharmacy.
  3. If the crown is lost, smear the top of the tooth with dental cement to alleviate discomfort.
  4. DO NOT use any other kind of glue to affix the crown.
  5. See your general dentist as soon as possible to evaluate the problem.

The dentist will check the crown to see if it still fits.  If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.  If the decay is extensive and the tooth non-restorable, your will be referred to the oral surgeons at San Antonio Oral Surgery.  The tooth will be removed and a socket preservation graft procedure done as needed to promote better bone healing.  After adequate time for the bone to heal (about 3 months) then dental implant can be placed.  After the bone has bonded to the implant, usually 3-4 months, the referral general dentist will make a new crown over the implant..


Cracked or broken teeth

Even though teeth are strong, they are still susceptible to fractures, cracks and breaks.  Sometimes fractures are fairly painless, but if the crack extends down into the root, it is likely that the pain could be extreme.  Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting.  If a tooth has been fractured or cracked, there is no alternative but to see the dentist as quickly as possible.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

  1. Call the dentist.
  2. Rinse the tooth fragment and the mouth with lukewarm water and keep it to show your dentist.
  3. Apply gauze to the area for ten minutes if there is bleeding.
  4. Place a cold, damp dishtowel on the cheek to minimize swelling and pain.
  5. Cover the affected area with over-the-counter dental cement if there is no way to see the dentist immediately.
  6. Use a topical pain reliever.

The nature of the break or fracture will limit what the dentist is able to do.  If a fracture or crack is limited a crown could solve the problem.  If the fracture is more extensive, root canal therapy followed by a crown may be the only effective way to retain the tooth.  In the case of a more complicated break, the general dentist will refer the patient to our oral surgeons here at San Antonio Oral Surgery for treatment.  In most cases the the tooth is removed and a socket preservation graft procedure done as needed to promote better bone healing. After adequate time for the bone to heal (about 3 months) then dental implant can be placed. After the bone has bonded to the implant, usually 3-4 months, the referral general dentist will make a new crown over the implant.  In the case of front teeth, the hopeless tooth can usually be removed and a dental implant placed immediately.  A temporary crown or appliance can then be used for normal appearance and function.  After the bone bonds to the implant, a final crown would be made by the general dentist. 


 

If you have questions or concerns about dental emergencies, please contact our office.



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