Dental Emergencies:

Below is a list of the treatment for the most common Dental Emergencies. Please follow these instructions carefully.

• TROUBLE BREATHING OR SWALLOWING
• TOOTHACHE
• BROKEN/ FRACTURED /CHIPPED TOOTH OR FILLING
• INJURY TO THE SOFT TISSUE INSIDE THE MOUTH to include tear, puncture wounds or lacerations to the check, lips or tongue
• CROWN COMES OFF (temporary or permanent crown)
• BLEEDING AFTER AN EXTRACTION
• PAIN AFTER AN EXTRACTION "Dry Socket"
• SWELLING AFTER A DENTAL INJECTION
• AVULSED (KNOCKED OUT) TOOTH
• TOOTH PUSHED OUT OF PLACE (INWARD/OUTWARD)
• ORTHODONTIC PROBLEMS -Braces
• POST-OPERATIVE INSTRUCTIONS

TROUBLE BREATHING OR SWALLOWING  

1. GO DIRECTLY TO THE EMERGENCY ROOM. THIS IS NOW A MEDICAL EMERGENCY AND YOU COULD BE IN JEOPARDY OF LOSING YOUR AIRWAY!

TOOTHACHE  

1. Try taking Tylenol or Ibuprofen to ease the pain.
2. Rinse your mouth with warm water to remove debris.
3. Use dental floss to remove any food that may be trapped between the teeth.
4. Apply a cold compress or ice wrapped in a cloth to the outside of the check if there is swelling present to reduce this swelling.
5. Use an over the counter topical anesthetic with 5%-20% benzocaine every two hours or as needed to help relieve the pain temporarily. Do not rely on over-the-counter remedies or medication!
6. If there is a hole in the tooth place Oil of Clove on a small cotton pellet and place in the site to relieve pain.
7. DO NOT PUT HEAT OR ASPIRIN ON THE SORE AREA.
8. Please contact your dentist for definitive treatment.

BROKEN/ FRACTURED /CHIPPED TOOTH OR FILLING  

1. If the tooth is broken/chipped/fractured and there is no other bodily damage requiring hospital care, please contact your dentist. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. The dentist can smooth minor chips. More severe fractures might require a filling or a crown.
2. Stop any bleeding by applying direct gentle pressure to the gums. If an upper tooth, apply pressure to the gums above the tooth. If a lower tooth, apply pressure to the gums below the tooth. Do NOT press directly on the broken tooth.
3. Rinse the mouth with warm water and apply cold compresses to reduce swelling.
4. To avoid further aggravation from the damaged tooth, place a piece of soft wax into the area that was chipped. You can also try Dentemp, a temporary filling material.
5. Eat only soft foods. Avoid this side of your mouth when eating. Avoid food and drink that are too hot or too cold.
6. Do not take aspirin or aspirin-substitutes that can slow clotting. Try 400-800 mg of ibuprofen (Advil or Motrin) or 200-400 mg of naproxen sodium (Aleve)...if you are not allergic or have any medications that could interact with these medications. Follow instructions on the bottle and your doctor’s instructions.

INJURY TO THE SOFT TISSUE INSIDE THE MOUTH to include tear, puncture wounds or lacerations to the check, lips or tongue.  

1. Clean the area right away with warm salt water.
2. Bleeding from the tongue can be reduced by pulling the tongue forward and using gauze to place pressure on the wounded area.
3. Go to the doctor/hospital if you suspect stitches might be required.

CROWN COMES OFF (temporary or permanent crown)  

1. Try to snap it back in.
2. Try Dent Temp, which can be purchased at the drug store, as a temporary adhesive OR
3. Purchase a small tube of denture adhesive paste, put a small amount in the crown and place it back on your tooth.
4. Do NOT use ordinary household glue.
5. Call the dentist as soon as possible to recement it properly.

BLEEDING AFTER AN EXTRACTION  

1. Slight bleeding after an extraction is normal. Clots usually form within one hour if you follow doctor’s post-op instructions.
2. Place a thick gauze pad over the extraction site and apply pressure by biting on the gauze. Firm direct pressure will usually stop most bleeding.
3. Avoid rinsing, drinking or eating for at least one hour following the extraction.
4. After 24 hours rinse the area with warm salt water (1/2 tsp. salt in 8 oz of water) after eating to keep the site clean.
5. Wet a tea bag and place it on the extraction site and bite on it.
6. Avoid sucking, spitting, and absolutely no smoking!

PAIN AFTER AN EXTRACTION "Dry Socket"  

1. Moderate pain is normal after an extraction. Use the pain medication given to use as prescribed.
2. If given a narcotic, alternate taking it with Motrin. Example: Take 1 Lortab now, then in 3 hours take a 800mg of motrin, in another 3 hours take 1 Lortab, then another 3 hours 800mg of motrin, etc. The theory is that while 1 pain reliever is peaking, the other is wearing off, therefore this method should provide a continuous level of pain relief.
3. If the problem persists, contact your dentist for further evaluation.

SWELLING AFTER A DENTAL INJECTION  

1. Sometimes after receiving a routine dental injection there is swelling, soreness, or stiffness when you open your jaw and bruising which can happen any time after an injection. This is especially likely to happen in patients on anticoagulant medications such as: aspirin, Coumadin, ibuprofen, and others.
2. Try a cold compress.
3. Try using a product like Tylenol or Motrin for the discomfort.

AVULSED (KNOCKED OUT) TOOTH  

1. If you were unconscious at any stage, go to the Dr. or hospital for a full assessment
2. If there are cuts to the face that need stitching, go to the Dr. or hospital.
3. If the tooth is avulsed (knocked out) and you cannot find the missing tooth/pieces, it may have been inhaled. Go to the doctor/hospital for further evaluation.
4. If the tooth is knocked out, find the tooth and pick the tooth up by the crown. (chewing surface) Avoid touching the root as this may damage the chances of it reattaching to the bone.
5. GENTLY rinse the tooth off in cool water to remove dirt, being careful not to touch the root. DO NOT: scrub the tooth, dry the tooth off or wrap in a tissue or cloth!
6. Try to place the tooth back in the socket by carefully and firmly pushing the tooth into the socket with your fingers. Bite down and hold it there with a clean wash cloth. If the tooth can be reimplanted within 30 minutes, the chance of retaining the tooth is good.
   

   The tooth can be stored in:

   water for up to 15 minutes. saliva for 30 minutes. milk for 1 hour.

7. Keep the tooth moist at ALL times. If you cannot get the tooth back in the socket and are near a drug store, purchase Hanks' Balanced Salt Solution, and follow the directions on the box. If you are unable to find this, place the tooth in clean milk. IF you do not have milk, put the tooth next to the cheek or under your lip (be careful not to swallow it) or if nothing else is available, water with a pinch of salt.
8. Try to get to the dentist within one hour and bring the tooth with you so it can be splinted in place.
9. Liquid diet.

TOOTH PUSHED OUT OF PLACE (INWARD/OUTWARD)  

1. It can be repositioned to its normal alignment with very light finger pressure.
2. Do not force the tooth into the socket.
3. Hold the tooth in place with a moist tissue/gauze.
4. It is vital to see the dentist within as soon as possible.

ORTHODONTIC PROBLEMS -Braces  

1. If a wire is causing an irritation, cover the end of the wire with some wax or a piece of gauze.
2. If a wire becomes embedded in the gum or cheek DO NOT remove it, go to the dentist immediately.