What is your dental emergency?

Bleeding

This is a genuine dental emergency, especially if it is uncontrollable and after a dental extraction. Call immediately to arrange an appointment. You may require sutures or special gauze placement to help control the bleeding. Please bring a list of any medication that you may be taking.

Broken Tooth

Teeth may break for a variety of reasons including:

• Trauma
• Dental decay
• Biting on hard foods

Treatment is dependent upon the degree of the break, how much tooth is broken and how much remains. Most teeth can have treatment to help save them, but a thorough assessment is required.

Dental Abscess

A dental abscess is a collection of pus that can form in the teeth or gums as a result of a bacterial infection.

There are two types of dental abscess:

• Periapical abscess (the most common type), when bacteria infect the inside of the tooth as a result of dental decay
• Periodontal abscess, when bacteria infect the gums

Dental Abscesses can be very painful and tender and make a person feel unwell. Without dental treatment, a dental abscess will get worse and may lead to the destruction of surrounding bone and other serious health problems.

Dental abscesses require immediate treatment, as left untreated they can cause severe pain, cause facial swellings and disrupt your day to day life.

It is important to arrange an emergency appointment to avoid the potential spread of infection. Treatment is dependent upon the severity and type of abscess, but may include root canal treatment, antibiotics, deep cleaning or extraction of the tooth.

Sports Injury

Playing football, rugby, cricket or on a set of rollerblades, sports injuries can range from minor chips of a tooth to severe cases where teeth have been knocked out, loosened or displaced. It is important with any dental trauma to arrange an assessment straight away, especially if you have disrupted the position of the tooth or knocked it out. Studies show that the highest success rates can be achieved within the first two hours.

Gum Pain

Gum pain can arise from a variety of causes, and maybe the result of something relatively minor (for example trapped food) to something that may require active treatment (periodontal abscess). It is important to arrange an appointment immediately as often this pain may escalate and may very well be the initial signs of an underlying problem.

Treatment is dependent upon the cause, but can vary from debridement of the area and antibiotics to specialist periodontal treatments.

Wisdom Tooth

Wisdom teeth are the last molars on each side of the jaws. They are the last teeth to emerge, or erupt, usually when a person is between 16 and 24.

Since wisdom teeth are the last permanent teeth to come through, or erupt, there is often not enough room left in your mouth to accommodate them. This can lead to impacted wisdom teeth - teeth that are trapped beneath the gum tissue by other teeth or bone. If teeth are impacted, swelling and tenderness may occur.
Wisdom teeth that only partially emerge or come through crooked may also lead to painful crowding and disease.

Food impaction and bacterial plaque accumulation around a wisdom tooth may set off an infection. This may very quickly spread and become very painful. Symptoms of a spreading infection may include difficulty in mouth opening and swallowing. This may or may not, be accompanied with a facial swelling. There is usually a significant amount of pain also which may radiate to the ear.

It is very important to arrange an appointment immediately, and you will probably require antibiotics to control the infection in the first instance, unless it is clinically appropriate to remove the wisdom tooth.

Lost Teeth

If a tooth is completely knocked out, it should be quickly rinsed off with water, but never scrubbed. The tooth should be held by the crown (top), not the root, so you do not damage the ligaments. In a cooperative adult, the tooth should be put back in the socket.

Many people may be uncomfortable re-implanting the tooth on their own. If this is the case, be sure to transport the tooth to the doctor or dentist in saline, milk, or saliva.

You may also place the tooth between the cheek and gum line of either the person who lost the tooth or any willing adult. The mouth is the best place for the tooth because it protects the root by keeping it moist and providing protection against bacteria.

Do not transport the tooth dry. This will cause damage within minutes. Transporting the tooth in water is also not recommended.

Lost Filling/Crown

It is important to see a dentist as soon as possible if you are unlucky enough to lose a filling or a crown. You may or may not have pain or sensitivity, but the longer you leave a tooth without a protective covering, the higher the chances of you possibly developing a problem, or exacerbating an existing problem. The loss of a filling or crown may also have occurred as a result of an underlying problem, for example dental decay.

Extraction Pain

Following dental extractions, there is likely to be some discomfort, but this should subside within 24 hours and should respond well to painkillers. If persistent pain is occurring after this period, then there is a chance that you may have developed a post extraction infection. This is much more likely if you are a smoker.

It is important to arrange an appointment to see a dentist, as left untreated these can become quite painful. Treatment normally consists of stopping smoking, irrigation of the extraction site, placement of an antiseptic dressing and use of antibiotics.

Root Canal

The crown of the tooth is made up of the hard, white, enamel layer and a thicker dentine layer. Both these hard layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves within and extends from the crown to the tips of the root or roots.

Root canal treatment involves the removal of the pulp tissues from the tooth in the event that it gets infected or inflamed. The pulp can be infected or inflamed due to either deep decay or an extensive restoration that involves the pulp, cracked or fractured tooth due to trauma, excessive wear of enamel and dentine exposing the pulp, and sometimes as a result of severe gum disease.

Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discolouration of the tooth, swelling, tenderness of the overlying gums or a bad taste in the mouth.
Root canal treatment saves teeth that would otherwise have been extracted.

Toothache

Sudden excruciating pain or toothache may indicate the deep spread of decay in the tooth. Often, root canal treatment is necessary. If you note mild symptoms on the teeth, a check-up with your dentist will help prevent a bigger problem from occurring.

Features:

• may start with sensitivity to hot or cold drinks and food
• sudden pain from tooth or jaw usually of moderate to severe intensity
• pain may last a few days or longer
• pain can be related to one tooth or over a wide area
• painkillers may provide temporary relief
• swelling could occur

Causes:

• decayed teeth
• history of trauma to teeth
• cracked teeth from excessive wear, chewing on hard foods

Management depending on cause:

• remove decayed area and protect tooth with filling
• root canal treatment if decay is extensive and has affected nerve of the tooth
• drainage of swelling
• antibiotics for swelling
• extract tooth if not restorable

Dental Trauma

We deal with all manner of dental trauma, from accidental trips and falls to sports injuries and assaults.

Treatment really is dependent upon the extent and degree of trauma.

Knocked out and displaced teeth can normally be replanted and splinted. If the tooth has been knocked out, it is important to care for it appropriately. Keep it clean, don't scrub the root, try to keep it in the socket if possible or in milk/contact lens solution. The important thing is not to let it dry out, and to avoid further damage to the root. It is ideal to see a dentist within two hours of the incident, but sometimes this is not possible-as long as the tooth has been cared for, it may still be replanted.

Minor cracks and chips can be restored by either bonding the fractured portion back to the tooth or restoring the missing part with some composite filling material.