Emergencies

What to do when something goes wrong

Accidents Happen!

knocked-out-tooth

A Knocked out Tooth

If your tooth is knocked out, softly lift it up by its crown and wash it carefully. There can be gum tissue remaining so leave it in place, and gently place the tooth inside the mouth against the cheek. If this isn't possible, put milk into a container and put the tooth inside it until you get to the dentist. The sooner you attend the dental clinic the more chance you have to save your tooth, so call as soon as possible for an appointment.
If your child's tooth is knocked out, click here to see further info.

De Politikaner - Fotografía propia, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=8842500

A Broken Tooth

If a section of your tooth has been damaged or knocked out, please contact us right away for an emergency check-up. Cleaning out your mouth using warm water is helpful and you can use a cold compress for any swelling.

bitten lip or tongue

Bitten your lip or tongue badly

All lacerations (cuts) within the mouth must be cleaned well and checked for any foreign bodies. A tongue laceration usually requires stitches if the edges of the tissue do not line up cleanly. Any tears to the frenum (muscle attachments) will usually heal well, without any long-term complications. Use an icepack to minimize swelling, and give the appropriate pain medication if necessary. Tongue laceration bleeding can be decreased by moving the tongue into a forward position and using a cloth to put strain on the wounded area. If you are in pain and losing blood, visit your closest emergency room because you may need stitches. If you have not managed to halt the bleeding with a compress or cloth, then this is the best course of action.

broken jaw

Worried your jaw is broken

Pain following an injury or accident involving your jaw means you may need to attend your local hospital. Apply a cold cloth to the area to ease swelling.

tooth ache

You have toothache

There are several reasons for toothache, but it is usually due to dental infection. If the toothache has become worse over time, use warm water to rinse your mouth and then gently floss to remove any bits of food that could cause infection. If this does not work, get in touch with the dentist to receive treatment and prevent the spread of infection. Although painkillers can sometimes lessen the pain of sore teeth and gums, do not let them rest on your gums as this can cause the gum tissue to burn.

dental problems

Dental Injuries

There can be many accidents to the mouth where teeth are evulsed (knocked out), broken (fractured) or forced out of their original position (extruded). Cheeks, gums and lips can also suffer cuts. The occurrence of oral injuries can be very painful and in such cases you should visit your dentist as quickly as possible.

glass of milk

Teeth that are Evulsed

If a tooth has been knocked out you need to contact us for a dental appointment and see if you can recover the tooth. If you find the tooth then you should gently rinse it, without scrubbing too hard, to get rid of dirt. Put the sanitised tooth in between your gum and cheek. Don't try to put the tooth back in the opening as this could lead to more damage. Visit the dental practice as soon as you are able to. If you can get there in around half an hour after the incident, it is feasible to restore the tooth. If there is no way to store the tooth in the injured person's mouth (for example, young child) gently cover the tooth in a dirt-free cloth and put the cloth into milk.

knocked-out-tooth

Extruded Teeth

In cases where the tooth is somehow knocked or moved out of position (outward or inward) it needs to be realigned to its usual position with gentle finger pressure. You should not pressure the tooth into the opening. Keep the tooth in position with a damp tissue. As with evulsed teeth it is important to go to the dentist within half an hour. The treatment of a fractured tooth will come down to how bad the injury is. Irrespective of the injury the treatment will be based on the dentist's guidance.

cracked-tooth

Small Fractures

Small fractures can easily be smoothed down by the dental practitioner with a small sandpaper disc or they may be left alone. The other alternative is to reinstate the tooth through a composite restoration process. Whatever treatment is applied you should look after your teeth for the next few days.

knocked-out-tooth

Moderate Fractures

Dentin, pulp and enamel are associated with moderate fractures. If the pulp is not damaged in a permanent fashion, the tooth could be fully repaired with a permanent crown. In cases where there is damage, additional action will be needed.

knocked-out-tooth

Serious Fractures

Severe fractures can result in a traumatised tooth and there is a limited possibility of mending. Injuries to the interior of the mouth comprise puncture wounds, lacerations and tears to the lips, tongue or cheek. The wound needs to be cleaned immediately and the person assisted to the treatment room for wound repair and suturing.

child-closed-mouth

Child's tooth gets displaced

After assessing the injury, making sure your child is conscious and breathing well, contact your child's dentist for an immediate evaluation. For toddlers, the most common type of tooth displacement is a luxation, because the bone around the baby teeth is very soft, and teeth can move more easily within the socket. When this happens, there is usually a lot of bleeding from the surrounding gums. During a fall, a child's tooth is usually pushed inward, towards the palate. This is less damaging to the developing tooth bud because as the crown portion of the tooth moves inward, the roots are pushed away from the developing tooth. The most damaging type of displacement is intrusion (when the tooth is pushed upward). The root of the baby tooth can be forced into the developing tooth bud, causing possible developmental issues and color changes within the developing adult tooth. If the baby tooth is pushed up less than 3mm, it has an excellent prognosis and chance of re-erupting on its own. Allow the baby tooth to spontaneously erupt over a 2 to 3 month period (as long as the developing adult tooth bud is not injured). If re-eruption does not begin within 2 months, the baby tooth will need to be removed. If the baby tooth is pushed up more than 6mm, the tooth is hopeless. If the baby tooth is displaced into the developing adult tooth, it should be extracted to prevent further damage to the adult tooth bud. It is very important to take an x-ray to see if the tooth is present, because a severely intruded tooth may be pushed all the way inside and appear to have been knocked out.

If an adult tooth gets displaced, gently try, if possible, to reposition the tooth back into the right place, hold it there, and seek immediate dental care. If a tooth gets displaced less than 5mm, there is a 50% chance that the nerve won't be damaged. These teeth may reposition themselves, but may also require orthodontic repositioning. It is possible that there could be a fracture of the bone surrounding the tooth during these luxations. If the tooth is very loose, and can be moved more than 2mm, a flexible wire and composite splint may be placed for 7-10 days to help stabilize it.

child-smile

Child's adult tooth gets knocked out

The first thing you should do is try to find the tooth and put it in a cup or baggie with your own saliva, milk or saline (to keep it hydrated) and bring it immediately to your dentist (Do Not Touch the root of the tooth, handle it by its crown). Time is of the essence. With each minute that passes the chance of reattachment diminishes. DO NOT SCRUB the tooth. If you do, it will wipe away its outer ligament and prevent its reattachment within your empty tooth socket. If you are in a place where dental care is not accessible, immediately start replacing the tooth back within the socket (slowly and carefully), and hold it there with gauze. If there is dirt on it you may gently rinse in cool water (no scrubbing or using soap) before replacing the tooth within the socket, otherwise just leave it alone. Remember, the faster you act, the better your chances of saving the tooth. Almost all replanted teeth will show some signs of root resorption and ankylosis (where the root fuses with the surrounding bone). It is possible that this may affect one's bite later on.

baby teeth

Child's baby tooth gets knocked out

Contact us as soon as possible. The baby tooth should not be replanted because it may cause subsequent damage to the developing permanent tooth. Usually this type of injury happens between 7-9 years of age, when the bone surrounding the tooth is softer and more resilient. This means there is less of a chance of a bone fracture around the tooth. Your dentist should then see your child to check and verify that everything else is fine.