Seeing a dentist regularly is important not only for check-ups to maintain your good oral health, but also to ensure that there is someone available for you when that unfortunate situation arises where you or your family member needs emergency care. Four common emergencies that may require an immediate call to your dentist are: a tooth that has been knocked out, a broken tooth, a crown that has come off, or a toothache.
If an entire permanent tooth, root and all, has been knocked out, hold the tooth by the crown portion and rinse the root off if it is dirty. Do NOT scrub the tooth or remove any tissue fragments. If possible, try to place the tooth back into its socket. Otherwise, place the tooth into a cup of milk or hold it in your mouth next to your cheek to try to maintain a normal pH and keep the root from drying out. If the tooth is a primary (baby) tooth, do not try to reimplant it without your dentist’s recommendation as it may damage the underlying permanent tooth that is developing. In any case, see your dentist as soon as possible! Your dentist will check for root fractures and make sure no pieces of the tooth have broken off inside your lips, cheeks, or tongue.
The tooth may also need to be stabilized with a splint, and root canal therapy (removal of the tooth nerve) may be necessary.
If a portion of your tooth has broken, call your dentist immediately to see what his or her recommendations are. A front tooth that has been chipped may not be painful, but certainly may pose an esthetic emergency! Larger fractures of front or back teeth may expose the underlying dentin, which can be sensitive to cold, heat, or air, or may even expose the nerve of the tooth. You may or may not need to be seen by your dentist right away depending on the depth of the fracture.
If your tooth has a crown or cap that has come off and the tooth is not painful or is sensitive only when air, heat, or cold are applied, you may be able to give yourself a quick fix by obtaining some temporary cement from your pharmacy until your dentist can see you. First, try on the crown to be sure you can place it on correctly. Bite down to check that it does not feel too high. You may need to remove some of the old cement from the inside of the crown with a toothpick. Dry the inside of the crown with a cotton swab, and also try to get the tooth as dry as possible. Being sure to follow the cement’s package directions, lightly line the inside of the crown with the temporary cement and place the crown on the tooth. Bite down on a cotton swab or press firmly with your finger. Again following the package directions, once the cement is slightly set (usually within 2 minutes) remove any excess with a toothpick and floss. See your dentist soon to have the crown removed, the tooth checked for possible decay under the crown, and the crown recemented permanently or replaced if necessary.
There are many causes of a toothache. Call your dentist immediately to discuss whether your symptoms warrant an emergency visit. A dull ache or throbbing can indicate an infected or damaged tooth nerve, and root canal therapy may be needed. Pain upon biting may be a sign of a cracked tooth, and the tooth may need a crown or new filling. Occasionally sinus problems and TMJ dysfunction can mimic a toothache. In any case, your dentist should be informed, so that together you can decide if you need to be seen right away. No one wants to be calling all over town looking for a dentist when an emergency arises. Having a relationship with a dentist is important for keeping your teeth healthy and for knowing a friend who cares about you when you have a dental concern, so be sure to get yourself and your family members established with a local dentist.