A True Dental Emergency

Often as parents we are caught in the middle of the dilemma of calling or not calling the emergency number to our doctors or dentists. The emotions of fear, crying children, fevers, or blood spread panic. We don't want to call if it's unnecessary, but we do want to make sure all is well. So our Smiles For Kids team wanted to make it easier on parents and provide a guide to dental emergencies.

BABY TEETH often fall victim to unstable first steps, and poor decision making of a young explorer. Front teeth are often broken, moved, and otherwise abused. Often children have a thick and low positioned frenulum (piece of fleshy tissue) that holds the lip to the gums between the two front teeth and is very vascular. That area bleeds heavily when cut. Gums and lips around those front teeth are also easily bruised and bleed freely. Whenever those front teeth and surrounding soft tissues are injured it is best to call the dentist. Injuries include fractures, complete loss of a baby tooth, teeth being pushed into the gums, misplacement of teeth, or soft tissue bleeding. Many times we can simply discuss the details on the phone and look at texted photos, which will help us make a decision on whether this is an emergency needing immediate attention (rarely) or something that can be looked at during regular business hours within a day or two. Most of the time, waiting for a little while is perfectly fine, as long as bleeding and pain are controlled. However, you do want to see your dentist soon as an x-ray must be taken to rule out fractures of the bone or roots and to have a baseline image in case of future injury in the area. Many times these teeth heal on their own with occasional darkening, but serious fractures might warrant extractions. Another baby teeth dental emergency is pain connected to an abscessed (infected) tooth. This is usually preceded by large decay or previous treatment such as a large filling or a crown. An abscess usually presents as swelling, pimple on the gum, redness, and pain. This pain cannot be easily controlled and requires treatment with antibiotics and eventual extraction of the baby tooth. It is very important to call your dentist as this infection can spread and have serious consequences. Your dentist will either see your child within a short period of time or call in antibiotics and see you within few days for extraction once the infection is controlled.

ADULT TEETH are a bit different ball game as we must do everything we can to save them from consequences of the injury. Dentists are much more likely to come in after hours to treat an adult tooth emergency. Infections of permanent teeth need to be seen by a general dentist or a root canal specialist (endodontist) and will be eventually treated with a root canal. Initially we might call in an antibiotic to control the infection. Front teeth fractures are the most common adult teeth emergencies. Call your dentist immediately and email or text them photos of the fracture from various angles to determine urgency of the appointment. These teeth must be restored soon, but immediate action is needed only if the nerve is exposed or if the patient has sensitivity. The most urgent front tooth injury and one that requires immediate attention to ensure a chance of survival for the tooth, is avulsion, or complete loss of an intact tooth. Here time is of essence and you MUST immediately call your dentist and meet him or her in the office to have the tooth reimplanted within minutes. It is best if you can put the tooth back in the socket or store in patient’s saliva. If you cannot do this, your second best option is milk. However, DO NOT let the tooth stay dry on your way to the dentist and DO NOT put it in regular water (saline solution is fine).

There are probably million other reasons why you would and should call your dentist. Dr. Lindhorst or Dr. Jadav are always on call with cell phone in hand to ease anxiety, look at photos, and to answer any questions. If in doubt, call!