ROYAL YORK DENTAL
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416-231-0550
416-231-0550
3034 Bloor Street West | Toronto, Ontario | M8X 1C4
416-231-0550
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How to Survive Common Dental Emergencies
Toothache
Front Tooth Knocked Out
Fractured Tooth
Broken Tooth or Filling
Cracked Tooth
Abscessed Tooth
Lacerations
What to Do in a Dental Emergency
A dental emergency involving an injury to the teeth or gums can be potentially serious. Call immediately and we'll take care of you.
What happens when you're out of town, or out of the country? You may need to take care of things yourself until professional help is available.
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Here's a quick summary of what you can do to alleviate some common dental problems.
Toothache
Many dental emergencies in our office fall into this category. Something hurts but it's uncertain which tooth may be the culprit and why it's acting up. Sometimes the pain is relatively mild, sometimes it's excruciatingly severe.
Your best move is to call and arrange a dental visit ASAP before it gets any worse. Once you're here, our job will be to detect and correct - diagnose the source of your pain and eliminate it. Sometimes we can zero right in on the problem and come up with a "magic bullet" solution that corrects your situation. Sometimes the signs and symptoms are less clear and we can't be certain of the source.
What can you do about it in the meantime?
Treat your symptoms until we can have a good look at things and zero-in on the problem. Take Ibuprofen (Advil, Motrin) for the pain rather than Tylenol. That extra anti-inflammatory affect can be a big help. Keep the area clean and avoid chewing anything on it.
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Dr. Joe Bulger on Toothaches... Pain can be your friend. I know that could be a real tough sell when you're suffering from it. Please hear me out... Pain is your built-in alarm system, telling you something is wrong or to stop doing whatever is causing it. Tooth pain can help alert you to any trouble that's brewing inside your mouth. It also motivates you to act and finally do something about the problem. That's not to say you should let pain be your only stimulus to act. The whole point of preventive measures is to take action that will prevent illness, pain and suffering in the first place. How much pain you feel doesn't necessarily indicate the severity of your condition. Some people think that if something doesn't hurt much, it can't be all that bad. That's not how it works. Pain isn't an accurate indicator of severity. Even if pain isn’t a good indicator, it sure is a great motivator. It’s easy to get motivated when something hurts like heck. Better to take care of problems long before things ever get that bad. |
Front Tooth Knocked Out
What do you do when someone has an adult tooth knocked out? People literally have nightmares about this, and yet it's a relatively rare occurance. It's still worth mentioning here because knowing what to do can make a HUGE difference.
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Pick up the tooth (without touching the root part), gently rinse it off and quickly put it back in! The best place for a tooth is right back in the socket where it came from. Where it can maintain a nutrient and oxygen-rich blood supply.
There are living cells on the surface of the root, and they'll quickly die off if the tooth dries out. Those cells can also be harmed if you vigorously clean the root. If you lose those cells, that tooth loses it's ability to properly re-attach to the bone.
So quickly rinse the tooth off and immediately reinsert it.
If the tooth can't be reinserted, place the tooth in some contact lens solution or milk and get to the dentist immediately. It must be reinserted within 1 hour to have any chance of reattaching properly.
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Tooth Knocked Out Story (what NOT to do)... When my nephew Peter was 8 years old, he knocked his left front tooth loose while skiing in Quebec. His dad noticed it was only hanging by a thread, so he plucked it out and put it safely in his pocket. That wasn't the right move. They skied down to the bottom of the hill and went to the ski patrol. Luckily the ski patrollers knew exactly what to do. They rinsed off the tooth and put the it back in. Unfortunately, that tooth had been in his dad's pocket for a good 20 minutes. Back in Toronto, I sent young Peter off to a specialist to perform root canal therapy. The tooth had a questionable long-term prognosis, but we made every effort to save it. That tooth lasted for a few years, but it ankylosed (fused) to the bone and gradually became misaligned as Peter grew. Peter's bone began eating away at the root. Eventually, he lost his front tooth and needed an dental implant to replace it. All the struggles, even the root canal, could have been avoided if Peter's dad knew what to do in that moment. All he had to do was push his son's tooth back in instead of pulling it out. This circumstances of that story are not unique. We've had a few other parents in this very situation - caught not knowing what to do. Their children also lost teeth as a consequence. |
Fractured Tooth
Something hard banged into your front teeth and a piece of your tooth broke off. This is far more common than knocking out a tooth.
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What do you do? Save the broken piece if you can. If you have bleeding, rinse with warm water and apply pressure with clean gauze. If your lips or face were impacted, apply a cold compress to the area to mimimize swelling. Take Ibuprofen to help keep your teeth from over-reacting to the trauma. Get in to see us as soon as you can.
The good news is your tooth is usually easy to repair with Bonding (white filling). The bad news is it could be more serious than you think. Sometimes the pulp (nerve) of the tooth is traumatized to the point that root canal therapy is required. Sometimes the remaining tooth is compromised to the point of needing extensive restoration such as a crown. Sometimes the tooth can be so badly damaged that extraction is required.
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Fractured Tooth Story... With a trauma situation, there can be multiple teeth involved. Perhaps only one broke, but 3 or 4 may have been impacted by the blow. Sometimes a tooth that breaks is better off than one that doesn't. The broken one releases the energy of the blow, while the unbroken one absorbs it all. You never know. We may fix the broken one, but a few weeks later we might see that unbroken tooth changing color and the area starting to swell. We had a university student to us recently that had been knocked unconscious with a punch. The attacker was probably wearing rings on his fingers that added to the force of the blow. The student had multiple teeth damaged on top and bottom, including one knocked out completely and others that were bent out of position. His jawbone had fractured as well. As bad as things looked, I was able to quickly repair some of his broken teeth and get his smile back. His soft tissues mended quickly, the bone more slowly. The first few weeks after any injury is critical in the recovery. If the pulp of a tooth is going to die, that's when it's likely to happen. I usually advise to take Ibuprofen with meals for 4-5 days afterwards to help calm the teeth down. Keep checking the teeth and gums for changes such as swelling or discoloration. Call us if there seems to be any change for the worse. ~ Dr. Joe Bulger |
Broken Tooth or Filling
You bit down into something and a piece of your tooth (or filling) just broke away. You feel a jagged edge with your tongue and it's now sensitive to cold. Food is now getting stuck between your teeth.
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What do you do? Avoid chewing on that side. Keep the area clean. Come in to see us at a reasonable convenience.
In most cases this is a routine thing. We see a lot of broken teeth, particularly around large fillings. The bigger the filling, the weaker the remaining tooth.
Most breaks are minor and can be attended to at a reasonable convenience. How do you know if it's not just a minor break? If you start experiencing significant pain or facial swelling, you've probably got more than a broken tooth to deal with.
Dr Bulger shares, "Broken teeth are rarely out of the blue. Perhaps you bit down unexpectedly on a popcorn kernel a while back. Now, seemingly out of nowhere, the side of your tooth falls off. Unknowingly, that tooth had been an accident waiting to happen. Another scenario is having a cavity slowly progress between the teeth. Gradually the tooth hollows out like an eggshell. One day the enamel shell on the tooth caves in and you've got a gaping hole."
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You bit down on something and got a jolt of pain. Nothing broke off, but it felt like it was going to break and now it's sensitive to cold and chewing pressure.
A cracked tooth is one that's been weakened and could break at any time. We see lots of cracks on teeth, but not all are sensitive. On the other hand, a cracked tooth can sometimes be more sensitive than a broken tooth. Why? The crack will flex under chewing pressure, triggering a jolt of pain. Especially when eating something more firm.
What do you do? Treat it just like a broken tooth. Avoid chewing on it, keep it clean, and come visit us at a reasonable convenience.
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Cracked Tooth Story ... We had one patient that kept cracking her back teeth. After numerous root canals and crowns I half-jokingly asked her if she was chewing a lot ice cubes and popcorn kernels. Turns out she was, with great frequency! She had a "crunchy food" addiction - she loved the sensation of biting hard on extremely crunchy things. If I didn't convince her to stop she was going to destroy all her back teeth. ~ Dr. Joe Bulger |
Abscessed Tooth
You woke up with part of your face swollen, a bad taste in your mouth and your tooth feels loose. Perhaps you've notice a boil or blister on your gum beside one of your teeth. Perhaps it's been there for a while and it swells up off and on.
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An abscess is an infection and it's fairly common around teeth. A deep cavity, trauma and extensive dentistry can all lead to a non-vital tooth. Once a tooth is dead, bacteria from your mouth can infect the inside of it. Your bodies defenses can't get inside the tooth to eliminate the infection.
An abscess can also occur in the gums. In that situation, the tooth is still alive, but an infection has started brewing under the gums. We don't usually see gum infections that severe with people who are making regular visits to the dentist.
Some people will leave an abscessed tooth unattended for a long time because they don't have much pain from it. That's not wise. Pain or not, an abscess is a potentially serious problem. Back before the days of antibiotics, death from a tooth infection was a frequent occurrence. Infections tend to spread, and with teeth infections can spread to the brain.
What do you do with an abscessed tooth? First you'll need antibiotics to get the infection under control. After that, we can treat the tooth properly. That will usually involve a deep cleaning (for gum infections), root canal therapy, or an extraction.
Lacerations
Cuts to the soft tissues of the mouth - the lips, cheeks, gums and tongue - can be alarming because of the bleeding involved. There's very good blood supply to these areas and that means a cut can induce significant bleeding. Blood in the mouth will mix with saliva to give the appearance of even more blood. Small wounds around the mouth can appear much worse than they really are.
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Here's what to do:
1. Clean the wound. Rinse your mouth with warm water. You can add a slight amount of salt to make a mild salt-water solution.
2. Assess the damage. How deep is the wound? Is this an emergency medical situation, or a dental situation? Is professional help needed?
3. Use a pressure bandage to reduce bleeding. Apply pressure to the site with moist gauze or a teabag. Hold in place for 15-20 minutes.
4. Use a cold compress to reduce swelling. Lips tend to swell. A plastic bag with crushed ice (or frozen peas) wrapped in a towel makes an effective cold compress.
5. Take pain-relief medication. Over-the-counter Tylenol or Ibuprofen should help reduce any discomfort.
6. Seek definitive care. Yes, you can rush off to the hospital. However, you may end up waiting a few hours in their Emergency Room. Call us and we'll assess the situation ASAP. We can advise you if you do need further medical assistance.
Call our New Patient Hotline 416-231-0550 to take care of your smile.
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