DENTAL EMERGENCIES

• ACCIDENTAL BITTEN TONGUE/LIP
• BLISTERED LIPS
• LOOSE TOOTH-CHILDREN
• NUMBNESS CONTINUES
• OBJECT WEDGED BETWEEN TEETH
• PREGNANCY AND DENTAL PROBLEMS
• SAVE-A-TOOTH
• MOUTH SORES COLD SORE
• CORNER OF THE MOUTH; CRACKED AND/OR SORE
• SORENESS INSIDE YOUR CHECK
• SWELLING AFTER A DENTAL INJECTION
• TOOTHACHE
• TOOTH KNOCKED OUT
• TOOTH PAIN-NON DENTAL CONDITIONS THAT CAN CAUSE
• TOOTH KNOCKED OUT-CHILD'S "BABY TOOTH"
• TOOTH PUSHED OUT OF PLACE (INWARD/OUTWARD)
• TOOTH SENSITIVITY
• TOOTH SENSITIVITY AND JAW PAIN UPON WAKING
• TRAVEL DENTAL EMERGENCY KIT
• WHAT TO TELL YOUR DENTIST WHEN YOU CALL:
• WISDOM TEETH-PAIN FROM BACK BEHIND A "BACK TOOTH"
• YEAST INFECTION

Dental Emergencies when YOU ARE ALONE

ACCIDENTAL BITTEN TONGUE/LIP

1. Apply direct pressure to the bleeding area with a clean cloth
2. Clean the area gently with a cloth
3. If swelling is present apply a cold compresses to reduce swelling
4. If bleeding does not stop go to the doctor/hospital
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BLISTERED LIPS
1. Could be due to sunburn. Try a lip balm with SPF of at least 15 or
higher.


LOOSE TOOTH-CHILDREN

1. If they have a loose tooth with no decay or swelling present you need to reassure them that this is "normal" and they are getting their "big teeth" or "adult teeth" in
2. Have them rinse with salt-water rinses three to four times a day
3. Use Tylenol to help with the discomfort
4. Gently help them to wiggle the tooth to help it come out sooner.


OBJECT WEDGED BETWEEN TEETH

1. Use dental floss and GENTLY guide it through, to avoid cutting the gums, to remove the object
2. Avoid using a sharp/pointed instrument to get it out, it will only cut the gum
3. If you can't remove it, contact the dentist


PREGNANCY AND DENTAL PROBLEMS

1. Your gums may swell and possibly bleed due to high hormone levels
2. Keep your mouth clean by gently brushing and flossing after each meal
3. Keep your regular recare appointments with the dentist


MOUTH SORES

1. Canker sores are small and painful inside the mouth. Apply an over the counter medicine like Orajel, Zilactin B or Orabase B campho-phenique that will produce a bandage like film over the sore by applying three times a day or as directed
2. Avoid triggering foods like nuts, chocolate, acidic fruits. Avoid trauma: like toothbrush trauma, cheek biting, etc. Avoid Sodium Lauryl Sulfate often found in most toothpaste and tarter- control toothpaste.
3. Ask the dentist for a prescription of peridex and/or Aphthasol
4. Supplement your diet with a very high potency multi-vitamin with iron
5. If persists for more than 14 days see your dentist/doctor


COLD SORE

1. Try putting an application of a topical prescription of Zovirax
2, Contact your dentist/doctor for a systemic prescription


CORNER OF THE MOUTH; CRACKED AND/OR SORE

1. This can be caused by a yeast infection. This especially can happen in older adults due to decrease in skin elasticity, decrease in tooth length, and loss of back teeth or improperly fitting dentures/partials
2. Contact your doctor for a prescription anti-yeast cream like Mycolog and apply it three to four times a day for a week
3. Make a follow up appointment with the dentist to have the fit of your denture or partial evaluated


SORENESS INSIDE YOUR CHECK

1. This can be knows as "lichen planus" and could be caused by nuts, chocolate, acidic fruits, sodium lauryl, medications or stress so try avoiding these items to see if it helps
2. Contact the dentist is it is persistent

SWELLING AFTER A DENTAL INJECTION

1. Sometimes after receiving a routine dental injection there is swelling, soreness. stiffness when you open your jaw and bruising which can happen any time after an injection. This is especially likely to happen in patients on anticoagulant medications such as: aspirin, coumadin, ibuprofen, and others.
2. Try a cold compress
3. Try using a product like Tylenol for the discomfort
4. Immediately notify your dentist

TOOTHACHE

1. Try taking Tylenol or aspirin substitute to ease the pain
2. Rinse your mouth with warm water to remove debris
3. Use dental floss to remove any food that may be trapped between
the teeth
4. Apply a cold compress or ice wrapped in a cloth to the outside
of the check if there is swelling present to reduce this swelling
5. Use an over the counter topical anesthetic with 5%-20% benzocaine every two hours or as needed to help relieve the pain temporarily. Do not rely on over-the-counter remedies or medication!
6. If there is a hole in the tooth place Oil of Clove on a small cotton
pellet and place in the site to relieve pain
7. DO NOT PUT HEAT OR ASPIRIN ON THE SORE AREA. Remember relief is only temporarily so………
8. Go to see the dentist
9. A new product is out that might give some temporary relief: Zilactin Toothache Swabs with benzocaine to offer instant relief from tooth and gum discomfort.


TOOTH KNOCKED OUT

1. If you were unconscious at any stage…go to the Dr./hospital for a full assessment
2. If there are cuts to the face that need stitching…..go to the Dr./hospital
3. If the tooth is knocked out and you can not find the missing tooth/pieces it may have been inhaled so to the Dr./hospital
4. If the tooth is knocked out, find the tooth and pick the tooth up by the crown (chewing surface) NEVER the root as this may damage the chances of it reattaching to the bone
5. GENTLY rinse the tooth off in cool water to remove dirt, being careful not to touch the root. DO NOT: scrub the tooth, dry the tooth off or wrap in a tissue or cloth!
6. Try to place the tooth back in the socket by carefully and firmly pushing the tooth into the socket with your fingers. Bite down and hold it there with a clean wash cloth. If the tooth can be reimplanted within 30 minutes the chance of retaining the tooth is good.
The tooth can be stored in: water for up to 15 minutes.
saliva for 30 minutes.
milk for 1 hour.
7. Keep the tooth moist at ALL times. If you can not get the tooth back in the socket place it in clean milk, sterile contact lens saline, or saliva. If you don't have milk put the tooth: next to the cheek or under your lip (be careful not to swallow it); emergency tooth preservation kit or if nothing else is available, water with a pinch of salt.
8. Try to get to the dentist within one hour and bring the tooth with you so it can be splinted in place
9. Liquid diet.


NON DENTAL CONDITIONS THAT CAN CAUSE TOOTH PAIN

1. Sinus problems due to being clogged from allergies or cold viruses that can become infected to swell and put pressure all over the bone. This puts pressure on all the upper teeth and can make them hurt, be sensitive to hot, cold and pressure and even hurt to bite. You need an X-ray of the sinus area. See your doctor for possible antibiotic and decongestion therapy
2. Referred pain. Sometimes your body has a hard time interpreting where pain is coming from. Studies show that 30% of pain that is referred from the heart goes to the lower jaw. If this occurs during exertion notify your doctor immediately.


TOOTH KNOCKED OUT-CHILD'S "BABY TOOTH"

1. If they were unconscious at any stage…go to the Dr./hospital
2. If there are cuts to the face that need stitching..go to Dr./hospital
3. Primary/deciduous/baby teeth are not replaced due to ankylosis that can cause cosmetic deformities and interfere with the eruption of permanent teeth. Many of these teeth will not even have a root to reimplant.
4. Use a cold compress or ice in a cloth for swelling
5. Give Tylenol for discomfort
6. Contact the dentist to determine if your child needs to be evaluated for a space maintainer to keep this space open for the eruption of their permanent tooth.


TOOTH PUSHED OUT OF PLACE (INWARD/OUTWARD)

1. It can be repositioned to its normal alignment with very light finger pressure
2. Do not force the tooth into the socket
3. Hold the tooth in place with a moist tissue/gauze
4. It is vital to see the dentist within as soon as possible

TOOTH SENSITIVITY

1. Avoid extreme hot and cold foods
2. Use a toothpaste for sensitive teeth
3. Apply desensitizing toothpaste directly on the tooth with a Q Tip
4. Have regular fluoride treatments by the dentist to remineralize this area
5. Brush teeth gently after every meal
6. See the dentist for treatments available for this condition


NUMBNESS CONTINUES

1. If a tooth has been extracted on the lower back area, it is possible that you may not regain full sensory feelings immediately
2. After 24 hour contact your dentist to let him know your symptoms

JAW PAIN AND TOOTH SENSITIVITY UPON WAKING

1. You may be grinding your teeth at night. This requires a visit to the dentist for adjustments, nightguard or future evaluation

WHAT TO TELL YOUR DENTIST WHEN YOU CALL:

Questions will you be asked when you have a toothache and call your

• How long has it hurt?
• What makes it hurt? Does it keep you awake at night?
• How much does it hurt?
• Have you been taken anything for the pain?
• What is the location of tooth or pain?
• What symptoms are you having? (swelling, fever, pain)
  This is done to determine the type of emergency treatment you require. Make sure to follow up on what the dentist tells you and to attend your return appointment.
  Remember antibiotics are not the answer for all situations. An antibiotic will only keep the infection from spreading and can be used to rule out sinusitis and other infectious outside the tooth.
  Antibiotics cannot clear up an infection inside the pulp of a tooth. Taking too many antibiotics can cause you to build up an immunity to antibiotic therapy in your future.

PAIN FROM BACK BEHIND A "BACK TOOTH"-WISDOM TEETH

1. You may have a wisdom tooth coming in. They can easily get infected and cause swelling, pain and even a fever
2. Try salt water rinses (1/2 tsp. salt with 8 oz. of water)
3. Try to control the pain and fever with ibuprofen or Tylenol
4. Call your dentist to get evaluated

YEAST INFECTION

1. Yeast is a common inhabitant of the mouth. There will be a Yellowish like mass, burning feeling and bad breath.
2. Contact the doctor/dentist for a prescription of " Nystatin or another type of anti yeast medication.
3. If you wear dentures or a partial denture thoroughly clean them and try soaking them in a solution of "Nystatin"

DENTAL EMERGENCY WHEN ALONE

What to Do in a Dental Emergency When You're All Alone
There is nothing worse than being on your honeymoon, in-flight, on a camping trip, or on a long car ride when it strikes -- an unrelenting toothache so severe you feel like you want to die. Knowing what to do can prevent major discomfort.
Fortunately, the chance of an unforeseen dental crisis can usually be prevented by early detection and treatment of dental disease. When dental disaster does strike (and it always seems to be at the most inopportune time), knowing how to alleviate the pain is invaluable information everyone can use.

A toothache is any pain or soreness within or around a tooth, indicating inflammation and possible infection. Generally, a toothache occurs if tooth decay is very close to or has penetrated the pulp chamber that contains nerves and tiny blood vessels. Ideally, it's best to undergo dental treatment.

Toothache caused by trapped food: rinse the area with warm water and swish it about. It may loosen whatever is causing the pain. Alternatively, a cotton ball soaked in lime juice can be placed on the tooth. You can also try using this poultice: Steep a teaspoon of yarrow in hot water, drain the liquid with a piece of gauze, and then put it on the tooth.

Over-the-counter pain relievers to cure toothaches : paracetamol, aspirin and acetaminophen. If you feel that a small swelling has occurred, you may take non-steroidal anti-inflammatory drugs (NSAID) for their inflammatory components, like ibuprofen and mefenamic acid. (However, those with a history of ulcers as well as pregnant women need a doctor's recommendation before taking NSAID and aspirin.) Rubbing aspirin on your gums to numb an aching will do more harm than good. Aspirin contains salicylic acid, which can burn and damage gum tissue. Try pain-relieving gels like Anbesol or Orajel.

Home remedies for a toothache include: rinsing your mouth with salt water or dabbing some clove oil directly on the bad tooth. Clove oil has bacteria-slaying properties, along with a remarkable numbing effect. Also try the numbing power in cooled peppermint tea. Swish, then swallow if you like the flavor.
" Most challenging are toothaches that stem from inside a tooth. But in cases where a lost filling or a broken tooth is causing the pain, "caulking" the sore tooth with softened chewing gum can ease the pain.
" Canker sores:check to see if their toothpaste contains sodium lauryl sulfate, or SLS. SLS is a foaming agent that in some studies has been linked to the development of canker sores. An additional remedy for both canker sores and gum pain is tea tree oil. Tea tree oil should be applied directly to the infected site and can even be purchased in mouthwash form to soothe inflammation. Another preventive measure for canker sores is to avoid eating chips and other jagged foods that can cause tiny cuts and scrapes, which can be an entryway for a virus. Besides that, stay away from foods that trigger canker sores. Potential troublemakers include whole wheat, rye, barley, shellfish, pineapple, chocolate and tomatoes.

" Gum problems: Ginseng can be used to alleviate the pain associated with irritated gum tissue. A ginseng tonic can be directly applied to the gum to promote circulation and speed healing. An additional home remedy suggestion is to use a wet tea bag for tooth or gum pain. Tea contains astringent tannins, which have the power to shrink swollen tissue and stop bleeding.
" No toothache will heal on its own. A toothache is a dental problem that needs to be treated as soon as possible.
" Knocked out a tooth: Shake off debris (rinsing or scrubbing could remove important periodontal ligament), place it in a container of milk or back in its socket and try to reach the dentist within 30 minutes.
" Broken tooth: If you've lost the broken piece, just get to the dentist. If you have it, gently shake off surface dirt and definitely keep it. Even if the piece can't be bonded back to the original tooth, it can be used to help re-create the look of that tooth.
" Something wedged between your teeth: Gentle flossing or brushing is fine, but if the object does not respond to that treatment and the surrounding gum begins to swell, make an appointment with your dentist. A bit of broken filling or chipped enamel can throw your bite off and make you panic. Popcorn husks are one of the worst offenders and occasionally need to be removed by a dentist.
" Something wedged between your teeth: Gentle flossing or brushing is fine, but if the object does not respond to that treatment and the surrounding gum begins to swell, make an appointment with your dentist. A bit of broken filling or chipped enamel can throw your bite off and make you panic. Popcorn husks are one of the worst offenders and occasionally need to be removed by a dentist.
" Lose a filling or crown: Cover the hole with temporary material, do not try to put the old filling back in the tooth. If you lose a crown, you'll want to try and salvage it (you can surprisingly use vaseline, denture adhesive or over-the-counter temporary dental cement available in pharmacies to put the crown back in place until you can reach a dentist). Visit the dentist as soon as possible.
Source: HealthNewsDigest.com

HOW TO MAKE YOUR OWN DENTAL EMERGENCY TRAVEL KIT

This kit will help you to deal with a toothache, loss of a filling, cap or crown, tooth fracture, and gum irritation. This kit is for emergencies only. It is not intended to replace regular professional dental care.

Take a small study plastic box/ container and include:

• Alcohol preps Breath freshener
• Travel toothbrush and toothpaste Floss threader
• Acetaminophen tablets, Motrin Tongue scraper
• Oral antiseptic Tea bag
• Anesthetic gel-Ambesol, Campho-Phenique orOrajel Salt
• Dent Temp or Tempenol-temporary filling material Cotton rolls
• Cotton swabs Explorer
• Dental floss-double sided Cotton balls
• Antibiotics Cotton gauze (2x2)
• Mouth mirror Tweezers
• Oil of cloves Stick of wax
• Rubber gloves Small plastic spatula
• Round two picks Ice Pack
• Baking soda Aloe vera gel
• Wintergreen
• Antibacterial towelettes
  

Greater New York Dental Meeting CPR and Medical Emergencies in the Dental Office: A Certification Course David B. Jacobson, B.A.,D.M.D. New York, New York November 2009