Dental Emergencies

Dental emergencies are quite frightening and often painful.  Prompt treatment is almost always required to alleviate pain and to ensure the teeth have the best possible chance of survival.

Sometimes, teeth become fractured by trauma, grinding, or biting on hard objects.  In other cases, fillings, crowns, and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to contact our office immediately.  The pain caused by dental emergencies almost always gets worse without treatment.


Toothache: common in children of all ages and rarely occurs without cause.  Impacted food can cause discomfort in young children, and can be dislodged using a toothbrush, a clean finger, or dental floss.  If pain persists, contact our dental office.  Some common causes of toothaches include tooth fractures, tooth decay, tooth trauma, and wisdom teeth eruption (adolescence).

How you can help:

  1. Cleanse the area using warm water.  Do not medicate or warm the affected tooth or adjacent gum area.
  2. Check for impacted food and remove it as necessary.
  3. Apply a cold compress to the affected area to reduce swelling.
  4. Contact the pediatric dentist to seek advice.

Dental avulsion (knocked-out tooth): If a tooth has been knocked out, it is important to contact your dentist immediately. 

How you can help:

  1. Recover the tooth.  Do not touch the tooth roots! Handle the crown only.
  2. Rinse off dirt and debris with water without scrubbing or scraping the tooth.
  3. Insert the tooth into its original socket using gentle pressure, or place the tooth in the cheek pouch.  For younger children, submerge the tooth in a glass of milk or saliva (do not attempt to reinsert the tooth in case the child swallows it).
  4. Do not allow the tooth to dry during transportation.  Moisture is critically important for reimplantation success.
  5. Visit a dentist (where possible) or take the child to the Emergency Room immediately – time is critical in saving the tooth.

Dental intrusion (tooth pushed into jawbone): Sometimes, dental trauma forces a tooth (or several teeth) upwards into the jawbone.

If dental intrusion of either the primary or permanent teeth is suspected, it is important to contact your dentist immediately.  Depending on the nature and depth of the intrusion, the dentist will either wait for the tooth to descend naturally, or perform root canal therapy to preserve the structure of the tooth.

How you can help:

  1. Rinse mouth with cold water.
  2. Place ice packs around affected areas to reduce swelling.
  3. Take Tylenol for pain relief.
  4. Contact your dentist where possible, or proceed to the Emergency Room.

Tooth luxation/extrusion/lateral displacement (tooth displacement): Tooth displacement is generally classified as “luxation,” “extrusion,” or “lateral displacement,” depending on the orientation of the tooth following trauma.  A luxated tooth remains in the socket – with the pulp intact about half of the time.  However, the tooth protrudes at an unnatural angle, and the underlying jawbone is often fractured.

The term “extrusion” refers to a tooth that has become partly removed from its socket.  In young children, primary tooth extrusions tend to heal themselves without medical treatment.  However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection.  It is important to contact your dentist if displacement is suspected.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer pain relief (Tylenol).
  3. Contact your dentist immediately.

Crown fracture: The crown is the largest, most visible part of the tooth.  In most cases, the crown is the part of the tooth that sustains trauma.  There are several classifications of crown fracture, ranging from minor enamel cracks (not an emergency) to pulp exposure (requiring immediate treatment).

How you can help:

  1. Rinse the mouth with warm water.
  2. Place a cold, moist compress on the affected area.
  3. Take strong pain relief (Tylenol).
  4. Pack the tooth with a biocompatible material.
  5. Visit your dentist or Emergency Room depending on availability and the severity of the injury.

Root fracture: A root fracture is caused by direct trauma, and isn’t noticeable to the naked eye.  If a root fracture is suspected, dental x-rays need to be taken.  Depending on the exact positioning of the fracture and the child’s level of discomfort, the tooth can be monitored, treated, or extracted as a worse case scenario.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer pain relief (Tylenol).
  3. Contact your dentist.

Injured cheek, lip or tongue: If the child’s cheek, lip or tongue is bleeding due to an accidental cut or bite, apply firm direct pressure to the area using a clean cloth or gauze.  To reduce swelling, apply ice to the affected areas.  If the bleeding becomes uncontrollable, proceed to the Emergency Room or call a medical professional immediately.

Fractured jaw: If a broken or fractured jaw is suspected, proceed immediately to the Emergency Room.  In the meantime, encourage the child not to move the jaw.  In the case of a very young child, gently tie a scarf lengthways around the head and jaw to prevent movement.

Head injury/head trauma: If the child has received trauma to the head, proceed immediately to the Emergency Room.  Even if consciousness has not been lost, it is important for pediatric doctors to rule out delayed concussion and internal bleeding.

If you have questions about dental emergencies, please ask your pediatric dentist.

 





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