Dental emergencies can happen at the worst of times, and can be very distressing. With the Coronavirus (COVID-19) worldwide pandemic, dental pain and emergencies can be all the more alarming for patients.
Our principal dentists Dr Helen Walsh and Dr Nick Beirne have put together some tips and advice, to give you a better understanding of what a dental emergency is, and how to deal with them in case you can’t come in to see us in Portobello Dental. We want to assure you that we will still be available to provide an emergency dental service for our patients, as we understand that emergencies will continue to happen over the next few months irrespective of viruses but we hope this blog will provide some helpful information.
This post is very much a guide and every patient’s case is different so if you have any concerns or are unsure, please call the clinic on (01) 454 2022 or email info@portobellodental.com to speak to a dental professional.
You need to go straight to A&E if you have;
- Facial swelling affecting your vision, breathing or preventing your mouth opening more than two finger width
- Trauma causing loss of consciousness, double vision or vomiting
You need urgent dental treatment if you have;
- Facial swelling
- Bleeding after an extraction that does not stop after 20 mins of solid pressure with gauze.
- Bleeding due to dental trauma
- Severely broken tooth that cannot be managed with pain relief
- Toothache that is preventing sleep/eating combined with swelling
- Severe wisdom tooth pain and infection
A non-urgent dental emergency includes;
- Loose or lost crowns/bridge/implant crown or veneer
- Bleeding gums
- Broken, rubbing or lose denture
- Broken, loose or lost filling
- Chipped tooth with no pain and no soft tissue trauma
- Loose orthodontic wire (Please see our tips for our patients with braces)
We have given advice on some of the most frequent Dental Emergencies below:
I have an Abscess/Swelling:
Facial swellings can come about for a number of reasons other than teeth such as infected skin cysts or blocked salivary glands. However, if there is associated tooth pain or swelling around the gum it is likely to be a dental problem. Facial swellings that have come about over a short period of time, are usually a sign of infection which may need antibiotic treatment.
If the abscess is draining, rinse your mouth regularly with hot salty water and take painkillers if needed. Please contact the clinic when a facial swelling occurs.
I have a Broken Tooth, what do I do?
If your tooth has chipped and is not painful, most likely this will be fine to leave until you can see your dentist for a restoration. If the broken tooth is sharp, sensitive or cutting your tongue, you can purchase a temporary filling material at your local chemist. To use this follow the instructions as directed, but ensure your tooth is dry and place the filling material over the surface that is exposed. If required take regular painkillers to help with pain.
While waiting to have the tooth restored, maintain a good oral hygiene routine; brushing your teeth regularly, flossing and/or using interdental brushes combined with a low sugar diet to prevent any decay from occurring or existing decay from getting worse.
Stress and anxiety can lead to tooth grinding (Bruxism), so as you can imagine during this time there has been a significant increase in fractured teeth due to grinding. To try and help alleviate symptoms, wear your night guard if you have one, or use a whitening tray (with no whitening gel in it) to separate your teeth at night-time.
What helps a toothache or a sensitive tooth?
Take regular painkillers and rub desensitising toothpaste (such as Sensodyne or Colgate Sensitive) around the tooth and repeat this several times through the day. Maintain your excellent oral hygiene routine and make sure to use fluoridated toothpaste when brushing twice daily.
If the desensitising toothpaste does not relieve the pain after a few days of use, it may be that you have pulpitis, which is an inflammation of the nerve inside the tooth. Call us and we will advise you on how best to deal with this.
I have lost my Crown/Veneer/Bridge, what should I do?
Again, maintain a good oral hygiene routine, combined with a low sugar diet to ensure the tooth underneath does not get decayed. If required you can buy a dental emergency kit from a chemist and this can be used to stick a crown/veneer/bridge back in temporarily. At the very least, cover the tooth or tooth peg left with this temporary filling material, and it should provide some form of seal until we are able to see you.
I have an Implant Crown and it’s loose:
A loose implant crown can be scary, but it can and does happen from time to time. Stay calm, and if the implant crown happens to fall out, keep the implant crown safe and the gum clean by using hot salt water rinses. The gums may grow over the implant and will have to be opened up surgically again in the future. This is a simple procedure if it is necessary, and the crown will be screwed back in again once the gum has healed in the correct position. If the crown remains loose, but does not fall out, take care to avoid it during eating. If the crown is very loose, but is still attached, please call us at the clinic.
I think I have a Wisdom Tooth Infection:
To help keep the area clean, rinse your mouth with warm salty water and take regular painkillers. Keeping your head raised (Sleeping with a number of pillows) can help alleviate inflammation in the area. If you have a bad wisdom tooth infection, you will need antibiotics, so please call the clinic.
My gums are bleeding when I brush, is this an emergency?
Bleeding gums are not a dental emergency, so please don’t be worried. Maintain an excellent oral hygiene routine and ensure that you are brushing twice a day but not too hard! Use floss and/or interdental brushes and mouthwashes like Corsodyl or Kin helps short term (long term, they will stain your teeth). Rinsing with warm salty water will also help keep the area clean until you can see us.
My denture is rubbing and/or feels loose:
You may want to consider using a denture fixative for a loose denture (e.g. Fixodent or Poligrip) as a temporary solution. If your denture is too sore to wear, consider not wearing it until we can see you. If any parts of the denture are sharp you can try adjusting this with an emery board (nail file). While we don’t encourage this, it might be helpful under the current circumstances!
We will do our very best to assist you during these challenging times. If you feel that you have a dental emergency, please telephone the practice on (01) 454 2022, and our coordinators will triage your dental needs over the phone. Please don’t be surprised when they ask you questions about your general well-being, recent travels or possible exposure to COVID-19.
Again, please use this as a guide only!!
Best wishes and stay safe,
Dr Helen Walsh & Dr Nick Beirne