There are very few dental emergencies that require immediate attention. Many can be treated with over the counter remedies until definitive dental treatment can be delivered.
The best medication for any dental pain is Ibuprofen (Motrin, Advil). Follow the instruction on the bottle for the age/weight of your child. Tylenol will work, but Ibuprofen works better.
Knocked Out Baby Tooth
If a baby tooth gets knocked out, this is not an emergency (dental wise). The baby tooth should never be 're-implanted' because of the damage it can cause to the developing adult tooth underneath. Make sure the child is comfortable. Have him/her bite on gauze or washcloth to stop the bleeding. Locate the tooth, if possible. Put it under the child's pillow for the tooth fairy.
Knocked Out Adult Tooth - This is a true emergency. Time is very important!
Find the tooth. DO NOT WASH THE TOOTH! HANDLE IT BY THE CROWN ONLY, NOT THE ROOT. Gently remove any visible dirt (some dirt on the tooth is okay) and try and put the tooth back into the tooth socket. You may have to push hard! If you vigorously wash the dirt off or touch the root, damage will occur to the fibers that are needed to keep the tooth alive once put back into the socket.
If you cannot get the tooth back into the socket, put it in a glass of milk or saline solution. Call the dental office and come to the dental office immediately (during normal business hours).
If it is after hours, it may be faster to get to the hospital. Go to St. Elizabeth’s main campus or Northside Hospital, as they have dentists who are on 24-hour call. Call the emergency room ahead of time so that the dentist is waiting for you.
If the tooth is out of the tooth socket longer than 30 minutes, the chance of the tooth surviving is very slim…this is why the ER may be faster than the dental office (if after hours) and why you need to try very hard to get the tooth back in.
This tooth may require a root canal either in a few days, a few weeks, or even a few years. Dr. Melissa can discuss with you the future of the tooth.
Knocked Out of Position, But Still in the Socket (Baby Tooth)
No treatment. Make the child comfortable, see the dentist within a week or two. Most of the time, the tooth will move back into the correct position on its own.
Knocked Out of Position, But Still in the Socket (Adult Tooth)
Most likely this tooth will require a root canal in the future. If the tooth is severely loose, try and put it into its correct position, and then call the office so that Dr. Melissa can stabilize the tooth ASAP. This may also be a situation where the emergency room is faster than coming to the office if it is after hours. St. Elizabeth's main campus or Northside Hospital have dentists on 24-hour call.
If the tooth is minimally out of position, again, try and put the tooth back into the correct position, eat soft foods until you can make an appointment with Dr. Melissa.
Fistulas
If you develop a fistula (an abscess without swelling), it will look like a pimple on the gum. Ibuprofen is all that is needed until you can see the dentist.
Swelling
Swelling is a sign of infection. If this swelling is small, call the office and an antibiotic may be called in until we can see you in the office for definitive treatment. If the swelling is large, or is close to the eye or making it hard to swallow or breathe, please get to the emergency room ASAP. Swellings that get too large may need to be treated with IV antibiotics.
Cold Sores
These are lesions normally noticed on the outside of the mouth, around the lips. They are caused by a virus. Make sure the child continues to stay hydrated and use a pain relieving ointment at the drug store specifically made to treat cold sores. It should resolve in 7-10 days. Cold sores are contagious. Don’t share beverages, chap/lip stick, or kiss while you have an active cold sore.
Canker Sores
These are lesions normally noticed inside the mouth. The cause for them is unknown. Some speculations are stress, lack of sleep, poor diet, citrus foods, acidic foods, dental work. They can be very painful. The best treatment is keeping the child hydrated and using a product sold at the drug store specifically for canker sores. Orabase by Colgate is a product that works well. It should go away in 5-7 days. They are not contagious and may also be referred to as apthous ulcers.