Emergencies


Emergencies

During office hours, immediate attention will be given to your situation, and you will be seen as soon as possible.  After office hours, please give the office a call and follow the instructions provided.  Your call will be returned as soon as possible. If you are experiencing a serious or life threatening emergency, please call 911 or visit the nearest emergency room.


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Many injuries are as a result of participation in a sport or falls, with a number requiring our care. Injuries involving the head, neck or face may require a visit to the emergency room or your family’s physician. Some of the more common emergencies are listed below with advice as to how to manage them:

Apply pressure with clean gauze or cloth. Place ice in contact with the area of the wound to control bleeding and swelling. Call us immediately. If the bleeding cannot be controlled, go to a hospital emergency room immediately.
This is often attributed to untreated tooth decay or a broken filling. Do not chew in the area if possible and avoid extremes of temperature. If swelling is present, apply cold compresses and do not use heat or aspirin placed on the gum of the aching tooth. Provide Tylenol and/or Ibuprofen for pain and call us as soon as possible.
bumped-tooth-photo
Check for any soft tissue damage, and apply cold compresses to the area. Do not chew on the area and note if the tooth is in the same position or not. If teeth that have been bumped turn color, it may very well be because the nerve has been affected. Should this occur contact our office.
over-retained-teeth-photo
Lower Front: These baby teeth often times are lost with tongue moving permanent teeth that were behind in to a more forward position. No need to panic looks worse than it is, but let us evaluate.

upper-front-photo
Upper Front: Often times are not lost as easily and could benefit from early removal to let the teeth move forward and not get caught behind the lower teeth.

cracked-tooth-photo

Rinse the mouth with warm water to remove dirt and debris from the area. Apply cold compresses to the lip and face in the area of the injury to control swelling. If you can find the tooth fragments save them, and see us immediately bringing the fragments with you.

If your child suffered trauma and there appears to be teeth missing that cannot be found, it is possible that the tooth (or teeth) were pushed into the gums. Blood and swelling in the area will make it even more difficult for the tooth to be visualized. Control the bleeding and schedule an appointment immediately to discuss treatment options.
 

Find the tooth, control bleeding, and call us immediately. Do not reimplant the tooth, but do bring it with you.

knocked-out-permanent-tooth-photo

Find the tooth. Hold the tooth by the crown (the white part), not by the root (the yellow part).
Replant immediately, if possible.

If contaminated, rinse shortly with cold tap water and put the tooth back as closely to its orginal as is possible.

Hold the tooth in place. Bite on a handkerchief to hold it in position and call us immediately.

If you cannot put the tooth back in, place it in a cup of milk or saline. When milk or saline are not available, place the tooth in the child’s mouth (between the cheeks and gums)

Seek immediate treatment. Time is of essence.

Children between 7 and 10 years of age are more exposed to suffer avulsion (a tooth being knocked out of the mouth) due to the elasticity of the bone at this age.

Contact our office. In the interim, you can make your child comfortable by covering the end of the wire or bracket with cotton, gauze, wax, or chewing gum. If any part of the appliance is loose, try to gently remove it from the mouth without force and place it in a container to bring to the dentist. Should the appliance be embedded in the gum, tongue, or cheek, call us immediately.

Children especially can very easily injure their cheek, tongue, lips that have been anesthetized following dental work. They should be carefully observed until the numbness is gone, and frequently reminded to not bite these structures. If damage does occur call us immediately.

Canker sores, or Apthous ulcers are very common and not contagious. They are white ulcerations with red borders that are very painful. They always occur on the inside of the mouth which distinguishes them sometimes from Cold Sores. Exact cause is unknown. They usually heal on their own within one to two weeks, but children should avoid irritating, caustic foods to limit the discomfort. Palliative treatment in the form of over the counter ointments e.g. Orabase and Benzocaine, or prescription medications can be provided by our office.

Herpetic stomatitis is a contagious viral illness (Herpes Simplex Virus) and is seen mainly in young children. This condition is probably a child’s first exposure to the herpes virus, and it can result in a systemic illness with high fever, blisters, ulcers in the mouth, and inflammation of the gums.

Sometimes the blisters are very painful, often forming in groups inside the mouth, around the lips, and sometimes the face. These are contagious, and are often fluid filled. Once a child has a primary infection, it stays in the body and does have the potential to produce recurrent attacks. They usually heal on their own within one to two weeks. Treatment is often palliative with over the counter creams and ointments, although severe cases are treated with antiviral drugs.

If you experience any breakage or loosening of any of your appliances please call our office as soon as possible. By calling us first we will be able to schedule a time to see you. Please do not come directly to the office. If you have a scheduled appointment already, please call to let us know that you need something repaired so that we may add additional time to your appointment if needed.

Other non-emergency problems may include:

Irritated cheek tissues – Non-medicated orthodontic relief wax can be placed over brackets or wires that may be irritating the mouth.

Food stuck in braces: Dental floss, an interproximal brush or a toothpick can be used for removing food that gets caught between teeth or wires.

Wire out of place: If a wire is out of place and poking the cheek, use a Q-tip or pencil eraser to push the wire against the tooth. If this is not possible, or if the wire is still uncomfortable, place wax over the end of the wire and call our office to set up a time to have the wire adjusted and put back into place.

Soreness or discomfort: Non-prescription pain relievers, such as acetaminophen or ibuprofen, can help with the temporary discomfort that sometimes occurs for the first day or two after an orthodontic adjustment.

Sores in the mouth: Rinsing with warm salt-water several times a day can help to heal sores in the mouth. To lessen discomfort, topical anesthetic treatments, such as Orabase or Ora-Gel, can be applied with with a Q-tip to any abrasions or sores in the mouth.

Preventing Infections: For minor sores in the mouth, Peroxyl, an antiseptic rinse containing hydrogen peroxide, can be used to reduce inflammation and prevent infection. Use Peroxyl up to 4 times per day after brushing. Refer to the product label for specific instructions.

Additional Resources

Please visit our full website for more detailed information: Full Site

A wonderful “Dental Trauma Guide” can be found by clicking here: Dental Trauma Guide

Download “Management of Orthodontic Emergencies” flyer from the American Association of Orthodontists: American Association of Orthodontists Website

For more information on specific symptoms, visit: American Dental Association Website

For additional children’s emergency resource, visit a guide from the Academy of Pediatric Dentistry: Active Kids, Healthy Teeth