Urban Housecalls: Dental First Aid
Saturday, January 14, 2012


By Karla Robinson, MD
Dental Emergencies
Do you know what to do when facing a dental emergency?  Whether you are a parent and witness your child falling on the playground and knocking out a tooth or if you happen to be enjoying some peanut brittle and find yourself left with remnants of a broken tooth, it’s important to know what steps to take when there is dental trauma. 
Review these quick and easy things that you can perform at home until you can seek the attention of a dentist.
 • Bit Your Tongue?  If you have ever bitten your tongue, lip, or cheek, you know this can be painful.  However, this type of injury can usually be managed at home unless it is severe.  If there is bleeding, apply gentle but firm pressure with a clean cloth or gauze if it is available.  Apply ice to any bruised areas.  If bleeding persists longer than 15 minutes, or if it can’t be stopped by applying simple pressure, go to the nearest emergency room for evaluation. 
Achy Tooth?  
This can sometimes be the sign of a serious issue, so it is always advised to seek the help of a dentist right away.  If there is obvious trapping of food or debris in the tooth, you can use dental floss in an attempt to dislodge it.  You may also rinse the mouth with warm, salty water.  If there is swelling of the face and surrounding tissues, then applying a cold compress may offer some relief.  If there are no contraindications, you may use acetaminophen as directed for pain until you are seen by your dentist.  Never attempt to apply aspirin directly to the aching tooth or gum as aspirin is an acid and it may cause burns. 
Broken Tooth?  Gather any fragments of the tooth and seek dental attention immediately.  Rinse the injured area with warm water to cleanse it.  Apply cold compresses over the face to control any swelling in the area.
Total Knockout?  Act fast!  You need to get to your dentist immediately.  First, locate the missing tooth, but don’t handle it excessively.  It is important not to touch the root portion of the tooth as that may damage the structures needed to reattach it.  You may carefully rinse the tooth with water or milk and attempt to reinsert it in its socket, or you can keep it in the mouth between the gum and cheek, or you can put it in a cup filled with milk or water and transport it to the dentist.  It’s important to keep the tooth moist.  There is a great chance of saving the tooth if you act quickly.  Time is of the essence!
Broken Braces? 
If a wire can be taken out easily, remove it to avoid injury to the mouth from any sharp pieces.  If it cannot be removed, be sure to cover any sharp ends with cotton balls, gauze, gum, or dental wax.  If there is a wire stuck in the soft tissues of the gum, tongue, or cheek don’t try to remove it yourself.  Seek the help of a dentist immediately to prevent any further damage.  Loose appliances typically don’t require emergency attention if there is no immediate threat of injury.
Broken Jaw?  If you are concerned there may be a jaw fracture, try to keep the jaw from moving and seek emergency medical care.  Attempt to immobilize the jaw using a towel, tie, or handkerchief and go to the nearest emergency room for evaluation.
Cold Sores?  These are common and are rarely a dental emergency.  Oftentimes relief can be sought in the form of over-the-counter creams and gels.  If cold or canker sores persist or recur often, it is important to seek medical attention as they may indicate a serious disease or illness.
This column was printed in the January 15, 2012 - January 28, 2012 edition.

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