Common Dental Emergencies

Dental emergencies usually fall into two broad categories: oral pain and oral dysfunction. Pain is probably the most common reason for a dental emergency. The pain can arise from a tooth, the surrounding gum tissue or from both. The most frequent reason for dental pain is tooth decay or a cavity within the tooth. If the decay is relatively superficial, then the pain is often felt only when cold air or food comes in contact with the tooth. When such decay remains untreated, it leads to inflammation of the nerve tissue, otherwise known as pulpitis, and is sensed even without triggers such as cold liquids. Pulpitis is often described as being either reversible or irreversible. Reversible pulpitis is addressed by removing or excavating the decay and the placing of a temporary sedative or permanent filling. On the other hand, irreversible pulpitis is treated by the removal of the nerve tissue within the tooth, i.e. having root canal treatment, or by extraction of the entire tooth. rnSimilar to decay, the loss of a filling or another restoration from the tooth, results in similar pain symptoms When decay results in irreversible pulpitis, the pain will often be sensed as the tooth comes in contact with hot drinks or food. In fact, exposing such a tooth to very cold food or ice will provide immediate relief of the pain. In many cases, the pain of irreversible pulpitis leads to pain in the gum tissue that overlies the tip of the root. Pain will also be felt when chewing pressure is applied on the tooth and chewing will often need to be done using the non-painful side of the mouth. Gum pain is often commonly sensed around partially erupted wisdom teeth. In such situations, the pain results from food and bacteria accumulating beneath the flap of tissue that covers the partially erupted wisdom teeth. Such bacterial accumulation, leads to an infection and significant level of pain as a consequence of inflammation of the gum tissue around the wisdom tooth. Emergency dental treatment will consist of irrigation of the area beneath the flap of gum tissue along with prescribing of antibiotics. Although such treatment will relieve the pain, the relief is usually temporary. If the wisdom teeth are not removed, then similar dental pain can reoccur. Abscesses in the gums result in severe pain and swelling and require emergency dental care. Gum abscesses occur in individuals who have chronic periodontal disease. Normally, no pain is felt when one has periodontal disease which has been termed the silent epidemic. On occasion in such individuals, a deeper gum pocket surrounding a tooth will actually become infected and lead to inflammation, swelling with pain. Emergency treatment will consist of cleaning (scaling) the infected pocket surrounding the tooth and prescribing antibacterial mouthwash and antibiotics. This same area or other areas of the mouth will develop gum abscesses if the periodontal disease is not treated and continually managed. Another type of dental emergency develops when a tooth brakes. Normally this happens during chewing. When the brake is superficial involving only the enamel of the tooth, no pain at all may be felt. The patient’s main complaint relates to the sharpness of the broken edge of the tooth. If the tooth brakes in a way that involves the dentin structure underlying the enamel, then the patient will complain of cold sensitivity as well as the sharpness of the broken edge. While emergency dental treatment may be limited to smoothening out the sharp edge of the tooth, the tooth will require a proper restoration which is dependent upon the extent of the portion that is fractured. At times blunt trauma to front teeth results in the fracture of a tooth, loosening of the tooth or the complete loss of the tooth from the socket. When the structure of the tooth is fractured, then depending on the extent and location of the fracture, a simple bonded restoration may solve the problem or a crown may be needed. If the fracture of the tooth occurs at the root level, then the tooth will most likely need to be extracted. Any trauma to a tooth may necessitate a root canal procedure before the tooth is permanently restored. When a tooth becomes loose after direct trauma, then the tooth will need to be stabilized by temporarily splinting it to adjacent and more stable teeth. rnAlthough the loose tooth will often firm up within a couple of weeks, the tooth will most likely require root canal treatment. If the trauma causes the entire tooth to come out, it is best to keep it moist in a liquid such as milk or saliva and seek dental treatment as soon as possible. Ignoring any dental emergency is a mistake. Pain or oral dysfunction should be handled by a local dentist. For example, a person living in Boston should be aware of local dental offices and learn about those that provide emergency dental care in Boston.