It always seems at the most inopportune time, your tooth starts to ache, you might wake up swollen or shear off a part of your tooth leaving a sharp edge. While our practice is preventative focused, emergencies can still happen. One of my patients recently asked me- what if she needed to come in over the long Thanksgiving holiday. While we are always available to be reached by phone, it led to a great conversation about true dental emergencies that I wanted to share.
The most serious emergency in the dental field is swelling that causes closures of your throat, tongue and swelling upwards toward your brain. While very rare, I have seen cases where a patient was having trouble breathing due to the increased swelling and the patient went to the ER to be placed on IV antibiotics. They subsequently had their tooth extracted the next day. In our area, I would recommend UC Hospital for this type of emergency as they have a oral surgery residency. The residents are there or on call at all times for this type of condition.
The next emergency that requires immediate attention is a tooth avulsion/having a tooth knocked out. This is a time sensitive event. Research shows if the tooth can be cleaned appropriately and splinted back into place, there is a much greater likelihood the tooth will heal. While splitting a tooth is only the beginning of a process of wait and see, if the tooth is out longer than the 1 hour there is an increased chance of root resorption, infection and other ailments that lower the success. Last year I splinted a tooth on a basketball bleacher and fortunately the tooth was able to heal into place.
Now onto dental urgencies. While these are important, we don't consider urgencies as something that would require an office visit after hours.
Losing a temporary crown or permanent crown- while a tooth may be sensitive if your crown comes off, most likely the tooth will be okay until you can get into the office the next business day. If a crown is left off the tooth for longer than a few days there can be a noticeable amount of shifting in the teeth causing the bite to be high when putting the crown back on and the crown may feel tighter as the teeth adjacent to the space can tilt toward the empty space. If the tooth comes off inside of the crown, then the crown may not be able to be cemented back in. If that is the case, the tooth will need to be extracted.
Small amounts of swelling- while unsettling, if you wake up or notice that you are swollen, call us and let us know what is going on. Most likely we will get you started on some antibiotics and will schedule an appointment as soon as possible. Swelling can be caused by abscess teeth, necrotic (dead) teeth, failing root canals, periodontal disease and pericoronitis to name a few.
Broken tooth- while a broken tooth can rub your tongue raw, it is not at risk to leave until you can get in for an appointment as most likely the weak part of the tooth is gone and the rest of the tooth will more than likely stay in tact. Most of the time broken teeth require crowns or onlays. In rare cases if there is not enough of the tooth left than the tooth may need to be removed.
Sore spots- under partial or permanent dentures sometimes a sore can occur. It is best to leave the prosthesis out as much as possible to allow the area to heal. Note the location and we can adjust the spot at your next visit.
Please let us know if you're experiencing a dental emergency! We are here for you. Dr. Stewart has a dedicated line for her patients and will be happy to get back with you as soon as possible.