Dental Emergencies

Dental emergencies occur when you least expect them. When a dental emergency occurs, the most important aspect of handling the emergency is to have your child brought to our office as soon as possible.

Oral ulcers

Protective ointments and gels such as Zilactin and Orajel may provide symptomatic relief of pain for your child. These products can be purchased at the local pharmacy. The most helpful treatment for aphthous ulcers is application of Kenalog in Orabase ointment which is applied to the ulcers four times daily.

If your child is consistently presents with aphthous ulcers, a diary of when the ulcers occur and what possible items and events triggering the aphthous ulcers may be helpful. It is best to avoid trauma inside the mouth and avoid abrasive food such as hard pretzels and potato chips. Your child should avoid allergenic foods such as nuts, chocolate, and acidic foods that may trigger an aphthous ulcer event.

Toothache

Have your child rinse their mouth vigorously with warm water to flush out debris. Use dental floss to remove any food trapped between the teeth. If your child requires an analgesic, have them take either Children's Tylenol or Children's Advil. Do not apply the medication to the tooth or sore area.

Knocked out permanent tooth

If the tooth is dirty rinse it gently in cool running water. Don’t scrub it. Gently replace the tooth in its socket and hold it in place. If this doesn’t work, put in a container of cool water. GO IMMEDIATELY (within 30 minutes if possible) to the dentist, who may be able to reimplant the tooth. After hour emergency appointments are available by contacting our emergency answering service.

A baby tooth is knocked out

Rinse your child's mouth with water and apply a cold compress to reduce swelling. The best treatment is to spend time comforting your child and to call the office immediately. At the office, we will take a thorough history and exam to ensure no other injury has been sustained elsewhere to your child.

* Do not attempt to re-implant a baby tooth as this may damage the permanent tooth below.

Bitten tongue or lip

Apply direct pressure to the bleeding area with a clean cloth.  If there is swelling, apply cold compresses.  If the bleeding does not stop, take your child immediately to a hospital emergency room.

Broken or chipped tooth

Immediately contact the office and bring your child to the office. Immediate action can prevent infection and reduce the need for extensive dental treatment.  Gently clean the debris from the injured area with warm water.  Attempt to save the tooth fragment and bring it with you to the office. Use cold compresses to minimize swelling.

Emergencies can be prevented. The following are a few tips we suggest to reduce the chance of an dental emergency:

1. Keep regular dental visits and preventive care to protect your child from unnecessary toothaches.
2. Encourage your child to wear comfortable mouth guards during sports.
3. Child proof your home to prevent falls, electrical injuries and choking on small objects. A significant number of injuries occur in children under 3 as they are just learning to walk and develop their coordination.

Prevention of oral injury

Eighty percent of all fractured teeth occur in children, with the upper front teeth being most often involved. Injuries are the most frequent causes of mouth trauma. Biking, baseball, and skateboarding are the three main causes of tooth injuries. Home injuries, such as tripping over objects on the floor, stairway or ground, and not using handrails on stairways, cause many oral injuries. A large number of injuries happen on school playgrounds.

Safety Rules

Children need to prevent oral injuries. By learning and practicing common safety rules, children can prevent injuries to themselves and their teeth. Some of these rules are listed below.

1. Always wear a properly fitted helmet and mouth guard in vigorous games and contact sports.
2. Remember to wear a catcher’s mask when receiving pitched balls.
3. Keep your skateboard under control; don’t push or shove another skateboarder.
4. Don’t push or trip other skaters, or “hitch” a ride.
5. Use the ladder to climb out of a pool.
6. Don’t run alongside the pool or push playmates into it.
7. Don’t hit, push, or throw things at people as they drink from a container or fountain.
8. Be prepared for sudden stops in a vehicle; always use your seat belt.
9. Never climb a wet tree or fence; the footing may be slippery.
10. Always use your handlebars when riding your bike. Be extra careful when riding in rainy weather; wet roads and leaves are dangerous.
11. Never trip or push another playmate.
12. Watch out for trees, stumps, and other objects in your path when walking or running.
    
13. Climb with an experienced person and be sure to test firmness of rocks and footing.
14. Remain seated in a swing and don't jump from or walk under a moving swing
15. Watch out for trees and other things in your path when sledding.

Mouthguards

Many experts recommend that mouthguards or mouth protectors be worn during any recreational sport. Mouthguards help prevent injury to the protect against head and neck injuries by cushioning blows that might otherwise cause concussions or lead to jaw fractures. Some of the sports for which mouthguards are recommended include:

Acrobatics
Baseball
Basketball
Bicycling
Boxing

Discus
Field Hockey
Football
Gymnastics
Handball

Ice Hockey Lacrosse
Martial Arts
Racquetball
Rugby

Shotputting
Skateboarding
Skiing
Skydiving
Soccer

Squash
Surfing
Volleyball
Water Polo
Weightlifting
Wrestling

Mouthguards cover only the upper teeth because they are the most frequently injured. Covering lower teeth may create additional bulk, diminishing comfort and fit while providing little extra protection. Mouthguards should be resilient, thin enough for easy breathing, tear-resistant, and comfortable. They should also fit properly, be durable, easy to clean, and not difficult to speak with. Rinsing the mouthguard with cold water or mouthrinse before using it will help increase its comfort in the mouth.

There are three types of mouthguards. Although the three types provide protection, they differ in comfort, fit, and cost. The three types are:

1. Stock mouthguard - the stock mouthguard is ready-made and can be found at most sporting goods and department stores. It is commonly constructed of rubber or a polyvinyl material. Little can be done to adjust the fit of a stock mouthguard. It is often bulky and uncomfortable. The jaws must be closed to hold the mouthguard in place. Good for a developing dentition.
2. Mouth-formed mouthguard - the mouth-formed guard is a plasticized acrylic gel or thermoplastic material conformed to the contours of the individual’s teeth. Good for a developing dentition.
3. Custom-made mouthguard - the custom-made mouthguard is individually designed and constructed by a dentist. It is constructed over a plaster replica of the individual’s teeth and is more expensive. It offers exceptionally good fit, comfort, and overall quality. Ideal for a permanent dentition.

A strap is often fastened to any of these mouthguards, protecting against loss and allowing the mouthguard to be removed or suspended from other face gear when the individual is not in play.  Mouthguards can last a long time if they are cared for properly. The mouthguard should be rinsed under tap water after each use and allowed to dry before storing.

Dental first aid

If an oral injury should occur despite using safety precautions and mouthguards, prompt attention is necessary. Try to clean dirt or debris from the injured area with warm water. Place cold compresses on the face next to the injured area to minimize swelling. Then, see your dentist at Kids Dental immediately. Loss of primary teeth due to accidents may not cause concern to some parents because they feel those teeth will soon be replaced by permanent teeth. However, the absence of these teeth may affect the child’s speech, appearance, and ability to eat properly. Injury to or premature loss of primary or permanent teeth should be checked by your dentist.
 
A dental first-aid kit is necessary to apply proper dental first aid. Items needed in the dental first aid kit or as as part of a general first-aid kit are as follows:

Cotton swabs-
Stops bleeding; cleans injury

Tea bags-
Stops bleeding by pressing a wet tea bag on bleeding injury (tannic acid in tea stops bleeding)

Dental floss-
Removes objects from between teeth

Interdental cleaner-
Removes objects wedged between teeth or toothpicks
   
Sterile gauze squares-
Cleans injury or used as compress

Tweezers-
Removes objects between teeth

Dental wax-
Stops irritation to cheeks or gums by placing the dental wax (or paraffin) over a chipped tooth or a protruding wire from orthodontic bands

Ice pack-       
Helps reduce swelling of an injury

Handkerchief-       
Immobilizes broken jaw

Milk-           
Stores a knocked-out tooth, if unable to place immediately back in socket or store under the tongue
   
Medications-       
Consult school nurse and/or school’s medication policy