Dental emergencies - When to go to urgent care dentist

Just as when we have a serious and/or sudden health problem, we should try to go to the hospital as soon as possible, it is advisable to do the same when we are faced with severe oral problems. Among the most common dental emergencies are abscesses, knocked out teeth, fractures, problems with braces... We talk about all of this in this post.

1) What is a dental emergency?

We consider a dental emergency those oral problems that require immediate treatment, such as severe pain, infection, uncontrolled bleeding or trauma. Aesthetics are also considered within emergencies and some problems that, without being excessively serious, can become complicated if they are not solved as soon as possible.

2) Types of dental emergencies

We find severe tooth or jaw pain, fractures, fissures or avulsions, bleeding and problems with orthodontics, fillings, implants or dental prostheses among the most common dental emergencies.

2A) Severe tooth pain

Toothache and other tooth pain is a common problem that affects a large part of the population. On many occasions, these discomforts are mild and can be resolved on their own or alleviated with the use of certain medications. However, there are situations where the pain is very strong and requires professional intervention. Among these causes we find:

  • Pulpitis: inflammation of the dental pulp or nerve.

  • Dental abscess: infection around the tooth with a collection of pus.

  • Very widespread decay.

  • Dry socket: when the bone does not heal correctly after an extraction, it can cause very intense pain.

    2B) Severe jaw pain

    It is less common than dental, but the jaw and temporomandibular joint can also cause severe pain. Some require medical or physiotherapeutic treatment, but it may be advisable to go to the emergency dentist when they are caused by problems in the TMJ or the trigeminal nerve.

    2B.a) Dislocation of the jaw

    Dislocation occurs when the jaw bone slips out of its normal position in the temporomandibular joint. This can be caused by opening the mouth wide, biting down on something hard, or being hit. In order to reduce the dislocation, there is the Nelaton maneuver that we detail below:

    1. Keep calm: both you and the affected person. Anxiety will only make the situation worse.

    2. Comfortable position: ask the person to sit in a chair with a back and rest their head on a stable surface, such as a wall.

    3. Assistance: if you are the one to help, stand in front of the person and place your thumbs on the lower molars and your index fingers on the lower jaw.

    4. Gentle movement: apply gentle, steady pressure with your thumbs down and index fingers up, allowing the jaw to move down and then back into its normal position.

    5. Controlled movement: perform this movement carefully and smoothly, avoiding sudden or forced movements.

    6. Medical Professional: once the jaw is in place, seek medical attention. It is important to make sure that there is no additional damage.

    If you do not feel safe doing the maneuver it is best to seek medical help immediately. Jaw dislocation is a dental emergency that must be treated carefully and professionally.

    2C) Extreme tooth sensitivity

    Tooth sensitivity to hot or cold temperatures can be indicative of problems such as cavities, worn tooth enamel, or receding gums. Sometimes it is something specific, but if it is constant, you have to go to the dentist to try to identify the cause of the sensitivity.

    2D) Cracks or dental fractures

    The enamel, the protective layer of the teeth, is the hardest and most resistant of the human body, but the dental pieces can become cracked or fractured, situations in which it is advisable to go to the dentist urgently. Among the most common causes of this problem are trauma, severe dental caries, opening containers with the teeth and bruxism.

    2E) Avulsed teeth, other dental emergency

    A trauma to the mouth can also pull out a tooth by the root. In this situation, it is recommended to take the tooth as soon as possible WITHOUT touching the root, store it in a device with Hank's solution, in serum, milk or even in the mouth itself, and take it to an emergency dentist. If you act properly and in a short time, the professional could reimplant the tooth.

    2F) Objects stuck between the teeth or gums

    If an object, food debris or a piece of dental floss, gets caught between the teeth and causes pain or discomfort, it may be necessary to see the dentist to remove it to prevent further damage.

    2G) Mucosal or lip lesions

    Injuries to the soft tissues of the mouth, such as cuts, canker sores, or ulcers on the lips, tongue, or cheeks, can be painful and prone to infection. If you accidentally bite down on the inside of your mouth, it can also cause sores or painful wounds. These lesions generally heal on their own, but if they persist or worsen it is advisable to seek dental care, since it could also be an infection such as herpes, candidiasis or some other STI. In any case, it is important to keep these areas clean to prevent them from becoming infected.

    2H) Continued bleeding after extraction or surgery

    Normally, bleeding after extraction or surgery stops before leaving the dentist's office, where coagulation is precisely checked. Sometimes it may come back after a few hours, but it should stop within 24 hours. If not, the first thing to do is place a compact gauze pad on the bleeding area and press firmly for 20 minutes. If the bleeding does not stop, you should see your dentist as soon as possible. To prevent this problem, it is important to follow the postoperative guidelines provided by your dentist, such as avoiding rinsing or spitting during the first day, not drinking hot drinks in the first 24 hours, and avoiding physical exertion or sudden head movements.

    2I) Orthodontic dental emergencies

    It is common for dental appliance wearers to occasionally suffer some type of orthodontic emergency during treatment. Among the most common are the debonding of brackets and/or bands, bent or nailed archwires, loose ligatures or infection of microscrews or miniplates. It is advisable to go to the emergency dentist in any of these situations.

    2J) Fallen fillings, another dental emergency

    The dental filling, also called obturation or restoration, is used to repair dental pieces damaged by cavities or fractures. However, if this has not been done correctly, they can overflow or detach and, if this happens, it is recommended to visit a professional if pain or sensitivity is noticed.

    2K) Problems with dental implants

    Dental implants are an excellent option to replace missing pieces, although there are also situations in which they can cause problems, even requiring emergency treatment. The most common is peri-implantitis, an infection in the tissues surrounding the implant that can cause its loss if it is not treated in time. In the same way, a trauma to the mouth can cause it to fall or fracture.

    2L) Fallen dentures

    Dental prostheses such as veneers, crowns, bridges, or restorations on implants can also break and/or fall out. It is advisable to save the fractured prosthesis or pieces of prosthesis and go to the dentist to repair it. These cases normally do not cause pain, but they can cause wounds or canker sores from rubbing against sharp or irregular edges.

    2M) Aesthetic emergencies

    Although it is not considered a medical emergency in itself, it is true that many patients consider that having broken or fallen a veneer, crown, or dental prosthesis in the previous aesthetic sector requires immediate attention, especially if they work facing the public. This type of "emergencies" is tried to be resolved as soon as possible, taking into account that the priority is always emergencies in which there is pain, bleeding or infection.

    2N) Other dental emergencies

    Although the ones we have presented so far are the most common, any serious and/or sudden oral problem must be evaluated by a dentist as soon as possible.

    3) How will the dentist act in the event of a dental emergency?

    Having already explained the different dental emergencies that exist, we now present the protocol to follow. After a first telephone or telematic contact, the patient must explain the origin of the problem as thoroughly as possible. In certain cases it is possible to solve the patient's problem by indicating the instructions to follow. Otherwise, the patient will be recommended to go as soon as possible so that the doctor can review it. Upon arrival at the dental clinic, the dentist will explore and assess the patient's situation, doing any x-rays or additional tests that are necessary. If it is determined that urgent action is required, it will be carried out as soon as possible, intervening whatever the causes of the problem. If, on the contrary, it concludes that an immediate intervention is not required, the appropriate guidelines and/or medication may be prescribed if necessary, and an appointment will be scheduled for a future intervention depending on the needs.

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