Many people perceive dental treatment as a routine task done at their convenience during scheduled appointments. Yet, lurking beneath this notion lies a critical aspect that often goes overlooked, dental emergencies. These unforeseen and often painful situations can strike at any time, demanding immediate attention and care.
The most common types of dental emergencies are traumatic dental emergencies and infectious dental emergencies.
Traumatic dental emergencies
These emergencies are incited most commonly due to falls, sports injuries, road traffic accidents, or physical violence. They include :
Fractures of the tooth, root
Fractures, dislocation of jaw
Luxated (partially dislodged) tooth
Avulsed (knocked-out) tooth
Severe soft tissue injury (lips, tongue, cheeks, gums)
Infectious dental emergencies
While dental caries themselves are not life-threatening, their presence can predispose patients to irreversible pulpitis (severe tooth inflammation), pulp necrosis (dead tooth pulp), apical periodontitis (infection around root tip) and periapical abscess (abscess at the root tip).
Another emergency of infectious origin is pericoronitis in gingival tissue overlying an erupting 3rd molar which collects food and debris leading to infection. These types of infections present with severe pain and swelling.
Broken tooth or jaw - cold compress to reduce swelling
Knocked out tooth - gentle water rinse, preserve tooth in milk or place back into the socket until you reach the dentist’s office
Deep soft tissue injuries - clean wound thoroughly, cold compress, control bleeding using a moist piece of gauze for 10 to 15 minutes
Dental abscess - warm salt water rinses, cold compress in 15-minute intervals, over-the-counter pain relievers
Pericoronitis - warm salt water rinses, pain relievers, oral water irrigators, tooth brush and floss to remove debris
Reaching out to a dentist or an emergency dental clinic promptly is of utmost importance. Seeking professional help allows for proper diagnosis of the problem through clinical examination, patient history, and radiographic methods. This helps to provide appropriate treatment, with immediate relief from pain and discomfort.
In case of abscesses, it's crucial for individuals to promptly seek care to prevent the spread of infection from the affected tooth, leading to cellulitis. Without timely intervention, cellulitis can escalate, spreading to other facial areas or even the bloodstream, posing severe complications like deep space infections of the head and neck or sepsis. Avoid self-medication or natural remedies during emergencies; instead, seek professional attention immediately.Dr. P. Selvaraj, BDS, Proprietor, Ramya's Dental Care, Thayanur, Tiruchirappalli, Tamil Nadu, India
| Dental emergencies | Treatment options |
|---|---|
| Tooth fracture | Simple restoration to pulp treatment procedures depending on extent of damage |
| Root fracture | Stabilization with dental splint and regular follow-ups |
| Luxated tooth | Splinting or repositioning combined with root canal therapy depending on the type of luxation and extent of damage |
| Avulsed tooth | Prompt reimplantation, regular follow-ups and root canal therapy if needed |
| Severe soft tissue injury | Irrigation, debridement, primary suturing if necessary, antibiotics, tetanus vaccination |
| Lower jaw dislocation | Reduction and muscle relaxants |
| Jaw fracture | Controlling the bleeding and securing the airway. Reduction and fixation depending on the severity and site of the fracture |
| Irreversible pulpitis | Root canal treatment or extraction |
| Pulp necrosis | Root canal treatment or extraction |
| Periapical abscess | Oral antibiotics, root canal treatment or extraction. If these are not desired, then incision and drainage of the abscess |
| Apical periodontitis | Root canal treatment followed by periradicular surgery if infection persists post treatment |
| Large abscesses with deep space infections | Hospital admission, parenteral antibiotics, and sometimes operative intervention |
Furthermore, during a dental emergency, time is of the essence. For example, knocked-out teeth have a higher chance of successful re-implantation if addressed quickly. Dental issues can worsen over time if left untreated, potentially leading to life threatening situations or more extensive treatments in the future.
As we navigate the complexities of dental emergencies, it becomes evident that proactive education and awareness are essential. Patients, parents, school teachers, sports coaches, and first responders should be educated on basic first aid for dental trauma.
Public awareness can help the patients to take necessary measures, like wearing helmets, mouth guards, etc., while doing activities that has high chance of facial injury. In addition, it will equip individuals with the knowledge and confidence to respond effectively in critical situations such as knowing how to store an avulsed tooth before reaching a dentist.Dr. Nibir Chakma, BDS, General dentist, Dr. Pawan's Bright Smile Dental Care, Guwahati, Assam, India
Preventing infectious dental emergencies requires prioritizing oral health with regular brushing and flossing. Avoiding chewing hard objects and limiting sticky foods are essential steps to prevent tooth damage. Additionally, quitting smoking and reducing intake of sugary foods and drinks contribute significantly to overall oral health.
Practise good oral hygiene and be mindful of your food choices. Regular dental visits every six months can prevent tooth decay from turning into emergencies.Dr. P. Selvaraj, BDS, Proprietor, Ramya's Dental Care, Thayanur, Tiruchirappalli, Tamil Nadu, India
Dental emergencies often extend beyond physical discomfort, impacting individuals emotionally and psychologically, as they grapple with fear, anxiety, and uncertainty about their dental well-being.
During dental emergencies, I think it is very important to approach the patients with empathy, as they have experienced trauma and are generally in confusion. Explaining the treatment in detail can help in reducing their anxiety.Dr. Nibir Chakma, BDS, General dentist, Dr. Pawan's Bright Smile Dental Care, Guwahati, Assam, India.
Dental emergencies are not just inconveniences. They can have serious consequences if ignored or delayed. From severe pain and discomfort to potential complications that jeopardize oral health, the consequences of neglecting dental emergencies can be significant. Through patient education, timely intervention and proper care, the impact of dental emergencies can be mitigated, preserving both oral health and overall well-being.
(By Dr. Nirainila Joseph)
References:
Garispe A, Sorensen C, Sorensen JR. Dental Emergencies. [Updated 2022 Dec 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK589664/
Roberts G, Scully C, Shotts R. Dental emergencies. West J Med. 2001 Jul;175(1):51–4. PMCID: PMC1071467.
https://my.clevelandclinic.org/health/articles/11368--dental-emergencies-what-to-do