Emergencies

Here are some common dental emergencies and how to handle them:

Facial Swelling  

If your face becomes swollen following a toothache it generally means you have an abscessed tooth. This needs to be treated by a dentist as soon as possible.

For pain take Nurofen (if you are not allergic to aspirin), Panado or Panadeine. Avoid taking aspirin.

Toothache

A toothache can generally (but not always) be diagnosed from the symptoms. Listed below are the five most common types of toothache. If you recognize your symptoms get to a dentist ASAP. If you don’t recognize your symptoms, get to a dentist ASAP.

1. Tooth tender to touch, pain kept you awake last night, hot drinks make the pain worse but cold drinks make it better- This is an abscess. You need this tooth treated as soon as possible. It will NOT get better by itself. For pain take Nurofen (if you are not allergic to aspirin), Panado or Panadeine.

2. Tooth will ache for no reason, possibly in waves. Pain is severe but then passes This is probably an abscess starting. You need this tooth treated as soon as possible. It will NOT get better by itself. For pain take Nurofen (if you are not allergic to aspirin), Panado or Panadeine.

3. Tooth hurts when chewing hard things. Pain comes quickly and goes quickly. There is no pain at other times- This is most likely a cracked tooth or filling. This is not urgent if you avoid biting on the tooth but should be looked at as soon as possible.

4. Tooth hurts when eating or drinking sweet things – This is most likely caries (a cavity). This is not urgent but should be looked at as soon as possible.

5. Tooth sensitive to cold drinks- This can be any one of a number of things (new dental work, decay, cracked teeth, clenching and grinding, receded gums etc). This is not urgent but should be looked at as soon as possible.

Knocked Out Tooth

1. Don’t Panic. If you follow these instructions generally there is no long-term harm done.

2. Is it a baby Tooth? (child 0-5 years)  – If yes and the tooth is completely knocked out then there is no treatment. If yes and the tooth is out of position see a dentist as soon as possible.

3. Is it a permanent Tooth? If yes and the tooth is out of position call us immediately. If yes and the tooth is completely knocked out do the following:

If the tooth is clean put it straight back into the hole it came out of. Avoid touching the root. If done quickly it will go back in easily. Make sure it is around the right way. Have the patient hold the tooth in place with their finger or by biting gently on a handkerchief. 

Get to a dentist as soon as possible.
If the tooth is dirty in order of preference: 

• rinse in milk or 
• rinse in cold running water for 1-2 seconds or 
• have the patient suck the tooth clean. DO NOT touch the root or try to clean the root any other way. Put the tooth back in. Hold in place as above.
• If you can’t put the tooth back in then it must be kept moist while you get to a dentist. Cover the tooth with milk or wrap in “glad wrap”. If neither is available the tooth can be kept moist in the patient’s mouth (in the pouch of the cheek). If none of this is possible use water.
• Ring the telephone number below or get to a dentist as soon as possible. A dentist will need to be seen as soon as possible. They will either place the tooth into position for you or see whether you have done a good job. The tooth will then be splinted to the other teeth to hold it in place.

Follow up visits will be made to determine the treatment plan for the tooth. In many cases root canal treatment will have to be performed (from the Biological perspective we DO NOT advise you to have root canal therapy). Just remember that the chances of success are higher the quicker the tooth is placed back into its socket

We will give the patient antibiotics immediately. For adults give 2gm Amoxicillin stat, 500mg qid for 7 days and in proportion for children. Use Erythromycin if allergic. If the tooth has contacted soil administer Tetanus Toxoid. Refer to a dentist for splinting ASAP)

Broken Tooth

If the tooth is broken as a result of an accident then try to find the broken piece and get to a dentist as soon as possible. Broken pieces of tooth can often be reattached.

If the tooth is broken during normal chewing then it is most likely the result of decay or a crack in the tooth. Bring the piece along if possible but it is unlikely it will be reattached.

Fluoride

Now let’s talk about Fluoride, fluoride works in two ways:

1. Systemic fluoride strengthens the teeth that have erupted as well as those that are developing under the gums.  We gain systemic fluoride from most foods and some water supplies.  It is also available as a supplement in drop or gel form and can be prescribed, but we are STRONGLY OPPOSED TO THAT!.  

If too much fluoride is consumed while the teeth are developing, a condition called fluorosis (white to brown spots on the teeth) may result as well as many other side effects. Please check our “YOUR HEALTH” page on fluoride toxicity.

2. Topical fluoride strengthens the teeth once they have erupted by seeping into the outer surface of the tooth enamel, making the teeth more resistant to decay.  We gain topical fluoride by using fluoride containing dental products such as toothpaste, mouth rinses, varnishes and gels.  It is generally recommended that children have a professional application of fluoride twice a year during dental check-ups.

At THE HOME OF BIOLOGICAL DENTISTRY, when requested by the patient or parent, we only use fluoride varnishes. Though sodium fluoride varnish has a higher concentration of fluoride than current gels, foams, rinses and pastes, it is less toxic to children because less of it is swallowed during application. Toxicity and nausea are a cause of concern with children. Studies have shown that fluoride in patient’s blood plasma is lowest amongst fluoride varnish users than users of other topical treatments. 

Some scientists believe that even mild to moderate cases of fluorosis can lead to more significant problems. Studies have associated fluorosis with lower IQ, endocrine system problems, and skeletal damage.

St. Petersburg Times June 4, 2007

Increasing focus on the toxicity of fluorides and fluorine compounds and related health effects is largely the result of fluoride’s ongoing “invisibility”. THE HOME OF BIOLOGICAL DENTISTRY wants to convey the scientific information that is known about fluoride/fluorine compound toxicity to those who ought to know but do not.

This is what Dr Rojas had to say in a Business Day interview (although a bit misquoted…)

DISCLAIMER: we do not diagnose or treat any conditions. We are providing information to be used only as guidelines. Only the individual’s medical providers can make medical diagnoses and prescribe treatments.