Is It Your Turn Yet?

“Is It Your Turn Yet?”
April 2010

Dental Emergencies

I hope for this month’s topic that it is never “Your Turn Yet” as this month we want to speak about dental emergencies. Most people have stories in the family about breaking a tooth while growing up or a vacation that was ruined by a terrible toothache. The most common emergencies we have besides a toothache (caused many times from neglect of preventive care) is trauma to the teeth of children while they are playing sports or playing with friends. As always, the best way to treat a broken tooth is to prevent the accident in the first place. The Maine Principals Association has just initiated mandatory mouth guard wear for some sports. This is very welcomed as most of the traumatic injuries we see during sports is from soccer or basketball. It is rare to have a football, field/ice hockey injury because of the mandatory mouth guard wear. A concern for athletes in soccer is that their ability to breathe may be restricted.

There are two types of mouth guards available. The first is the traditional boil and fit mouth guard that is most commonly used in football and hockey. Two advantages of the boiled mouth guard are the very low expense and the ability to easily make another if the mouth guard is lost or deformed. The second option is called a lab processed mouth guard. This mouth guard fits more exactly and is slightly smaller, but must be made by a dental office. An impression is made and the dental laboratory then makes an appliance constructed from the mold of that impression. Ask your dentist if you feel the boiled mouth guard does not fit your need.

Parents always ask the question of what age a child should start wearing a mouth guard. There is a limit to the protection you can have for your child. It reminds me of the little boy in the movie, “Little Giants”. The little boy enters practice completely mummified in thick foam padding to the point that he couldn’t even walk. Although there is some danger, I personally have never had my children wear mouth guards playing baseball or riding a bike. It is a personal decision because those two activities have been the highest incidents of dental trauma in this practice.

So, what if you or your child is unprotected and has an accident which breaks or knocks out a tooth? If a portion of tooth is broken, amazingly enough, you should find that portion of tooth and bring it to the dentist. Modern methods of bonding now allow us to sometimes rebond the piece of tooth back into place. If the tooth is completely knocked out, most of us know that if treated quickly, the tooth may be placed back in the mouth and kept. If a tooth is avulsed (knocked out), a couple of basic points will help the tooth’s chances. If the tooth is dirty, rinse the tooth off, but do not scrub. The live cells that reattach are on the outside of the root and must not be removed. If possible, put the tooth back in the mouth. If that is not possible, place it in milk and find the dentist as soon as possible. The critical time is two hours to replant the tooth. After that, up to approximately six hours, the tooth can still be replanted but its chances for survival diminish.

Finally, a tip on dealing with a toothache (usually on vacation or out of town). The most important determination is whether the tooth aching is dead or alive. An “abscess” is an infection around a dead tooth. With an abscess comes swelling, pressure and constant aching that is not sensitive to hot or cold. Immediate treatment can be given by the dentist or antibiotics. If the tooth is sensitive to hot or cold and aches after being stimulated, the nerve is alive and antibiotics will not help. Temporarily, you can sedate the tooth by placing a cotton plug with oil of cloves on it. This can be obtained from most grocery stores. The worst pain, dentally, is a nerve in the process of dying. The classic symptom is an extremely severe aching that is stimulated by hot and relieved with ice. If you ever have that condition, drink a cold glass of ice water and locate a dentist as soon as possible.

We hope it is never “Your Turn Yet” for these injuries, but in the active days of summer, there are always potential accidents lurking around every corner. We hope the remainder of your spring and the upcoming summer is safe and enjoyable.