SENSITIVE TEETH--Duration for a few seconds
Teeth that are sensitive to cold, air or sweets are by far the most common dental "emergency". In nearly all cases the cause is an exposed root surface and is very rarely caused by dental decay. Many cases can be resolved without an office visit. Diligent, gentle brushing and flossing of the root surface adjacent to the gumline can greatly reduce or eliminate sensitivity in the majority of cases. Use of a desensitizing toothpaste such as Sensodyne can also help but may take 1 to 2 weeks to be effective. Discontinue the use of whitening toothpastes and bleaching products during periods of sensitivity.
If you recently had a filling or crown placed, an adjustment may be necessary to resolve the problem.
If sensitivity persists or worsens, the office should be contacted.
SENSITIVE TEETH--Duration for minutes or unprovoked
If a tooth is sensitive for minutes at a time or without stimulation such as cold, heat, or contact with air or sweets this may be an indication of a condition that requires professional attention. Effective brushing and flossing (as noted above) may provide some relief but if the sensitivity does not improve, the office should be contacted as this condition is likely to continue without professional intervention.
A recently placed crown or filling may also be the cause and may require an adjustment.
SHARP PAIN WHEN CHEWING or BITING: This is usually a sign of a developing fracture or occasionally, exposed dentin. These cases should be evaluated when possible. A recently placed crown or filling may also be the cause and may require an adjustment.
DULL PAIN or TENDERNESS WHEN CHEWING or BITING: If the pain feels "deep" under the tooth it may be a sign of an abscess and should be evaluated especially if swelling is present.
If the pain or tenderness is more on the surface or in the gums it could simply be gum irritation. Diligent flossing and brushing will resolve many of these cases.
A heavy bite from a recently placed restoration or a tooth that has slightly shifted may also be the cause of discomfort.
If any of the above conditions persist, the office should be contacted.
SWELLING, DEVELOPMENT of a BAD TASTE or DRAINAGE: These are usually signs of a more significant problem and the office should be contacted as soon as possible.
MUSCLE PAIN or HEADACHES: Habitual clenching or grinding of the teeth while awake or asleep is much more common than most people realize.
Symptoms may include: jaw pain or headaches located in the temple areas upon waking or when eating, vague pain that may be hard to localize and may even feel like a toothache but without localization to a specific tooth, pain may increase during times of stress or deep concentration (ie working on the computer)
Basic treatment consists of: relaxing the jaw when awake so that the teeth are not in contact, soft, easy to chew diet, NO Chewing gum!, Ice the affected area(s)--if ice is not effective after a few days use a heating pad on affected areas, gently massage the affected area(s), if you are able to take Ibuprofen (Advil, Motrin etc) take 1-2 200mg tablets 3-4 times per day for several days. ******If symptoms persist or worsen contact the office for an evaluation and additional treatment.******
BROKEN, FRACTURED or CHIPPED TEETH: Keep the area clean by rinsing and brushing. If there is no initial sensitivity, it is not likely to develop. If plaque is allowed to accumulate, sensitivity is more likely to follow. Contrary to popular belief, a chip or fracture usually is not followed by additional damage or breakdown so do not panic!........keep the area clean and seek care when convenient.
Some fractures are a result of decay. These cases are more likely to be sensitive or painful and collect food and debris and treatment becomes more urgent.
********We do consider visible chips or fractures on front teeth to be "cosmetic emergencies" and will make every effort to you as soon as possible********
TRAUMATIC INJURIES:
Blunt Trauma-Tooth not Displaced (In Normal Position): Place cold compress or ice on the area, take 400-800mg Ibuprofen if you are able. If not able to take Ibuprofen, take a normal dose of Tylenol. Contact the office for evaluation of unseen damage. If sensitivity, pain, swelling or discoloration develops anytime in the future, please contact the office as these may be signs of residual nerve damage.
Blunt Trauma-Tooth Displaced (Out of Normal Position): Attempt to gently replace the tooth to its normal position. Contact the office immediately. Place cold compress or ice on the area, take 400-800mg Ibuprofen if you are able. If not able to take Ibuprofen, take a normal dose of Tylenol. These teeth will usually need to be temporarily splinted in place and may be likely to require a root canal either immediately or in the future. If sensitivity, pain, swelling or discoloration develops anytime in the future, please contact the office as these may be signs of residual nerve damage.
Blunt Trauma-Tooth Avulsed (Totally Out of Position or Out of the Mouth): Holding the tooth by the crown portion only, gently rinse the root with tap water -Do Not Rub to Clean- If possible, attempt to replace the tooth into its socket. If unable to replace into the socket, placing the tooth under your tongue is preferred, if unable to do this, place in milk (next preference) or finally, transport in tap water. Seek care immediately-TIME IS CRITICAL! Chances of successful re-implantation diminish with every minute. If unable to contact a dental office, go to a hospital emergency room (only as a second choice). Place cold compress or ice on the area, take 400-800mg Ibuprofen if you are able. If not able to take Ibuprofen, take a normal dose of Tylenol.
Traumatically avulsed teeth will require root canal therapy in all cases.
LACERATIONS: Place cold compress or ice on the area applying pressure to control bleeding. If able, take 400-800mg Ibuprofen, if unable to take Ibuprofen, take a normal dose of Tylenol. Call the office or hospital emergency room for treatment. If initial care is received in a "non-dental" setting, a dental evaluation is needed to evaluate for unseen problems.