Dental Emergencies

Toothache and/or Swelling

While root canal problems can occur with no pain at all this is not always the case. If you find you have tooth pain that lasts longer than 5 minutes after eating or drinking hot or cold foods, or you have tooth pain that starts by itself for no apparent reason, this is frequently an indication that the pulp tissue inside the tooth is starting to die. If left untreated the infection will spread out of the tooth and into the jaw bone. At this stage the disease is called an abscess which can be associated with extreme pain, swelling and pain on chewing. If you wish to retain the tooth root canal therapy will have to be undertaken (See Procedures Offered).

In order to control the pain take a pain medication such as Ibuprofen (i.e. Advil or Motrin) or Acetomenophen (i.e. Tylenol) and contact your dentist immediately for a referral to Dr. Maguire.

Note: Delaying root canal treatment until symptoms have gotten out of control frequently results in greater difficulties in the treatment process, including difficulties with local anesthesia and greater incidence of post-operative complications and pain. Don’t wait – root canal problems never get better by themselves.

Avulsed Teeth/Knocked out Teeth

A multitude of teeth are knocked out every year in Canada. The main cause of knocked out (or Avulsed Teeth) in the permanent dentition is sports injuries. Researchers have developed methods of saving most of these teeth. Knocked out teeth can often be replanted. If the tooth can be replanted within minutes of the accident, there is a good chance that the tooth will be retained for life.

When an accident occurs that involves a knocked out tooth, it is important that the tooth be located as quickly as possible and picked up by the crown portion of the tooth, NOT the root. If the tooth is dirty or contaminated, it should be rinsed gently with milk. If milk is not available then water can be used for rinsing only. The tooth should NOT be stored in water as water storage damages root surface cells.

If possible the tooth should be replanted within 5 minutes of having been knocked out. Once the tooth is replaced in it’s socket, the patient should then bite gently on gauze and see a dentist as soon as possible. The tooth will need to be stabilized by splinting it to the adjacent teeth.

If it’s not possible to replant the tooth immediately, then the tooth should be placed in a container with milk, saline or in a tooth saver jar. The tooth should not be allowed to become dry. The tooth can also be placed between the cheek and gumline of either the person who lost the tooth or a willing adult, however if the individual is a child there is the risk that they may either swallow the tooth or inhale it.

The latest research recommends replanting the fully formed tooth within 5 minutes. Regeneration of a normal periodontal ligament, the essential element for success, is not expected beyond 5 minutes of the tooth being out of the socket, especially if it is allowed to become dry.

It is advised that if the accident victim shows any signs of head injury, unconsciousness, nausea or persistent headaches, they should be first evaluated for their head injury by proper medical personnel. Once a head injury is ruled out they may proceed to a dentist for treatment of the avulsed tooth. A tooth should not be immediately replanted if the injured person is unconscious for fear of aspiration.

Therefore, the treatment of choice is immediate re-implantation, after rinsing the tooth if necessary, and immediate transfer to a dentist for proper splinting and evaluation. If one cannot replant the tooth, then store the tooth in milk or saline while on route to a dentist.