Dental emergencies refer to acute, severe problems with your teeth, gums, or mouth that require immediate care to relieve pain, prevent bleeding, or maintain oral health. Dentists consider these conditions to be possibly life-threatening conditions that need urgent attention, including trauma, infection, swelling, or severe pain.
Timely treatment may help avoid such complications as the permanent loss of teeth, further developing infections, or irreversible damage. For example, early treatment of an avulsed tooth, preferably within 15 minutes of the injury, has a significant effect on the success of replantation, because the periodontal ligament cells can only survive a short period. Likewise, infections treated early prevent the transmission to the jaw, neck, or brain.
Knowing what a dental emergency is and realizing that it requires urgent treatment, you can now know what to do in case of the unexpected.
What to Do With Dislodged/Extruded Teeth
A tooth partially pushed out of its socket (extrusion) is loose, tender, and usually painful. This is a severe dental trauma that requires prompt and knowledgeable first aid, since the way it is managed may have a profound effect on the long-term prognosis of the tooth.
If the extruded ticket is displaced, reposition it by applying light pressure with clean fingers. This movement must be performed gently—any aggressive action may cause additional damage to the periodontal ligament and the ligament cells, which are essential in reattachment. After repositioning the tooth, it is crucial to stabilize it by biting on a sterile gauze or cloth to keep it in position.
The tooth might have been damaged due to nerve or blood supply issues, even after a successful repositioning. Clinically, you are to observe such signs as a gray or darkened tooth surface, which usually signifies the impairment of the internal blood flow. The patients can also have a long-lasting numbness, a persistent sensitivity, or the inability to reposition the tooth, which indicates full pulpal injury.
Pulp necrosis is often a common sequel to luxation injuries. Rates of about 34 percent have been observed in extruded permanent teeth. Professional assessment is critical and urgent for such signs to avoid infection and enable timely treatment, including root canal treatment or splinting.
What to Do When You Have a Toothache
A toothache usually indicates a more serious problem that severely affects oral health. Causes of toothaches are usually cavities, infected root canals, TMJ problems, bruxism, and gum disease. Cavities, which are caused by acid-producing oral bacteria, are one of the most common chronic diseases, which in most cases cause pain when the decay reaches the nerve.
Likewise, gum disease, which affects almost every other adult, irritates the supportive tissues surrounding teeth and may reveal sensitive spots, making them painful. Additionally, temporomandibular joint dysfunction and bruxism may appear in the form of jaw and tooth pain, which may cause headaches via the trigeminal nerve.
Postponing a toothache treatment will enable the minor decay to progress to severe infection, increasing the chances of an abscess and systemic disease. As clinical evidence demonstrates, untreated pulpitis may lead to pulp necrosis and periapical abscess, a painful pus-filled infection that may necessitate root canal treatment or extraction.
The pain of TMJ can be aggravated by stress, leading to a cycle of muscle tension and more pain. Health advisories suggest a warm salt water rinse and over-the-counter ibuprofen or acetaminophen as temporary relief. Nevertheless, direct application of aspirin to the gums is highly discouraged because of chemical burns and mucosal injury. Toothaches should be treated immediately to avoid complications, minimize pain, and normalize oral health.
What to Do After a Broken or Fractured Tooth
Once a tooth fractures, it affects the aesthetics and allows bacteria to penetrate sensitive tissues, which can lead to pain or infection. Identifying the type of fracture helps with urgency and proper care.
Fractured Cusp
A fractured cusp usually happens near a filling that is already present and frequently brings no or minimal pain. It can, however, cause sensitivity to chewing. You should keep broken pieces and carry them to your dentist in a clean container. A missing cusp may occasionally be re-glued in place. Otherwise, your dentist will fill the tooth with composite or a crown to stabilize it and avoid bacterial invasion.
Split Tooth
A fractured tooth—the crack below the gum line—can be painful and throbbing and even cause some bleeding. In these cases, the debris is removed by rinsing gently with warm water, and a cold compress may assist in reducing swelling. Patients are encouraged not to chew on that side, which would cause more damage. Often, a fractured tooth cannot be salvaged completely; depending on the severity, it can be treated with crown coverage on one side or extraction in case of a deep fracture.
Vertical Cracks
Vertical cracks that run along the chewing surface to the root, though not completely dividing the tooth, are likely to produce sharp pain on biting or release. Since these cracks are not always visible at first sight, X-rays or bite tests are necessary to identify the depth and the presence of the dental pulp involvement. Crack propagation can be halted by endodontic treatment, commonly a root canal, followed by a protective crown, and save the tooth.
Diagnostics Tools
Dentists use several instruments to diagnose fractures. Visual inspection can show cracks on the surface, and dyes like methylene blue can show the slight cracks. Symptoms typical of cracked-tooth syndrome can be simulated by tactile examination using a dental explorer and bite-release testing. Radiographs, such as periapical and occlusal films, can help eliminate the possibility of root involvement. Suspected hidden cracks can be enhanced with advanced modalities such as fiber-optic transillumination.
What to Do in Case You Have Damaged Soft Tissues
The mouth has soft tissues that can be injured in a dental emergency, such as the cheeks, tongue, and lips. Healing and preventing infection require immediate and proper care.
Burns and Scalds
The lining of your mouth may be burned or scalded when it is in contact with a hot surface, liquid, or steam. Cool or plain water should be used to wash the area and clear irritants, and the area should be gently wiped. Pain can be reduced, and further tissue injury can be avoided by prolonged cooling (several minutes).
Burns that do not have blisters are best treated with cool, wet compresses for at least 15 minutes, whereas a medical professional should assess more serious burns. Once rinsed, hot, spicy, acidic, and alcohol-containing foods and drinks should be avoided, as they may worsen the pain and slow down the healing process. A protective coating can be applied temporarily to cover the damaged mucosa, like a soothing oral gel, e.g., aloe vera or an anesthetic.
Biting Lacerations
Bleeding lacerations are common due to accidental biting of cheeks, lips, or tongue and can be frightening. The initial management involves applying firm, gentle pressure with sterile gauze or a clean cloth and keeping it in place for approximately 10 minutes to aid clot formation. Professional assessment is recommended if the bleeding lasts longer than 10 minutes or the wound is deep. Lip and tongue lacerations are prevalent in trauma, according to a systematic review of dental trauma.
Dentists use several instruments to diagnose fractures. Visual inspection can show cracks on the surface, and dyes like methylene blue can show the slight cracks. Symptoms typical of cracked-tooth syndrome can be simulated by tactile examination using a dental explorer and bite-release testing. Radiographs, such as periapical and occlusal films, can help eliminate the possibility of root involvement. Suspected hidden cracks can be enhanced with advanced modalities such as fiber-optic transillumination.
How to Handle Avulsed Teeth
Immediate intervention significantly enhances the long-term prognosis of one of the most urgent dental emergencies, a knocked-out tooth, or avulsion.
First, find the tooth and grasp it by the crown, never the root, to save fragile periodontal ligament (PDL) cells vital to replantation. Wash the tooth for 10 seconds under cold, clean water or saline to clear off debris, without any scrubbing that may destroy essential cells. Ideally, place the tooth back into the socket, with the proper orientation, and bite on gauze to keep the tooth in place.
Nevertheless, in case on-site reinsertion is not possible, it is essential to keep the tooth in a physiologic solution, preferably milk, Hank Balanced Salt Solution (HBSS), saline, or, in case of necessity, saliva of the patient, to preserve the viability of the PDL cells. Do not use water, which may lead to cell rupture. It is permissible to place the tooth between the cheek and the gum to remain moist in the case of a conscious patient.
Reinsertion should not be tried if the tooth is fractured or soiled beyond simple rinsing or if you are unsure of its position, which can increase damage. Also, do not replant milk teeth, as there is a risk of damaging the permanent tooth forming. The tooth should be brought to an emergency dentist as quickly as possible, preferably within 30 to 60 minutes, because PDL cell viability decreases dramatically after that point, and complete reattachment may not be possible.
How to Remove Stuck Foreign Objects
Whenever a foreign body gets stuck between your teeth and the gum, it may lead to pain, irritation, and even destruction of the enamel or soft tissues. It may be tempting to use sharp objects such as pins or toothpicks, but improper use may lead to tears in the gums, scratches in the enamel, or even force the object further in, leading to a greater risk of infection.
Instead, the safest thing to do is to make a mild effort to remove it with waxed dental floss. Flossing is a key element of oral hygiene since it may assist in removing trapped debris without damaging tissues. Waxed floss works best in this situation. The smooth coating makes it glide between the close teeth gaps without fraying and can dislodge and lift the object without causing harm.
Gently slip the floss down each side of the blockage. Do not snap it into the gums; cease immediately in case of bleeding or resistance. If flossing is ineffective and pain or discomfort continues, do not use sharp or improvised objects to remove the object. Instead, visit a dentist. Dentists possess the necessary tools and can extract the object safely without causing additional harm to the enamel or gum tissues.
Treatment of Gum Abscess
A tooth abscess is a serious collection of pus due to bacterial infection, either close to the tooth's root (periapical) or inside the gum tissues (periodontal). The symptoms are usually severe, constant throbbing pain that can spread to the jaw, neck, or ear. These cause facial swelling, tender lymph nodes, and a bad taste or odor in the mouth. These abscesses appear as red, painful-to-touch, swollen lumps and may extend to the surrounding bone and teeth.
Dental abscesses are dangerous and life-threatening when left untreated. It may extend quickly into adjacent bone (osteomyelitis), soft tissues (cellulitis), the deep neck space, and, in severe cases, into the brain or bloodstream. Systemic dissemination can cause severe fever, deep swelling, shortness of breath or difficulty swallowing, and sepsis. Less common infections, such as Ludwig angina, which is the result of untreated abscesses, have a mortality rate of up to 8 percent, which is caused by airway obstruction and mediastinal involvement.
In case of suspected abscess, warm salt water rinsing may be performed to soothe the region and minimize bacteria. Cold compresses may be applied to minimize facial swelling. Over-the-counter anti-inflammatory painkillers like ibuprofen are advised. Systemic antibiotics can be prescribed for fever or systemic symptoms. However, these measures are temporary; therefore, immediate dental treatment is essential to drain the abscess, remove infection, and avoid recurrence.
How to Handle Orthodontic Emergencies
Orthodontic appliances may break at any time, which may be irritating or uncomfortable. Knowing how to treat the most frequent problems is essential until a professional treatment can be provided.
Protruding Wires
Cover the sharp end first with a pea-sized ball of orthodontic wax to give a smooth protective coating when a wire pokes the cheek or tongue. Otherwise, the wire can be flattened against the tooth with a clean pencil eraser or a cotton swab. If the wire does not remain in position and causes irritation, cut it out with clean, sharp clippers, having gauze ready to receive the piece. Seal the end of the cut with wax. This must be done when the assistance of a professional is not readily accessible.
Loose Brackets
Brackets can become loose because of trauma or biting hard food. If a bracket is still on the wire but displaced, it can be repositioned carefully with sterile tweezers and then temporarily fixed with orthodontic wax. If it has fallen off entirely, keep the bracket secure and take it to your orthodontist because it must be reattached to proceed with the treatment.
Temporary Fixes
In the case of general discomfort, including poking wires, loose brackets, or minor cuts caused by appliances, these simple steps may be used: Rinse the mouth using warm saltwater to soothe tissues; cover the area with wax; use tweezers or a pencil eraser to reposition the parts safely; and, as a last resort, trim a bothersome wire with clean clippers only when you have no access to urgent care. They are only temporary measures, and your orthodontist must complete a repair to guarantee the continuation of the treatment and avoid complications.
How to Find an Emergency Dentist Near You
Dental emergencies may happen within a few seconds, and your reaction defines the situation. Whether saving knocked-out teeth and stopping blood flow, alleviating pain associated with abscesses, or dealing with orthodontic breakages, the faster you handle the emergency, the more likely you are to heal and maintain good oral health in the long term. Rapid first aid and immediate dental care can avoid permanent damage, systemic infection, and expensive restorative care in the future.
At Los Angeles Advanced Dentistry, we are prepared to assist you during dental emergencies. Our state-of-the-art technology, trauma-trained dentists, and 24/7 accessibility enable patients to receive specialized, fast care based on their emergency. Call us at 310-361-2080 to get same-day emergency care and save your smile. Wait no more; call Los Angeles Advanced Dentistry now.
