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ADULT TEETH – When an adult tooth is knocked out it is quite a different matter. If the root is not fractured, adult teeth can be re-implanted. The likelihood of the success with that procedure is mostly time dependent. Some authorities say that for every 10 minutes that the tooth is out of the mouth, your chances of saving the tooth go down by 10%. In other words, if the tooth is out of the mouth for 30 minutes you have a 70% chance of saving the tooth, but if it is out longer than an hour, then your chances are not very good. Our patients have our home phone number on every piece of paper they receive from our office. We are in the phone book and can usually be reached in short order for assistance with these kinds of emergencies.
What to do immediately if you are present when someone has an adult tooth knocked out……
Firstly, save any tooth that has been knocked out for possible re-implantation. Bring it to your dentist as soon as possible. The longer you wait, the less chance there is for successful re-implantation. Handle the tooth only by the crown (chewing edge). Do not try to clean it if it is not visibly soiled. If there is visible debris on the tooth, do not try to remove it with anything more than a gentle, very brief stream of warm water. Then just suspend it in milk until arriving at the dentist. The point is to avoid scrubbing the root. Any kind of mechanical cleaning process will remove biological components that are needed for re-implantation.
Use one of the following options to transport the tooth to the dentist:
1. If the tooth looks very clean, then try to replace the tooth in the socket, to the level of adjacent teeth. Bite down gently on gauze or a wet tea bag to help keep it in place. The surrounding teeth can be used as anchors. Care must be taken not to swallow the tooth.
2. If the tooth cannot be replaced in the socket, place it in a container and cover with a small amount of whole milk or saliva.
3. The tooth can also be carried inside the mouth, between lower lip and lower gum or under the tongue. Just don’t make the mistake of swallowing or aspirating it!
For additional first aid, follow these steps:
1. Apply a cold compress to the mouth and gums for pain.
2. Apply direct pressure, using gauze, to control bleeding.
Teeth that have been knocked out and re-implanted always need a root canal procedure. In our practice, we would recommend that be done by a root canal specialist to insure the best possible outcome. Specialists are going to be far more experienced with this sort of thing simply because of the volume of patients they see.
2. FRACTURED TEETH
Teeth that have been badly fractured may have an exposed nerve. If a badly fractured tooth has sharp pain than you should see a dentist as soon as possible. If it is predictably “sore” , but not causing sharp pain, then this is a good indication that the nerve is not exposed. Less immediate care would be fine. In either case, the tooth will need attention to avoid decay, infection, abscess, and pain.
3. Toothaches
Toothaches are a sign of a real problem. The majority will recur and escalate in severity over time, even if they have come and gone before. It is best to see us early with a toothache. We can always assure you a better outcome and experience if we catch problems in the earliest stages. If you wait to call after hours, when the pain has become intolerable, then it is very hard to get an accurate diagnosis and exact solution. Usually the cause of a toothache that starts right out of the blue, is a dental infection from deep decay or fracture. Initially, an antibiotic and prescription pain reliever will reduce the throbbing for a couple of weeks while plans can be made to either restore or extract the tooth. DO NOT put any pain killers, including aspirin, on the gums beside the tooth because it can burn the gum tissue. Clean your mouth out by rinsing thoroughly with warm water. Gently floss around the tooth to remove any food particles that may be caught there. If your tooth continues to hurt, you should call your dentist as soon as possible. A toothache can result from several dental problems. Regular dental check ups and dental cleanings can help prevent toothaches.
4. Possible Broken Jaw
If you think that your jaw might be broken, apply a cold compress to the area to minimize any swelling. You will need to see your dentist immediately. Usually a panoramic X-ray will reveal a fracture. Hospital emergency rooms do not often have this type of diagnostic tool so they are not able to diagnose jaw fractures with complete accuracy.
5. Bitten Tongue or Lip
If you have bitten your tongue or lip, gently wipe the area clean with a cloth. Apply a cold compress to the area to minimize any swelling. A cold, wet tea bag can also be of some help in stopping the bleeding. If the bleeding will not stop, you should go to the emergency room of a nearby hospital. But remember that the mouth always looks like it is bleeding far more than it really is. This is because your saliva turns red and looks like a lot more blood than is actually present.
6) Something Caught Between Your Teeth
Gently insert a piece of dental floss or a dental flosser. Be very careful not to cut the gum tissue. If you are unable to remove the object, contact your dentist. Never use a sharp object to try and remove something that is stuck in between your teeth.
7. SIMPLE CHIPPED TEETH
Simple chips or fractures may be tended to on a non-emergency basis, but should still be fixed to avoid sharp edges that can cut the lips or tongue, and for cosmetic reasons.
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