Emergency Care

In case of a dental emergency we are always available to help. Just call the office for the pager number of the doctor on call. He or she will call you back as soon as possible.

Most injuries to baby teeth occur during the toddler years when children are learning to walk, yet lack good coordination. The central incisors (i.e., the top front teeth) are most frequently affected. In the permanent dentition, the most common age for dental trauma is ages 8 to 11 years old. At these ages oral injury is common during sports activities.

CUTS TO THE LIPS, CHEEKS, OR TONGUE

Apply ice to the bruised area to prevent swelling. If there is bleeding, apply direct pressure with clean gauze or cloth. If bleeding cannot be controlled by simple pressure, call us or take the child to a hospital emergency room. Make sure to check for any lacerations that may require stitches.

MOBILITY OF TEETH

Loosening of a tooth is a common result of trauma. It is often accompanied by some bleeding of the gum near the crown of the tooth. Although many of these teeth can recover, call us for follow-up to be certain no further treatment is required.

TOOTH FRACTURES

Tooth fractures can involve the root, crown, or both. Sometimes small enamel fractures can be smoothed. Larger fractures may require a bonded restoration. Fractures involving the pulp tissue.(i.e. nerve supply of the tooth) may require pulpal therapy and sometimes extraction. Avoid chewing in the area and call our office for evaluation and treatment if necessary.

TOOTH DISCOLORATION

Occasionally, trauma causes a color change to a tooth. In baby teeth, this is indicative of hemorrhage into the dentinal tubules (the layer under the enamel) of the tooth. Sometimes this blood pigment is resorbed and only mild discoloration remains. Color change alone may not indicate the need for treatment, however, this needs to be evaluated for possible treatment of the nerve that will attempt to prevent the need for extraction. With permanent teeth, discoloration could be reflective of nerve degeneration and the tooth may require root canal therapy.

TOOTH DISPLACEMENT

Sometimes traumatized teeth are driven further into the socket, dislocated in the bone, or completely displaced out of the mouth. An examination with a radiograph will determine the course of treatment.

AVULSED or KNOCKED OUT BABY TEETH

If a baby tooth is knocked out, do not reimplant the tooth. Call the office as soon as possible. If you cannot locate the avulsed tooth, sometimes it is possible that it was actually driven up into the socket. Therefore, it is necessary to call the office and see the doctors for an examination and x-ray.

AVULSED or KNOCKED OUT PERMANENT TEETH

If a tooth is knocked out completely from the mouth, first locate S the tooth. Hold the tooth by the crown portion only and try not to handle the tooth unnecessarily. Rinse it gently in cool water but do not scrub it vigorously. The best thing to do is to reinsert it into the socket. If you cannot reinsert it back into its socket, transport the tooth to us in milk preferably or water. We will reimplant it at the office. Either way, see us immediately as time is critical in saving a tooth and at the office we will stabilize the tooth. The sooner the tooth is reimplanted into the socket, the higher the success rate.

TOOTH INFECTION OR ABSCESS

An abscess is a tooth infection that has spread to the surrounding tissue and bone. It usually originates either as an infection from a tooth with a cavity which has spread to nerve and bone tissues or as a traumatic injury to teeth resulting in necrosis of nerve tissue. The tooth may be painful and is sometimes accompanied by swelling, or draining fluid.. There are instances when there is no pain associated with a tooth infection especially when there is drainage from the gum.

If you suspect your child had a dental abscess:

1) Call the office and schedule an appointment as soon as possible.

2) If necessary, give the child pain medication.

3) Instruct the child to eat on the other side

4) Irrigate the area by rinsing

CANKER SORES

Canker sores or aphthous ulcers are extremely common yet their cause is unclear. Both in school-aged children and adults, these ulcers occur singly or in multiple locations, are usually 5 mm or less in diameter, and are clearly defined and painful. Predictably, the ulcers usually heal within 4 to 12 days. Individuals more prone to canker sores include the following:

1) those who have suffered a minor injury of the mouth caused by, for example, brushing too vigorously, braces that rub against the cheeks, and lacerations of the gums or mouth by sharp-edged foods.

2) those with diet deficiencies, such as in iron, folic acid, and other B vitamins.

3) individuals who are allergic to certain foods or who have food sensitivities may develop canker sores after eating those foods. Eliminating the offending foods can reduce the occurrence of canker sores. A useful suggestion is to keep a journal of one's diet and the incidences of canker sores. In this manner, one may identify the canker sore inducing-food. Some of the more common foods are:

For a child with canker sores , it could take 7 to 10 days to resolve. The following treatments can make your child more comfortable until it runs its course.

1) Pain-relieving. Over-the counter topical gels containing benzocaine.

2) Peroxide rinses. Bacterial biochemical activities produce metabolites that will that will irritate canker sores. Rinsing vigorously with an antimicrobial mouthwash will reduce bacteria in the mouth.

3) Corticosteroids. These are medications, presented as prescription gels or creams, which reduce inflammation caused by canker sores.

PRIMARY HERPETIC GINGIVOSTOMATIS

Herpes virus is a widespread infection that is common in young children. The infection may be manifested with one to two mild sores inside the mouth, which may go unnoticed by the child. Other children, however may exhibit more severe symptoms, including fever, fiery red gums, pain associated with eating, irritability, malaise, headache, and painful ulcers on the tongue, lips, tonsillar areas, palate and oral tissues of the mouth. Apparently, anyone is potentially susceptible to a herpetic infection, even healthy children with clean mouths are at risk. Physical contact with an infected individual is the typical route of inoculation for someone not previously exposed. Reactivation of the virus may follow at a later time. A herpetic infection runs its course over a 7 to 10 day period. Treatment is directed to relieving oral discomfort and to maintaining proper nutritional intake.

The following points are recommended to make your child more comfortable at home:

1. Bed rest
2. Forced fluids and vitamin supplements for proper nutrition
3. A soft diet, including ice cream which may be soothing to the mouth
4. Use of an antipyretic, like Tylenol to control mild fever
5. Keeping the mouth clean by rinsing and gentle brushing

OVER-RETAINED TEETH

An over-retained baby tooth that is still in place when a permanent tooth has erupted can prevent normal eruption and cause a dental malocclusion. It is important for the child to visit us, so as to distinguish if the problem is a temporary acceptable malocclusion which we will monitor for a period of time, or, perhaps, an orthodontically unfavorable condition which requires treatment.