If you do have an emergency that requires care after-hours, call the office to obtain the phone number for the doctor on call. Please leave a message and Dr. Kayes or Dr. Griffiths will return your call as soon as possible. Feel free to call again if you do not hear back within thirty minutes.
If an accident is involved that requires emergency care at a hospital, proceed to the emergency room or call 911. You may want to request that an oral surgeon or pediatric dentist be called in to consult for dental injuries. You may also contact our office to discuss the case or to ask questions so that we can aid in coordinating dental care.
Below we have provided some general information on common dental emergencies. This information is not designed to substitute for in-office diagnosis and treatment.
Emergency care for accidents to teeth or mouth
Tooth Knocked Out
If a permanent tooth is knocked out, do not handle it by the roots. Do not scrape the tooth root to remove dirt. If the tooth is dirty, very gently rinse for about ten seconds with milk or with the saliva of the person who lost it. Do not use water, soap, or any chemicals to clean the tooth. Do not wrap the tooth in tissue or cloth.
Place the tooth in milk if possible (do not use water) or hold it in the person's mouth between the cheek and gum in contact with some saliva and get to the dentist or emergency room as soon as possible – ideally within thirty minutes.
If possible, a tooth can be placed gently back into the socket, especially if care cannot be reached within the thirty minute time frame.
If you have the broken piece available, save it to bring to the office. Sometimes it is possible to use the fragment to bond back to the remaining tooth, and if not, it can be useful for us to evaluate the overall damage by examining the pattern of fracture. If only a small portion of tooth fractured off, generally the visit can wait until the next day. If, however, you can see pink where the tooth has broken, the nerve is likely exposed and you should obtain care as soon as possible. If you cannot get to the dentist and the area is sensitive or sharp, covering the area with a "band-aid" of orthodontic wax (usually available at drug stores) can help relieve sensitivity and keep the area clean.
Gum or Lip Injury
If the cut is not severe, applying cold will reduce swelling. We usually recommend a popsicle for children with this type of injury. If the cut is severe enough to cause an open gash, sutures may be needed for proper healing. If you do go to an emergency room, you may want to ask if an oral surgeon is on call to suture the area and to examine for other possible injury to the mouth.
Knocked in Mouth, no Apparent Injury
If you have taken a blow to the mouth but nothing appears broken, it is still a good idea to see a dentist within twenty four hours, particularly if there are loose teeth or if sensitivity is present. Sometimes when an accident occurs and teeth are not broken, force from the trauma is absorbed by the roots of the teeth, and damage to the pulp may occur. We may want to evaluate with an x-ray, and then follow up with another x-ray in a few months to determine if nerve damage occurred.
Fall by a Child, Baby Teeth Jammed
The most important thing to remember when this happens is to not move the teeth any more after the accident. When baby teeth are jammed up, any further manipulation can damage the developing permanent teeth, so even if the baby tooth has changed position the best course of action is to leave it alone. You will want to schedule an office visit within twenty-four hours for a dental evaluation.
Emergency care for toothaches
When you have a toothache, it is important to figure out exactly what makes it hurt so we can obtain a proper diagnosis at the dental office. While some aches are very clear as to the cause, some toothaches can be vague, making it difficult to pinpoint the reason for the pain. Below is a guide we use to help in diagnosis of those vague aches, along with an explanation of what different types of aches may indicate. None of this information is meant to replace a proper diagnosis by the dentist, and any toothache should be evaluated at the dental office.
Throbbing, intense pain may come and go, touching the offending tooth makes pain worse
This is generally an indication of an abscessed tooth and care is needed as soon as possible to clear up the infection.
Soreness in upper arch cannot pinpoint one tooth, feels worse when you bend over
This could be from sinus pressure. If you have a cold, or if you have been working in a dusty area, this could be the problem. Taking an antihistamine or decongestant should alleviate pain, although if you have a severe infection (and it is possible to have a sinus infection and not realize it) you may need antibiotics. Evaluation at the dentist or physician's office can confirm a diagnosis.
Pain in several teeth, no pattern, may be accompanied by headache or jaw soreness
This pain could be caused by clenching or grinding of teeth to the point that the periodontal ligaments have been stressed. The dentist can evaluate your teeth for wear and examine the jaw joint for signs of stress to make a diagnosis. If you have been under stress this could be the problem. It should be noted, however, that it is possible for an abscess to cause referred pain to other teeth, and that option should not be ruled out. In either case, it is important to visit to the dentist as soon as possible for diagnosis.
Pain in one tooth while chewing or applying pressure
This could be the sign of a cracked tooth, although it could also be the beginning symptoms of an abscess. A cracked tooth can be difficult to diagnose properly since it may not show up on x-ray and may be hidden from view. Treatment for a cracked tooth generally involves crowning the tooth.