A Guide to Emergency Dentistry

If you search around long and hard enough on the internet, you can find plenty of horror stories about people who have needed emergency dentist work and have not been able to get the treatment that they need. The fear sets in when stories claim that, even when they are suffering chronic pain, patients cannot find a dentist who will treat them. Or alternatively, they will lead onto a suitably juicy story of ‘DIY Dentistry’ – without using anaesthetic and proper equipment, of course.

We’ve all read the stories and we now what is behind them. They play on our fears about a shortage of NHS dentists. This shortage of dentists means that more and more people are struggling to get the treatment they need. Therefore, more and more patients are resorting to treating themselves out of sheer pain and pure desperation. In an emergency, what other choice do you have?

The fact is that the majority of these types of stories are pure scaremongering. People sit up and take notice because most of us, as we read them, realise that we don’t really know what to do in a dental emergency. For many of us, it simply is not an eventuality that we consciously plan for. So maybe it is time to ask yourself: what would you do if you need some serious dental work, but your local practice is already closed for the night? Who would you call? Where would you go? And how would you cope with the pain until you see a dentist with the skills to help?

In an ideal world, we should all know exactly what steps to take if ourselves or a member of our family requires emergency dental treatment. In the same way that we know who to call when the car breaks down or when to call an ambulance, we should also know what steps we need to take when we need to contact a dentist out of hours.

After all, our teeth are important. When you lose a tooth, it will not grow back. So damage to your teeth, gums or jaw can not only be painful. It can mean a change to your facial balance, speech or ability to eat certain foods in the future. In many cases, the sooner you get appropriate treatment, the more likely you are to have less longer-term implications.

What exactly is a dental emergency?

The first thing you need to know is what exactly constitues a dental emergency. After all, you don’t want to get your local dentist out of bed in the middle of the night if it is really something that could wait until morning. So how do you know if you are simply worrying about nothing – or whether they really is an emergency waiting to be tackled!
Dentists agree that there are a number of dental injuries and issues that will require immediate and expert attention – no matter what time of the day or night they occur!

Serious toothache

Many of us suffer from toothache from time to time. Often, it is a minor problem that gets resolved during one of our regular dental check-ups. However, there can be times when toothache can arrive very suddently and can be very painful. Usually, this is the case when we do not visit our dentist regularly enough, so that cavities are allowed to rot right through to the pulp of the tooth. In very serious situations, a dental abscess can develop if dental decay is left untreated – and an abscess will certainly cause extreme pain and require immediate dental treatment.

Lost fillings

A lost filling may not be the end of the world and many people can happily wait for a day or so until having it replaced. Of course, the problem can become worse and more painful if food or other debris becomes trapped in the cavity – so it does make sense to have the filling replaced sooner rather than later. Some dentists recommend fillling the cavity with a peice of sugar-free chewing gum until you can visit them. Others will arrange to see you quickly and fit a temporary filling to cover the cavity. You can then arrange for a full appointment and a proper filling at your leisure.

Chipped, cracked and broken teeth

Teeth can easily become chipped, cracked or broken. It could be the result of a trauma, such as a sports injury. Alternatively, a tooth could chip or crack simply because you have bitten down hard on the wrong type of food. Of course, if there is some decay in a tooth, then this may already have weaked the structure of the tooth and made it more susceptible to damaged when you eat or drink.

There are a number of different types of treatment that your dentist can offer for chipped, cracked or broken teeth. Usually, your emergency appointment will be used to ascertain whether any decay is present and how badly the tooth has decayed or damaged. Once this is clear, your dentist can decide whether the damage is primarily cosmetic or whether the tooth may need a filling, crown or complete extraction.

Crooked teeth

By crooked teeth, we do not mean teeth that are naturally crooked. You need to speak to an orthodontist about those. However, we can include teeth that are knocked askew – or ‘extruded’ to use the technical term – in our list of possible dental emergencies. If your tooth has been knocked out of alignment, you can gently try to push it back into its socket to give it some much-needed support. Then, the sooner you can get to your dentist, the more chance you have of saving your teeth. It is possible to save the tooth if you reach a dentist quickly – so do not be tempted to pull the tooth out yourself!

Knocked-out teeth

A lot of people believe that if they knock a tooth out accidentally, it will need to be replaced by a false tooth or denture. The extra cost often puts people off, so unless they are experiencing pain, they just learn to live with a missing tooth.

What many people do not realise is that a knocked out tooth can be salvaged if they act quickly. You must visit your dentist as quickly as possible – ideally within one hour. Of course, if you want to keep your tooth, you will need to pick it up and take it with you! Dentists recommend keeping the tooth in a glass of milk.

Ideally, you should aim to keep as many of your natural teeth as possible. It not only means that you can smile confidently. Missing teeth can affect your ‘bite’ and cause problems with eating, chewing and talking. The remaining teeth also suffer greater stress, wear and tear, so they can become more damaged over time.

Cuts, gashes and broken jaws

When people think of visiting their dentist, for emergency treatment or otherwise, they usually focus on issues to do with their teeth. However, in an emergency, your dentist can also be contacted about a number of connected problems. In the majority of cases that includes issues such as cuts, gashes and broken jaws, your dentist will be able to provide an initial examination, clean the wound and give you painkillers before referring your to your local hospital.

Broadly speaking, these are the main types of dental problems that require emergency treatment. Of course, all patients need to use common sense. There are degrees of seriousness with every type of problem –for example, a cut lip is probably not an emergency in the same way that a broken jaw might be. Similarly, a larger filling or crown may require more immediate treatment than a smaller filling.

Now that you are aware of what constitutes a dental emergency, the next question should be obvious: what do you need to do in an emergency situation?

What should you do in a dental emergency?

If you are unlucky enough to require emergency dental treatment, your first step should be to ensure that you have taken all the necessary steps to stablise your injury. There are other articles on this site which talk in more detail about what you need to do in each case. It could be something as simple as wedging a peice of sugar-free chewing gum into the cavity where you’ve just lost a filling. It could be placing a lost tooth into a glass of milk. Or it could be ensuring that you take the right type of painkillers. Whatever the situation, there will be some steps you can take yourself to ease your condition.

Secondly – and fairly obviously – you are going to need to call your dentist. They are the experts, after all! Your local dental practice will anticipate a certain percentage of emergency work each week, so they will make sure that they have the depth of resources and the flexible staffing arrangements needed to accommodate you. That way, you can get the treatment you need as soon as possible.

Most dentists will also have an emergency out-of-hours hotline, for night-time emergencies. Alternatively, you can call NHS Direct, who can find the nearest emergency dental practice so that you can get treatment. They will also be able to advise you on any steps you need to take to relieve your pain or ease your condition, until you can get to the dentist.

If you follow these steps, gaining access to emergency dental treatment should be straightforward. While you may need to ease your condition with painkillers, you will certainly not need to try an DIY Dentistry – in fact, we would very much recommend leaving any dental work to the experts!

Could you be better prepared for dental emergencies?

For many people, the shock of a dental accident or the pain of a decaying tooth can mean that they find it difficult to think clearly at the time. This can often lead to them making bad decisions and not getting the treatment that they need quickly enough.

An important part of being prepared for every eventuality is that it helps you to avoid panic. Many people find it helps to create a ‘dental first aid kit’ to keep at home. Here, you can keep painkillers, swabs and chewing gum, as well as important phone numbers such as your local dentists emergency ‘hotline’ and NHS direct. You could also include a dental mouthwash to clean cuts and other injuries.

It may also be helpful to think about which friends or family members might be available to help you if you need it. Sometimes, it can be difficult to drive to your dentist if you are in pain.

What else do you need to know?

Many dental emergencies are caused, not by injury, but by neglect over a long period. This neglect means that decay can attack your teeth. For many people, cavities in the teeth go unnoticed for a long time – especially if they aren not visiting their dentist regularly – and the pain can arrive suddenly and without warning.

Therefore, most dentists will advise that the best preparation for dental emergencies is to ensure that your teeth are well-looked after and that your dentist is given the opportunity to spot potential problems well in advance. This way, you may still need some dental treatment – but ideally, you will have caught the problem before it becomes a full-scale emergency.

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