Common dental emergencies
By Steven Shi BDSc Hons Melb
Dental emergency - Toothache
Dental decay is a common cause of toothache. Dental decay occurs because the bacteria in your mouth feeds on the sugar in your diet to produce acid. The acid demineralises your tooth and over time the softened tooth collapses to form a cavity. A common symptom of tooth decay is sensitivity to sweets. A visit to the emergency dentist may halt the progression of tooth decay, preventing the bacteria from infecting the nerve. An infected nerve may then lead to the formation of a dental abscess. An abscess is a pool of pus which includes dead white blood cells and dead tissue. A dental abscess is treated with root canal therapy. Common symptoms of a dental abscess include constant pain and pain on biting. If this is the case, the emergency dentist may remove the infected nerve and drain the abscess. This procedure is usually not painful as you are numb. Once the infected nerve is removed, it is necessary to complete root canal therapy during subsequent visits. A crown needs to be placed on the tooth in some cases. An alternative to root canal therapy is extraction by the emergency dentist . Extraction of the tooth is not recommended unless the prognosis is hopeless, even with treatment.
Dental pain may also be caused by a cracked tooth. The emergency dentist will use a device called a frac finder to help diagnose a cracked tooth. When you have a cracked tooth, the tooth may be sore when you bite down on it. The placement of a crown can help prevent the crack from propagating any further.
An increasing number of patients are also visiting the emergency dentist because of sensitivity to hot/cold at the gum line. This is often due to excessively harsh brushing. The patient's gums may have receded, exposing tooth's root.
Our emergency dentist will also diagnose dental pain which may be a symptom of a non tooth problem. A common problem which causes dental pain is sinusitis. If you bend over or jump up and down, the pain will often be exacerbated. Grinding or clenching may lead some patients to visit the emergency dentist. Patients often report that it is the worst when they wake up in the morning (because they have been grinding or clenching during their sleep). The muscles which are used to help chew you food may be tender to palpation. An occlusal splint worn at night may help relieve the symptoms.
Dental emergency - Dental trauma
Dental trauma may occur on the sports field, during a brawl or simply from falling over. If the tooth has fallen out the of the socket, first determine if it is an adult tooth or a baby tooth. If it is a baby tooth, do NOT place the tooth back in the socket as it may lead to damage of the developing adult tooth. If the tooth is an adult tooth, rinse with saline and then insert it back into the socket. Please call us ASAP for an appointment. If appropriate, the emergency dentist will place the tooth in the correct position and splint the tooth. If the tooth has not come out but rather been displaced, the emergency dentist will reposition the tooth and splint it. Splinting is usually done with a wire and resin composite (filling material).
Dental emergency - Lost crown
A lost crown may result in tooth sensitivity to hot and cold. Additionally, if the crown is on a front tooth, it may impact one's appearance. Most of the time, we can simply recement the crown.
Dental Emergency - Wisdom tooth
There are two common problems associated with wisdom teeth. Wisdom teeth may get decayed. The other commmon wisdom tooth issue is pericoronitis. This occurs when there is inadequate space in the jaw to accomodate the wisdom teeth. As a result the tooth is only partially erupted. This results in a flap of gum covering the tooth. It is easy for food to be impacted underneath this flap and cause pain. In fact food can also get impacted around teeth which are not wisdom teeth, causing a periodontal abscess. When you visit us, the emergency dentist will determine if the wisdom tooth can be safely removed immediately or non extraction treatment should be performed first. Non extraction therapy usually involves the removal of the impacted food, drainage of any pus and prescription of antibiotics.
Are silver fillings safe?
Silver fillings are perfectly safe. The World Health organisation and International Dental Federation hold the position that silver fillings (amalgam) are a safe dental material. Amalgam is an alloy of silver, mercury, copper and tin. The reason that amalgam is safe despite the mercury content is because the mercury is not free mercury but in an alloy form. We do not believe in the replacement of silver fillings unless there is a justifiable clinical/aesthetic reason. The removal of amalgam may release more free mercury than would otherwise be released if the filling were left in place. Despite the material safety of silver fillings, our clinic does not use amalgam as a dental material on a regular basis. We usually prefer the use of white fillings because:
- patients expect an aesthetic, tooth coloured restoration.
- amalgam tends to stain the adjacent teeth with a dark hue which will remain even after the amalgam is removed.
- often more natural tooth needs to be removed to mechanically lock in an amalgam filling.
- amalgam does not bond to natural tooth structure.
I brush my teeth twice a day, why do I stil get cavities?
Dental decay (dental cavity) is multifactorial. You may be getting tooth decay because:
- You have too much sugar in your diet. Your dentist can provide you with dietary counseling. During dietary counseling, we go through your entire diet and identify sources of sugar. Sticky sugary food is worse than non sticky sugary foods. Sticky sugary foods to avoid include: chocolates, sweet cereals and sweet biscuits. Snacking on sugary foods through out the day is worse than having sugary food during a meal.
- You have poor saliva quality or inadequate saliva quantity. Your dentist can do a saliva study for you to examine saliva quantity/quality. Inadequate saliva can be caused by medications, radiotherapy and other causes.
- You are not brushing properly. Please visit your dentist for proper oral hygiene instructions.
Why is dentistry so expensive?
Dentistry is expensive because it involves skilled human labour, expensive equipment, high specialised material costs, large capital outlay and the work is custom made for you. We cannot mass produce dentures, fillings and crowns. Each piece of work is custom made for you by hand. The best way to keep your dental expenses low is to maintain good oral hygiene, have a good diet and go to the dentist regularly to prevent the need for extensive dental treatment. Health insurance may help to pay for dental treatment however there is often a waiting period especially for major dental work e.g. crowns. You can also get a tax offset for your dental treatment. If your total medical expenses (including dental treatment), exceed the threshold during the financial year, you may be entitled to a tax offset.
Does smoking damage my teeth?
Smoking damages the entire mouth. Smoking can increase the chances of you developing oral cancer. Regular visits to the dentist can result in early detection of oral cancer. Alcohol consumption and smoking compound the risk of oral cancer. Smoking also contributes to gum disease. Gum disease can result in loss of the supporting structures around the teeth. Over time, the teeth can become loose and eventually fall out. Gums infections can spread to the pulp of the tooth and these infections lead to the loss of the tooth. Smoking also affects the ability of your saliva to protect your teeth from dental decay. Smoking also causes unappealing dark stains on your teeth. In conclusion, smoking is terrible for your mouth and you should try to quit as soon as possible.