emergencies

Dental Emergencies

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Pediatric Dentistry Emergency Info » 
Orthodontic Emergency Info  »

Pediatric Dentistry

Our pediatric dentists maintain a 24-hour emergency service. If you need urgent advice or need to see one of the dentists on-call, please call our office to reach a receptionist during normal business hours. After office hours, our answering machine will provide you with the name of the dentist on call and how to reach them.

Pain

Pain in or around the mouth may be caused by a tooth or soft tissue problem and it can be difficult to distinguish between the two. Infections of the gums can result in significant pain and may need antibiotics to address. Toothaches can be either spontaneous or initiated by various stimulants such as cold air, hot or cold foods or beverages and by biting.

Aspirin is not recommended in children to treat pain. For temporary pain relief, acetaminophen or ibuprofen is recommended.

Soft Tissue Lacerations and/or bruises

Application of ice to traumatized areas can help to control the bleeding and limit subsequent swelling. For active bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the injury has resulted in significant bleeding, please call our office to be seen for evaluation and treatment or go to an emergency room.

Fractured Teeth

All but the smallest of fractures need to be evaluated within 24 hours of the accident. If the fractured segment is found, please keep it moist in a container of water and bring it to the appointment for evaluation. Emergency treatment consists of either rebonding the segment to the fractured tooth or temporarily applying a resin material over the fractured edge. At a subsequent appointment a full resin buildup of the fracrured tooth can be completed.

Displaced or Knocked Out (Avulsed) Teeth


All injuries to either primary or permanent teeth that result in significant loosening or displacement must be evaulated. Displaced teeth require repositioning and stabilization as soon as possible. Permanent teeth that are displaced totally out of the socket should be placed back into the socket by grasping the crown of the tooth and gently re-implanting the tooth. If the root is dirty, gently clean it by running it under cold water prior to re-implantation. If you are unable to re-implant the tooth, it should be placed in a container of cold milk. It is essential that the tooth be re-implanted by a dentist ASAP to maximize success!

Canker Sores (Apthous Ulcers)

Canker sores are usually small sores inside the mouth with a white or gray base surrounded by a red border. Generally, the ulcerations last one to two weeks and heal on their own but are quite painful and often mistaked for an abscessed tooth.  They also often recur.  Rinsing with salt water does not make them go away faster and is quite uncomfortable and they do not require antibiotics.

Lip bite

Following dental aesthesia, some patients play, suck or bite on their lip, cheeks or tongue. A raw and very swollen and tender area can then develop. This is not an infection. Keep the area clean and apply a cool compress as needed. For temporary relief please take acetaminophen or ibuprofen and please don't hesitate to call our office.

Orthodontic Emergencies

True orthodontic emergencies are rare. You may be surprised to learn that you can temporarily solve the occasional orthodontic problem at home. If you have a situation that cannot be remedied on your own, call our office. An orthodontic assistant will be able to give you advice on how to alleviate your discomfort, or schedule an appointment time to make you comfortable.

The following is a list of common orthodontic problems and guidance on how to alleviate them.

Loose/Broken Brace
A bracket may slide back and forth on the wire or a band may lift up and down on the tooth. This is generally not an emergency unless it is causing pain or discomfort.  If the bracket is attached to the wire, leave it in place and cover it with wax as needed for comfort. If needed, use wire cutters or nail clippers that have been cleaned with alcohol to clip the wire and remove the broken brace. Avoid connecting elastics to loose braces. Call the office to schedule a repair appointment.

Wire Irritation
As your teeth align, the end of the wire may begin to push out of the band around the back teeth and begin irritating the cheeks.  Place wax on the end of the wire or the band where it is irritating the cheek. You may also try cutting the wire with nail clippers or wire cutters that have been cleaned with alcohol. Call the office and we will schedule an appointment to clip the wire ends.

Poking Metal Tie
Metal ties are sometimes used to secure the wire into the bracket. Small metal ends are then tucked under the wire to keep them from irritating the lip or cheek. Occasionally, the end of this metal tie can become un-tucked and cause irritation. Try pushing the metal end away from the lips and cheeks and toward the tooth with the eraser end of a pencil or the flat side of a metal spoon.

Lost Elastic Tie (Colored or Clear)
If an elastic tie falls off it is not an emergency.  You can wait until your next appointment to have it replaced. 

Wire out of Tube or Slot
During treatment, flexible wires may slip out of the bands on the back teeth.  If the wire comes out of the tube, try placing the wire back in the tube using tweezers.  If necessary, clip the wire with clean fingernail clippers or wire cutters at the next bracket where the wire is secured. Call the office to schedule an appointment to have the wire replaced.

Tooth Discomfort or Soreness
Teeth may become sore or achy following an orthodontic appointment. Teeth are most sore during the first 24-72 hours.  Maintain a soft food diet as needed.  If necessary, take the pain reliever you would use for a headache such as Acetaminophen (Tylenol) or Ibuprofen (Motrin).

Sores/Ulcerations
During the first week of treatment, you may notice sores or ulcerations inside you mouth. This happens because your lips, cheeks, and tongue are not yet use to rubbing against your braces. This will get better as your lips, cheeks and tongue get tougher. Using a small piece of wax on the area of the braces that are causing the sore with provide some relief. You may also use an over the counter medication used for treating cancer sores such as Orabase.

Retainer Broken/Not Fitting
If your retainer is broken or not fitting properly, please do not wait until your next appointment. It is important to be seen sooner as teeth may shift if your retainer is not worn. Please call the office during business hours to make an appointment for adjustment or repair.

Injury Involving Teeth
If an accident occurs during orthodontic treatment and trauma occurs to the teeth, please call your dentist.


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