Here are a few useful tips which we have given to patients and acquaintances over the years, in cases of emergency outside of the surgery setting.
Chipped tooth or lost filling: Losing or breaking a filling can lead to a very sharp edge which can rub on the tongue or cheek, making it sore and causing an ulcer. If the sharp edge can be rounded over, even if it is just slightly, it will make it more comfortable. This can be done in one of two ways:
1: Use a clean emery board or metal nail file, to gently smooth over the sharp edge. Usually, 3-4 rubs will do it.
2: Use a temporary filling material available in the chemist or supermarket. This can be used to cover over the sharp edge, and also fill in the cavity. These often come in the form of 2 pastes which you can mix, a putty or powder to mix with water. This material does not harm the tooth and is easy to remove, so we quite like it.
Some such products are DentaNurse, Dr Denti, Dentekc- If you are unable to find either of the above, then you could even use some chewing gum! chew it till soft, then mould over the sharp edge. This is very temporary but will give relief to the tongue or cheek - Maintain good oral hygiene and limit sugar frequency to prevent any decay or existing decay from getting worse.
Swelling in the mouth: Most likely to be caused by a gum infection or an infected tooth and needs to be looked at by a dentist. Give us a call and arrange an emergency appointment as soon as you are able.
Until you can see or speak with the dentist, a useful tip is to use some warm salt water mouth baths. Half a glass of fairly warm water, but not too warm that you can burn yourself. Dissolve a heaped teaspoon of table salt, until the water goes clear. Hold some of this warm salt water in your mouth in the area of the swelling for a minute and then spit out. Repeat several times, until the water is finished. Repeat this every 1-2 hours, if possible. If the swelling is causing severe pain or causing an increase in temperature, please call us, and we will be able to prescribe you suitable antibiotics. If the swelling is spreading towards you eye or neck, or even affecting your breathing, then please call 111 or head down to your local A&E department.
Pain relief, what works well? If unsure, please speak to your pharmacist. If you are suffering from mild to moderate pain, then the usual analgesics- paracetamol and Ibuprofen work well. Please ensure that you are keeping within the recommended dosage guidelines. There is some evidence to suggest that lower dosages of Paracetamol and Ibuprofen taken together provided better pain relief than taking them individually.
Inside the mouth, if it is a gum or cheek problem, then something like Bonjela, or Difflam will help with the discomfort. Warm salt water mouth baths can also help soothe the sore area.
All the above tips are anecdotal, and no liability is accepted. The advice of a dentist is always advised as soon as possible.
Sensitive teeth: Sensitivity can be normal and the majority of us will feel the symptoms at one time in our lives. However, sometimes a crack or a cavity can be the cause of the discomfort. If the sensitivity is caused by the effects of over brushing, enamel wear or hot/cold foods then the advice below will help.
Tooth sensitivity is usually caused by open tubules on the tooth surface, receding gums or worn teeth. These dentine tubules are mainly on the exposed root of the tooth. The tubules are normally closed, but any acidity or abrasion can open them up. As the tubules contain fluid, all the way down to the pulp chamber, any extremes of temperature make the fluid contract or expand, thus stimulating the nerve inside the tooth. The sensation can also be felt if the open tubules are touched with a toothbrush or finger. The best way to help the sensitivity is to close up the tubule openings so that the fluid inside no longer contracts or expands with a change in temperature or touch. Our saliva has the ability to do this, but sometimes requires a bit of help. Sensitive toothpaste contains ingredients which can do just this by depositing in the tubule openings and blocking them up. Thus reducing the sensitivity. A lot of the newer sensitive toothpastes are good to use routinely. However, the best method is to dab a bit of the toothpaste onto the sensitive tooth, all the way up to the gum and leave it. Ideally, after brushing, dry the tooth by sucking some air in, apply, and leave. Repeat this for a few days, and once the sensitivity is better, continue twice a week, to ensure the tubules stay blocked.
Sore gums / Bleeding gums: In most cases, this is caused by not cleaning well enough and leaving plaque behind. This can happen occasionally, no matter how long you clean for. The plaque will cause your gum to become inflamed, which then makes it bleed when touched, e.g. with a toothbrush. Gums will not stop bleeding until your oral hygiene improves. Brush your teeth twice a day, paying special attention to the area where the tooth meets the gum and spending extra time on the ones that bleed. If the bleeding is coming from in between your teeth, then you can use TePe brushes or floss to ensure all plaque and food deposits are cleared away. Sometimes, bleeding can be caused by trauma from hard food. In all cases, the gums need to be kept very clean of plaque and should start to show signs of improvement after a day or two.
Even if the gum is sore and it is bleeding, gradually, and gently clean away as much plaque as possible. If there is plaque present, then it will hinder the gum from healing. Warm salt water mouth bathe can help, as it is anti-bacterial, and has a soothing effect. There is more information on our hygienist Anne's website www.healthywhitesmile.co.uk
Broken denture: Try not to use superglue, unless you really have to b, if the broken bits are not put together exactly, the denture may not fit as well and may also cause soreness. Superglue will only hold the repair for a short time, because of the wet environment of the mouth and leave a residue making the permanent repair more difficult. If there are any sharp edges, which are rubbing on the inside of the mouth, then a few rubs with a clean emery board or metal nail file will smooth off the sharp edges, and make it more comfortable until it is repaired.
For the permanent repair, either take it to your dentist, where it can be repaired using associated denture laboratory. The dentist can also take an impression if needed for the repair, and check the fit of it, once repaired. Alternatively, there are also some denture technicians who offer a denture repair service, and can often do it while you wait.
Denture Rubbing or loose: Any sharp or rough bits can be adjusted at home with a clean emery board or nail file. If a denture moves, it can cause soreness. Consider using a denture fixative for loose dentures, such as Fixodent or Polygrip. Leave your denture out if it is too sore to wear. this will also help the sore gum to recover.
Wisdom Teeth: In most cases, pain from wisdom teeth is due to the infection of the gum around the tooth. Often there is not enough space in the mouth for the wisdom tooth to come through fully, leaving a loose flap of gum covering part of the tooth. Plaque gets beneath this loose flap of gum and causes pain and swelling. When it is in this state it is tempting not to touch it, but by not cleaning the area the plaque builds up further making it worse. We advise the use of a small-headed toothbrush, like a single tufted brush to clean beneath the flap of gum. Initially, the swollen gum will be sore and will bleed, but the more it is cleaned, the better the chance of it settling. If you do not currently have a single-tufted brush then keep using your normal brush, but be thorough, even if it is sore initially. To help this cleaning process, you can also bathe the area in warm salt water, which acts as an antibacterial and will also help reduce the swelling. If convenient, bathe the area for a minute every 1-2 hours.
Lost Crown: If it is not broken, and locates well, then it can be put back in temporarily using the temporary dental cement available from the chemists. e.g. Dr Denti, Dentek, or DentaNurse. If you are out and about, then chewing gum can also help. Soften it well by chewing, then put inside the crown a place over the tooth. Both the temporary cement and chewing gum are easy for us to remove and will not cause any damage to the tooth. However, if the crown does not locate well then there is a risk that it can be swallowed. In this case, do not put it back over the tooth. Store it in a safe place such as an envelope or small container. Good oral hygiene and a low sugar diet will help prevent the tooth underneath from getting decayed.
Trauma/ Lost Tooth
Primary or Baby tooth – Often this happens when the tooth is ready to come out naturally anyway and there is no need to worry. If it is knocked out before it is ready, then there is little that can be done, as the adult tooth is directly below the surface.
Secondary tooth or Adult tooth – To save the tooth, it must be re-implanted as soon as possible (2 hours is the outer limit for survival). Right away is best. During normal surgery hours, please phone the practice immediately. Out of hours please go straight to an Accident and Emergency department.
First Aid Advice:
If more than 30 minutes away from dental or medical care, replace the tooth in the socket before coming in, use the following technique:
1. Rinse off the tooth with saliva or water (do not scrub it).
2. Replace it in the socket facing the correct way.
3. Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
4. Have your child bite down on a wad of cloth to stabilize the tooth until you can reach your dentist.
If unable to put the tooth back in its socket, follow these instructions:
1. It is very important to keep the tooth moist. Do not let it dry out. (Transport the tooth in milk ( preferred option) Place tooth in a small plastic bag or container with some cold milk. If the child is over 12 years of age, put the tooth inside the child’s mouth, ideally between the cheek and the tooth. (Be careful not to swallow it))
Ulcers: Mouth ulcers can be very sore and normally take 2 weeks to resolve. A few tips Use a Qtip/ cotton bud to apply Bonjela, Oralieve or topical oral anaesthetic on the painful area. Before meals in particular, so that you can eat comfortably. If you can get a product called igloo rapid relief gel, then this forms a protective barrier over the ulcer to make it more comfortable. Bonjela complete + works well too. Difflam spray or mouthwash can also help numb the soreness temporarily. Maintain good oral hygiene, even around the sore area. Take pain killers if needed. Use warm salt water mouth bathes to prevent infection, and speed up the healing. This may sting a little bit initially, but will certainly help.