Emergency Dentistry
There are many situations that fall under the category of emergency dentistry. Actual emergencies such as severe swelling, or severe trauma to the mouth from a fall or accident, may require a visit to the dentist as soon as possible, or in extreme cases the emergency room. If a tooth, or portion of a tooth, is knocked out of your mouth from trauma, it is important to see a dentist as quickly as possible to see if the teeth can be re-implanted. The tooth or teeth should be kept in a container of milk and brought to the dentist, or if no milk is available, kept in your mouth. In no circumstance is it a good idea to wash the tooth in water, even if it has been on the ground. Water will usually kill the ligaments that cover the root of a tooth, and make it unlikely that the tooth will be able to be saved. The tooth does need to be kept moist however, and therefore a container of milk or the saliva in your mouth are the two best options usually available. At sporting events, a trainer may have a solution called Save-a-Tooth, which is a special liquid formulation that is considered the best way to preserve a tooth.
How severe is your dental emergency?
An abscessed (infected) tooth can cause severe swelling, and the swelling can be considered a medical emergency depending on the severity. An abscessed lower molar can result in swelling that extends back to the throat area, which can make it difficult to breathe. An upper tooth can sometimes cause swelling that extends to the lower portion of the eye socket. In these extreme situations, a visit to the emergency room is required.
There are other situations that may not be considered true medical emergencies but do necessitate the help of a dentist on short notice. These include chipped or fractured teeth, a toothache, a crown or filling that has come loose, or a possible infection. In most cases, if the situation requires immediate attention, we can see you on short notice to evaluate your issue. Sometimes the problem can be solved right away such as fixing a chipped front tooth or replacing a crown or filling. For example, a chipped tooth can often be corrected in one short visit by applying highly esthetic dental composite, which restores the tooth to its original appearance.
We are here when you need us!
Even if the situation requires more than just a filling, we can often temporarily fix the problem and reschedule you for a longer visit. Other times, prescriptions may be needed to reduce infection or pain before any work is started.
If you are unsure whether or not you need to be seen, give us a call. Dr. Wahlers can always be reached, even on days we are closed.
Frequently Asked Questions
Dental emergencies involving extreme pain or swelling should be treated as quickly as possible. During our business hours Monday-Thursday, please call the office and we can typically see you quickly depending on your situation. For after-hours emergencies, you can obtain the contact information for the emergency line by calling our office and listening to the message. If it is not a true emergency, we will always respond to messages the next business day at 8am.
Things that can be done at home to help you:
Severe face or head trauma- Do not call our office. Call 911 or head directly to the Emergency Room.
Severe Pain/Toothache – A toothache can start at any time and become extremely painful. If the pain is mild to moderate, over-the-counter pain medication can be used to alleviate the discomfort until you can get in to see us. If the pain is extreme, call us immediately.
Swelling- This typically indicates an infection, and you should call for an appointment. Ice packs (10 minutes on, 10 minutes off) placed over the area of swelling can sometimes help reduce pain.
Tooth knocked out – Note: If there is a suspected concussion, the patient should head to the ER first, the dentist second. Teeth can become avulsed (knocked out) from intense trauma to the mouth such as a punch, a fall, or a sports injury. The tooth should NOT be cleaned or rinsed with water, as this can ruin the ligaments on the tooth. The tooth can be placed in a special vial of liquid that sports trainers often have on hand called Save-a-Tooth. If this is not available, place the tooth in a container of milk. If that is not available, the patient can place the tooth in their mouth, holding it inside of their cheek (saliva and/or blood are ok and will not harm the tooth). Call our office or the emergency line immediately. The tooth or teeth will need to be re-implanted in the gums as quickly as possible.
Crown (Cap) came off – This is not a true dental emergency, unless it is a front tooth and it creates a major esthetic issue! In many cases, a loose crown can be recemented at our office. Some patients do place the crown back on their tooth while waiting for their appointment, either with over the counter temporary cements (this can be difficult to do properly) or simply just pressing it into place. If the crown is at all loose, do not leave it in your mouth since there is a risk of swallowing it.
Lost filling – In the absence of pain, this is not a true emergency unless it is on a front tooth, and is deemed an “esthetic emergency.”
Front teeth, or incisors, are responsible for biting into foods. The relatively narrow edges of these teeth make it easy to bite into a sandwich, but also make them prone to chips and cracks. It is very common to see the corner or edge of an incisors chip. Most of the time if the chip is small, it can be repaired with a composite filling, which is tooth-colored and seamlessly blends with the rest of the tooth for a highly esthetic repair. If the chip is extremely small, sometimes the edge can be polished smooth and nothing else needs to be done. If the chip or fracture is too large for a filling, a crown or veneer may be recommended to provide a long-lasting, esthetic result. Even if your tooth requires a crown or veneer, we can often temporarily bond the tooth if an important event is approaching soon! Dr. Wahlers will discuss all of your options with you at your appointment.
A truly severe toothache is debilitating. The pain can become so intense that it is hard to focus on anything else. Hopefully, you will call us at the first sign of tooth pain, when the problem is likely less severe. But sometimes a toothache can seemingly come out of nowhere, either due to an abscess or severe nerve (pulpal) inflammation. In either case, call the office or the emergency line right away (the number is mentioned in our after-hours voicemail when you call). We will either give you an appointment as soon as we can, or have you see a local specialist depending upon the issue.
Over-the-counter ibuprofen (Advil) and acetaminophen (Tylenol) can help reduce pain somewhat. If you are unsure if you can take these medications, we can discuss it when you call, or you can always ask your pharmacist. Additionally heat or ice packs can often help reduce the pain (try both- every toothache is different). Lastly, sleeping upright in a recliner or propped up on pillows sometimes helps reduce the pressure that can intensify when lying flat.
Meet Our Doctor:
Dr. Christopher Wahlers
Dr. Wahlers was born and raised in central New Jersey. He attended Gettysburg College for his undergraduate studies, where he majored in biology, graduating summa cum laude. During his undergraduate volunteer experiences in different medical settings, Christopher decided to pursue a career in dentistry.
During his time at New Jersey Dental School (Rutgers University), Christopher served as president of his class and graduated in 2003 as a member of the OKU National Dental Honor Society. He continued his education with an Advanced Dental Education residency program at Temple University.
Prior to Wahlers ...
Featured Blog Posts - Emergency Dentistry
What are early signs of dental trouble?
Patients frequently ask us what signs or symptoms they need to be aware of, to know when to come to the dentist. Here is a list of the most common reasons to give us a call right away:
- Mouth sores, growths or changes that are not going away
- Jaw pain
- Swelling in the face or gums
- Worsening tooth sensitivity, especially if isolated to a specific tooth
- Broken tooth
- Bad odor or taste in your mouth, especially if coming from under a filling or crown
- Toothache, especially if pain is severe, constant, or throbs.
This is just ...