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When Should You Use an Emergency Dentist

Most dentists are not emergency dentists. They are not interested in providing emergency care and many refuse to see additional patients. However, although there are many obstacles associated with being an emergency dentist, there are also some benefits.

The reason why most dentists refuse to be an emergency dentist is because it throws off their regular schedule with non-emergency patients. Often, when emergency dentists interrupt their normal schedule to treat an emergency, their scheduled patients get irritated that they have to wait, and it damages the dental-patient relationship.

This can cause patients to choose to use another dentist, especially when patients have waited for two or three months for their appointment and are asked to wait an hour or longer to take care of the emergency. Because most dentists feel the need to create a feeling of trust and loyalty with their patients, they decline to service individuals needing emergency dental procedures.

Most dentists are pretty busy and it's not uncommon to hear that someone has to wait 3 months for an appointment. Patients who need immediate care often have a hard time finding someone to see them. The goal of an emergency dentist is to quickly provide needed treatment to get someone out of dental pain or to stabilize a critical situation.

Many dentists in fact, will make special provision for dental emergencies by reserving a portion of their time schedule to deal with such emergency cases.

          Emergency Dentistry often involves partially done procedures. For example, in a normal situation most root canals are done from start to finish in a 1 hour appointment. The problem is that an emergency dentist cannot do 2 procedures at the same time. With emergency dental care, the goal is to get the patient out of pain. It is not to perform the entire procedure. Instead of doing all of the root canal, for example, the emergency dentist can open the tooth and remove the nerves and the biting surface of the tooth so that the patient is unable to further damage the tooth.
          Emergency Dentistry often involves temporary procedures. Instead of getting a permanent restoration, temporary sedative fillings are used to protect the tooth until something can be permanently done. Unfortunately, many patients get upset (even though the dentist is fitting the patient into his schedule) about getting something temporary done and insist on getting the permanent filling done that day. This often creates a scheduling problem and provides the dentist and his patients with a bad experience.

Emergency Dentistry and Emergency Dentists
Dental emergencies are a fact of life – teeth chip, gums get cut and lips get bitten suddenly and without warning, giving rise to a dental emergency situation. Being prepared, and knowing what steps to take when you are faced with a dental emergency is of prime importance.  Many dentists in fact, will make special provision for dental emergencies by reserving a portion of their time schedule to deal with such emergency cases. Our comprehensive guide below gives an outline of what an emergency dentist deals with from day to day and also how different dental emergencies are dealt with.

Types of Dental Emergencies

Below are a few of the common dental emergencies that require treatment.

Chipped tooth
Bitten tongue or lip
Cracked tooth
Broken jaw
Tooth ache
Knocked out tooth
Objects caught between teeth
Extruded teeth

How are does an emergency dentist treat dental emergencies?

The type of treatment that an emergency dentist will prescribe will depend on the particular situation, below are a few common senarios and how they are treated.

Chipped tooth - A chipped tooth is rarely a disaster, and your emergency dentist is almost always certain to save your broken tooth. Before you see the dentist, rinse your mouth with warm water, and reduce any swelling by using cold compresses. Your dentist may fix the tooth using a white filling. If a filling is not likely to help, your dentist may recommend a root canal and a crown.

Bitten Tongue or Lip - Injuries to the soft tissues of the mouth, including the lips, tongue or cheek can occur often.  These injuries may be in the form of tears, puncture wounds or lacerations. First, clean the cut area, and reduce the swelling using a cold compress. If the cold compress doesn't stop the bleeding or the swelling, visit the emergency room of the nearest hospital immediately to get the wound sutured. In case of a tongue laceration, simply pull the tongue forward, and place a piece of gauze to put pressure on the affected area. 

Cracked Tooth - A cracked tooth can manifest itself in the form of a toothache. The crack may be invisible to the eye, and may actually be invisible even in an X-ray. Your emergency dentist will use methods like bonding or root canal treatment depending on the size of the crack and the location. In extreme cases, your dentist may extract your tooth.

Broken Jaw - First, use an ice pack to reduce the swelling. Visit your dentist or an emergency room as fast as possible.

Toothache - A sudden toothache can throw your life out of gear. First, call your emergency dentist, and make an appointment. Use a dental floss to remove any food or other forms of debris, caught between the teeth. Don't use any pain killers on the gums, because they can burn the gums. In the meanwhile, take an over-the-counter painkiller to ease the pain. An ice pack pressed against your face right at the source of the toothache will provide some relief.  Don't use hot compresses on the affected area, and rinse your mouth with warm water.

Knocked Out Tooth - In case of a knocked out tooth, or an evulsed tooth, the most important thing is not to panic. First of all, locate the tooth, and immediately, call your dentist. While waiting to see the dentist, rinse the area, but don't scrub. Don't try to remove any of the tissue fragments that may be attached to the tooth.  If you can, insert the tooth back into its socket. If however this is not possible, or if you fear that you might swallow your tooth, place it in a glass of cold milk, or wrap in a clean cloth. Visit the emergency dentist as quickly as possible. If you act fast and can get to a dentist within 10 minutes, the tooth has a very good chance of affixing itself once again and taking root. If you wait for more than 2 hours, the chances of your tooth taking root again are slim.

Objects Caught Between Teeth - Never use sharp or pointy tools to remove any object that is stuck between your teeth. Instead, use dental floss carefully to remove the object. Take care to protect your gums. If the object can't be dislodged, contact a dentist immediately.

Extruded Teeth - Extruded teeth means teeth that have been pushed, either inside or outside. In such cases, the tooth should be pushed back to its normal position by using mild finger pressure. Do not force the tooth back into the socket, and make an emergency appointment to see the dentist.

Fractured Teeth - A minor fracture will be treated by your dentist using a sand paper disc. He might also restore the tooth using a composite restoration. He may even choose to leave it alone if it is a minute fracture. Whatever the treatment, the tooth has to be treated with great care over the next several days.

In case of a moderate fracture in which there is no permanent damage to your pulp, your dentist will make use of teeth restoration methods, including placing of a permanent crown to bring your tooth to its pre fractured condition. If there has been damage to your pulp, your dentist may make use of additional treatment options. Besides pulp damage, a moderate fracture can also involve damage to the dentin or enamel.

In case of a severe fracture, chances of recovering the tooth may be slim. Even so, your dentist will make use of specialized dental procedures to restore severely damaged teeth. Consulting a dentist for emergency treatment as soon as possible is therefore imperative.

Lost Fillings - If you've lost your dental filling, simply place a piece of sugarless chewing gum that has been softened, in the hole which contained the filling. Consult an emergency dentist as quickly as possible, to replace the filling.

Emergency Dentistry

Most of the time our teeth and gums are healthy and don't require any treatment. If problems do arise then we can usually contact our local dentist.

This is fine if you are registered with a dentist, but if you're not then you may have to resort to emergency measures. This can mean contacting your nearest dental clinic and obtaining an appointment via their emergency service. This is usually an 'out of hours' service which is designed to cater for the unexpected, such as toothache or an abscess.

If you are in severe pain or have a serious dental problem then go to your nearest Accident and Emergency (A & E) department.

This includes the following:

Swelling in the face or neck: this could be due to an abscess or an infection that is rapidly spreading. If left untreated then it can block the airway.

Fractured jaw: if you have received a blow to your chin or have been involved in an accident then your jaws may need to be reset.

Loss of consciousness: if you have received a blow to the head or have been 'knocked out' then this will require further investigation.

Severe bleeding: this can happen following an extraction and is often due to an infection or the use of certain drugs. If bleeding cannot be controlled then seek medical attention.

These will require the attention of a specialist oral surgeon.

What are classed as 'dental emergencies?'

The following conditions are classed as dental emergencies:

Toothache
Abscess
Root canal problems
Broken or chipped tooth
Swollen gums
Broken dentures
Decayed tooth roots
Loose crowns
Lost fillings
Wisdom teeth problems
Painful mouth ulcers

Another option, especially if you are suffering from toothache is to use a temporary measure such as a 'toothache kit' which is available from your chemist or supermarket. These kits contain dental cement and an anaesthetic gel.

Other treatments include:

Painkillers such as aspirin and Ibuprofen. Avoid codeine as this tends to make you drowsy. Paracetamol is another option. Tempting as this may be, do NOT exceed the maximum dosage.

Oil of cloves: a few drops of this on a cotton wool bud can help to ease painful toothache. The only problem with this is that it is washed away by your saliva.

Antiseptic mouthwashes: this is good at treating bleeding or infected gums and mouth ulcers. Avoid 'Listerine' as it contains alcohol which is not advisable plus it can cause you to fail a breathalyser test!

Salt mouthwashes are useful if you have had a tooth removed. They can help with the healing process and are also good at soothing mouth ulcers.

Topical anesthetic gel: this type of gel is useful for treating mouth ulcers around wisdom teeth and soft tissue injuries. However, like oil of cloves it can be washed away by your saliva.

Antibiotics: these work for gum diseases and abscesses. If you have an abscess then you may be prescribed antibiotics beforehand to remove any infection before dental treatment.

They are useful as a short term measure but are not a replacement for professional help. What they can do is to temporarily ease your toothache whilst you try to find a dentist.

If you are a private patient then you can contact your dentist and be treated right away. This means no waiting until you find a dentist or having to adopt one of these emergency measures. This is why patients opt for private care as it gives you a wide range of options.

Except that you do pay more for this service.

But, it has become increasingly difficult to find an NHS dentist and if you are lucky enough to find one then there is the added problem of registration. Many dentists find that they simply cannot take on any more patients and unfortunately, have to turn people away.

Currently, around 50% of the UK population are not registered with an NHS or private dentist. This is extremely worrying as it means around half of the population could be facing long term health problems. Prevention is better than cure which is why dentists recommend twice yearly check ups.

If you require emergency treatment but are not serious enough to need your local A & E department then try NHS Direct. This 24 hour helpline can offer help and advice which is useful as a temporary measure. At the end of the day you will still need professional dental treatment but they can help in the meantime.

What is the most common dental emergency?

Unsurprisingly, toothache is the number one dental emergency. It is a very painful condition and one that needs treating as soon as possible. There are two types of toothache:

'Alive' nerve in the tooth root: this can become sore and inflamed. If it does then you will notice that your tooth hurts when you consume hot or cold drinks.

'Dead' nerve in the tooth root: if the nerve 'dies' then it can form an abscess at the end of the root. An abscess can be very serious if left untreated so please seek help right away.

Toothache is caused by tooth decay and gum disease which they themselves, are caused by the build of tartar and plaque. Both of these are preventable if you follow a daily oral hygiene routine combined with check ups at your dentist.

Your teeth can also be damaged when playing sport (such as rugby), falls, road accidents and accidents at home (doing DIY for instance). Accidents do happen and we can't legislate against every activity that we do but we can take precautions. For example, if you play a contact sport such as rugby or hockey then wear a protective mouth guard (similar to the ones worn by boxers).

I need emergency dental treatment how does it work?

If you are already registered with a dentist then you can contact your local surgery either during office hours or via their out of office system. Normal office hours are usually 9am to 5pm.

If you are phoning out of hours then they will have an Answer phone with details on emergency dental treatment.

You will find that your surgery will provide treatment if you phone before 10pm in the week and between 9 and 5 on weekends and Bank Holidays.

Note: if you contact your surgery out of hours then it is unlikely that you will see your own dentist. If this is the case then he/she will not have your medical records. If so then provide him/her with as much medical information as possible as well as details of any medicines you are taking.

If you are not registered with a dentist then your first port of call is to phone NHS Direct. This 24 hour helpline can be contacted on 0845 4647 and will be able to give you details of an emergency dentist. You will have to wait to be treated but you should be treated on the same day.

Another option is to find a private dentist. If you are already a private patient then you will be treated by your own dentist a.s.a.p. If you are not then you can still see a private dentist although this can be expensive. However, you will be treated immediately. It depends on whether you are able (or prepared) to pay a large sum of money to be treated right away.

Non-UK residents who have been in the country for less than 6 months are not entitled to NHS treatment. They will have to seek private treatment instead. If you are a non-UK resident then check your medical insurance policy to see what dental treatment you are covered for. See if you can claim for the cost of dental treatment from them or your travel company.

If you are in this situation then contact NHS Direct or look for a private dentist.

If your condition is serious then go to the Accident & Emergency (A & E) department of your local NHS hospital.

Emergency Dentistry is not routine dental treatment. Many patients confuse regular dental care with immediate care procedures. Most dentists are not interested in providing emergency care and refuse to see additional patients. It throws their schedules behind and all of the scheduled patients get mad that they have to wait. Most dentists are pretty busy and it's not uncommon to hear that someone has to wait 3 months for an appointment. Patients who need immediate care often have a hard time finding someone to see them. The goal of emergency treatment is to get someone out of dental pain or to stabilize the situation.
         
Emergency Dentistry often involves partially done procedures. For example, in a normal situation most root canals are done from start to finish in a 1 hour appointment. The problem is that an emergency dentist can not do 2 procedures at the same time. There's only 1 dentist! With immediate care, the goal is to get the patient out of pain, not do all of the procedure. Instead of doing all of the root canal, the tooth can be opened, the nerves removed and the biting surface of the tooth removed so that the patient can't batter the tooth any longer.
         
Emergency Dentistry often involves temporary procedures. Instead of getting a permanent restoration, temporary sedative fillings are used to protect the tooth until something can be permanently done. Unfortunately, many patients get upset (even though the dentist is fitting the patient into his schedule) about getting something temporary done and insist on getting the permanent filling done that day. This often creates a scheduling problem and provides the dentist and his patients with a bad experience.