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Dental Emergencies

Although dental injuries and dental emergencies are often distressing for both children and parents, they are also extremely common.  Approximately one third of children have experienced some type of dental trauma, and more have experienced a dental emergency.

There are two peak risk periods for dental trauma - the first being toddlerhood (18-40 months) when environmental exploration begins, and the second being the preadolescent/adolescent period, when sporting injuries become commonplace.

Detailed below are some of the most common childhood dental emergencies, in addition to helpful advice on how to deal with them.

Toothache

Toothache is common in children of all ages and rarely occurs without cause.  Impacted food can cause discomfort in young children, and can be dislodged using a toothbrush, a clean finger, or dental floss.  If pain persists, contact the pediatric dentist.  Some common causes of toothache include: tooth fractures, tooth decay, tooth trauma, and wisdom teeth eruption (adolescence).

How you can help:

  1. Cleanse the area using warm water.  Do not medicate or warm the affected tooth or adjacent gum area.
  2. Check for impacted food and remove it as necessary.
  3. Apply a cold compress to the affected area to reduce swelling.
  4. Contact the pediatric dentist to seek advice.

Dental avulsion (knocked-out tooth)

If a tooth has been knocked-out of the child’s mouth completely, it is important to contact the pediatric dentist immediately.  In general, pediatric dentists do not attempt to reimplant avulsed primary (baby) teeth, because the reimplantation procedure itself can cause damage to the tooth bud, and thereby damage the emerging permanent tooth.

Pediatric dentists always attempt to reimplant avulsed permanent teeth, unless the trauma has caused irreparable damage.  The reimplantation procedure is almost always more successful if it is performed within one hour of the avulsion, so time is of the essence!

How you can help:

  1. Recover the tooth.  Do not touch the tooth roots! Handle the crown only.
  2. Rinse off dirt and debris with water without scrubbing or scraping the tooth.
  3. For older children, insert the tooth into its original socket using gentle pressure, or encourage the child to place the tooth in the cheek pouch.  For younger children, submerge the tooth in a glass of milk or saliva (do not attempt to reinsert the tooth in case the child swallows it).
  4. Do not allow the tooth to dry during transportation.  Moisture is critically important for reimplantation success.
  5. Visit the pediatric dentist (where possible) or take the child to the Emergency Room immediately –time is critical in saving the tooth.

Dental intrusion (tooth pushed into jawbone)

Sometimes, dental trauma forces a tooth (or several teeth) upwards into the jawbone.  The prognosis is better for teeth that have been pushed up to a lesser extent (less than 3mm), but every situation is unique.  Oftentimes, the force of the trauma is great enough to injure the tooth’s ligament and fracture its socket.

If dental intrusion of either the primary or permanent teeth is suspected, it is important to contact the pediatric dentist immediately.  Depending on the nature and depth of the intrusion, the pediatric dentist will either wait for the tooth to descend naturally, or perform root canal therapy to preserve the structure of the tooth.

How you can help:

  1. Rinse the child’s mouth with cold water.
  2. Place ice packs around affected areas to reduce swelling.
  3. Offer Tylenol for pain relief.
  4. Contact the pediatric dentist where possible, or proceed to the Emergency Room.

Tooth luxation/extrusion/lateral displacement (tooth displacement)

Tooth displacement is generally classified as “luxation,” “extrusion,” or “lateral displacement,” depending on the orientation of the tooth following trauma.  A luxated tooth remains in the socket – with the pulp intact about half of the time.  However, the tooth protrudes at an unnatural angle and the underlying jawbone is oftentimes fractured.

The term “extrusion” refers to a tooth that has become partly removed from its socket.  In young children, primary tooth extrusions tend to heal themselves without medical treatment.  However, dental treatment should be sought for permanent teeth that have been displaced in any manner in order to save the tooth and prevent infection.  It is important to contact the pediatric dentist if displacement is suspected.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer pain relief (for example, Children’s Tylenol).
  3. Contact the pediatric dentist immediately.

Crown fracture

The crown is the largest, most visible part of the tooth.  In most cases, the crown is the part of the tooth that sustains trauma.  There are several classifications of crown fracture, ranging from minor enamel cracks (not an emergency) to pulp exposure (requiring immediate treatment).

The pediatric dentist can readily assess the severity of the fracture using dental X-rays, but any change in tooth color (for example, pinkish or yellowish tinges inside the tooth) is an emergency warning sign.  Minor crown fractures often warrant the application of dental sealant, whereas more severe crown fractures sometimes require pulp treatments.  In the case of crown fracture, the pediatric dentist should be contacted. Jagged enamel can irritate and inflame soft oral tissues, causing infection.

How you can help:

  1. Rinse the child’s mouth with warm water.
  2. Place a cold, moist compress on the affected area.
  3. Offer strong pain relief (for example, Children’s Tylenol).
  4. Pack the tooth with a biocompatible material.
  5. Visit the pediatric dentist or Emergency Room depending on availability and the severity of the injury.

Root fracture

A root fracture is caused by direct trauma, and isn’t noticeable to the naked eye.  If a root fracture is suspected, dental x-rays need to be taken.  Depending on the exact positioning of the fracture and the child’s level of discomfort, the tooth can be monitored, treated, or extracted as a worse case scenario.

How you can help:

  1. Place a cold, moist compress on the affected area.
  2. Offer pain relief (for example, Children’s Tylenol).
  3. Contact the pediatric dentist.

Dental concussion

A tooth that has not been dislodged from its socket or fractured, but has received a bang or knock, can be described as “concussed.”  Typically occurring in toddlers, dental concussion can cause the tooth to discolor permanently or temporarily.  Unless the tooth turns black or dark (indicating that the tooth is dying and may require root canal therapy), dental concussion does not require emergency treatment.

Injured cheek, lip or tongue

If the child’s cheek, lip or tongue is bleeding due to an accidental cut or bite, apply firm direct pressure to the area using a clean cloth or gauze.  To reduce swelling, apply ice to the affected areas.  If the bleeding becomes uncontrollable, proceed to the Emergency Room or call a medical professional immediately.

Fractured jaw

If a broken or fractured jaw is suspected, proceed immediately to the Emergency Room.  In the meantime, encourage the child not to move the jaw.  In the case of a very young child, gently tie a scarf lengthways around the head and jaw to prevent movement.

Head injury/head trauma

If the child has received trauma to the head, proceed immediately to the Emergency Room.  Even if consciousness has not been lost, it is important for pediatric doctors to rule out delayed concussion and internal bleeding.

If you have questions about dental emergencies, please ask your pediatric dentist.

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I WISH I COULD GIVE YOU 10 STARS!!!!
Omg!!! SOOOOO happy I found you!!!
I've had these 4 veneers on my front teeth for about 5 years, put on, again, and again and again, after pop offs and cracks and breaks, and several thousands of dollars, by another Santee dentist's office (won't mention who).
After about 4 years of miraculously no problems, I felt a familiar crunch while biting into a fish taco... I was so upset, I just froze staring at this tiny piece of porcelain in my hand. The tears starting welling up as I was reminded of the nightmares I often have of this exact thing happening on a date, or during a job interview... I knew I wouldn't be able to enjoy the rest of my mom's birthday lunch w my daughters, and luckily, I decided to drive myself. I held back the tears, apologized and asked that they wrap up the rest of my meal and I'll see you at home, and ran to my car, wanting to just vomit.... I'm not too vain, am I?
Not just for vanities sake, but the thought of coming up with another 2 grand to fix this, again, was taunting me! My head was spinning. I felt like I had been kicked in the jaw - literally.
First thing I did, after having a few glasses of wine to calm down, was do a search on Yelp. Dr. Fossett was the first to come up -- but still wanted to give my old office a chance, seeing as especially how They WERE THE ONES WHO PUT THE ORIGINALS ON. But, they offered no rest for my weary soul -- no discounts, no deals and no financing. And a replacement will cost @2000!!
I called Dr. Fossetts office next and was enchanted by Robyn, who understood my plight and offered all the help she could; gave me a rough estimate on cost (final cost was LESS than what she quoted!), and applied for Care Credit for me over the phone.
I could go on and on about how my appointment went -- didn't even have to sit or wait, was brought back for a consultation immediately. Not expecting to have everything even started the same day, the assistant and Dr. Dave came back in two minutes and said, let's get started!
Not more than 30 minutes later, I looked in the mirror to the most gorgeous "Temporary" veneer I have ever seen!! I mean, I'd be happy w this for years! The last office would spackle on this horrible looking crap that had no esthetically pleasing value at all!! THIS is a premier job!
And I'm a chronic perfectionist! Especially when it comes to my looks (hair, teeth, ect).
SO IF IM HAPPY, YOU BETTER KNOW THE JOB WAS STELLAR!!!
Thank you Dr. Fossett and staff-- THANK YOU!!!

Vanessa M.

Yesterday was my first visit to this wonderful Dental office. I haven't felt more welcome and comfortable in a Dental facility since I was 19... Now 31 years young. I grew up, going to a father/son dental group and Dr. David and Dr. Douglas Fossett had the same family centered vibe and conservative but smart dental care I've been searching for! As a Registered Nurse, quality care and patient centered care is the core of my own practice. Dr. David and Dr. Douglas exemplify this to a tee! I've finally found my go to family Dental office. I feel like a weight has been lifted off my shoulders after getting a second option from these very well informed Dentists!

Haylee R.

Great office!!! From the moment I walked in I felt very welcomed by the staff. I'm always nervous when going to the dentist no matter how many times I go, however after my visit to Dr. Fossett's office I felt much more relaxed and at ease. They did everything they could to make me comfortable. I felt the staff was very knowledgeable and answered any questions I had. The assistants are top notch . The smiles , kind hearts and exceptional service will keep me coming back. Thank you to the office for a positive experience.

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