Have you experienced an occasional twinge of sensitivity while you were enjoying ice cream or drinking ice-cold water? We at Smile Studios in Redmond, WA want to assure you that this sensitivity is benign; extreme cold can trigger the nerve endings in your teeth to give you the “brain freeze” sensation. However, if you have tooth sensitivity that occurs often, is intense enough to keep you from eating or sleeping, or occurs spontaneously, you may have a larger dental concern that requires professional attention, and we encourage you to call our office. In this article, we will discuss the 4 most common dental emergencies and how they should be addressed.
If your toddler accidentally bumped your jaw while you were playing or you slipped at the pool and fell on your face, this impact can cause trauma to your teeth. The front teeth are usually the ones to be most damaged by trauma. Part of the tooth structure can break off, causing the inner layers of the tooth to be exposed. The inner layers have more nerve endings, which explains why you would have tooth sensitivity. Even if the tooth structure remains intact, the nerve can be damaged. This damage can take a long time to detect as the nerve slowly dies. Sometimes years after the initial trauma, a tooth which seemed unaffected can start to turn gray due to a reduced number of red blood cells.
How to treat tooth trauma:
Trauma involving the mouth constitutes a dental emergency and it is important to call your dental office right away! Your dentist will evaluate your teeth, gums, and jaw joint with xrays and a visual exam. Fractured or broken teeth can be treated with fillings or a crown. If there is nerve damage, a root canal may be required. In cases of severe trauma where the tooth is fractured through the root, extraction of the tooth may be required. Your dentist can discuss options to replace the tooth (such as implants).In rare instances, trauma may cause the whole tooth may come out of the socket. If this happens, put the tooth in a plastic bag with some milk or saline fluid in it right away. This will keep the tooth from drying out. Visit your dentist immediately so that they can place the tooth back in the mouth and stabilize it. The tooth can stay out of the mouth no longer than ONE HOUR before it begins to dry out. After one hour, the chances of it being reimplanted in your mouth decrease significantly. If you don’t place it in milk or saline, it can dry out within 10 minutes.
Tooth decay, often called “cavities”, rarely causes any pain or sensitivity until it has progressed significantly. Most people are unaware of small- or medium-sized cavities until they go in for their dental exam. Once the cavity approaches the nerve of the tooth, a toothache can develop. However, this is not always the case. Sometimes people do not have any pain until the bacteria from the cavity cause an abscess, or infection, in the tissues surrounding the tooth. This abscess may cause swelling and can look like a “bubble” under the gums.
Treatment of tooth cavities:
Because cavities often do not cause symptoms until they have become extensive, it’s important to visit your dentist every six months for a comprehensive dental exam. The earlier a cavity is detected and treated, the more of your own tooth structure you can preserve. If you’re having dental pain or notice swelling or an abscess under the gums, this is a dental emergency and it’s critical that you call your dentist to have it assessed. Cavities can be restored with fillings or crowns. If the decay has spread into the nerve of the tooth, root canal treatment will be necessary. Teeth that are decayed to the point where there is very little tooth structure remaining above the gums may require extraction.
Gum Disease/Periodontal Disease
Periodontal disease is also known as gum disease. Like tooth decay, periodontal disease usually does not cause any pain until it has progressed significantly. In the advanced stages of periodontal disease, so much bone is lost that bacteria, viruses and fungi infect the empty spaces under your gums and surrounding your teeth. This can cause an acute, painful infection and an abscess. This is the swollen “bubble” that we discussed earlier – this is a dental emergency. In addition to dental pain, periodontal disease and the associated bone loss can cause teeth to become so loose that they fall out.
Treatment of gum disease
If you have red, swollen gums that bleed easily or have noticed teeth shifting or becoming mobile, call your dental office soon to have your gums and teeth examined. Periodontal disease in it’s early or moderate forms can be stabilized with scaling and root planning (SRP), which is often called a “deep cleaning”. An antibiotic may be prescribed to reduce the inflammation and pain until you can receive treatment. Your dentist may give you a referral to the periodontist, or a dentist that specializes in treating the gums and bone supporting the teeth. If teeth are lost due to periodontal disease, your dentist can discuss options to replace them.
Tooth Wear/Cracked Tooth
If you feel a twinge of pain when your bite down or have generalized sensitivity, you may be clenching or grinding your teeth. One sign of this is round indentations on the chewing surface of the molars or worn edges of the front teeth. Sometimes, you can even see vertical craze lines in the enamel. As these craze lines progress, the tooth can form a crack that is sensitive when biting down our chewing. Severe pain when eating is a dental emergency and you should call your dentist’s office immediately. Depending on the severity of the crack, the tooth may be treated with a filling, crown, root canal, or it may require extraction.
Treatment of cracked tooth:
Teeth with existing fillings are especially vulnerable to cracking under the pressure of clenching or grinding. Your dentist can fabricate a custom night guard to help protect the teeth under these forces. He or she will make sure that your bite is evenly distributed on the back teeth while wearing the nightguard to help prevent stress on the TMJ, which can cause jaw pain and trouble opening or closing your mouth. If your teeth come together in a way that is causing your teeth to be more likely to fracture, your dentist may recommend orthodontics, or correcting the alignment of the teeth.
Dr. Tina Subherwal is a dentist with over 17 years of experience and extensive training in cosmetic and implant dentistry techniques.
She attended the University of Missouri-Kansas City after being selected for its competitive accelerated dental degree program. Later, she followed the University of Southern California’s Advanced Education in General Dentistry program which equipped her with advanced knowledge and experience in family and implant dentistry, as well as cosmetic services such as Invisalign and veneers.
Dr. Subherwal opened Smile Studios in Redmond, WA and has since been providing high-quality dentistry and compassionate care to the communities in the area. She has utilized the latest technologies at her office to help her patients achieve their best smiles.