Dental emergencies: The clock is ticking

Dental emergencies can happen anywhere and are fairly common injuries.

On the job, such injuries can happen in the office as easily as on the factory floor. Whether an employee has been struck in the mouth with an object, fallen or simply bitten into something hard, quick action is required to save the tooth from further damage once it has been injured. Staying calm and knowing what to do can mean the difference between saving or losing an injured tooth.

Injuries to the mouth may include teeth that are knocked out (evulsed), forced out of position (extruded) or broken (fractured). Sometimes lips, gums or cheeks have cuts as a result of the trauma. These types of injuries are quite painful and should be treated by a dentist as soon as possible.

If a tooth is knocked out, it is not necessarily lost, but time spent out of the socket is one of the most critical factors affecting its long-term survival. Many times, the tooth can be saved if reimplanted within the first hour.

When a tooth is knocked out, you should:

* Immediately call a dentist for an emergency appointment.

* Attempt to find the tooth.

* Hold the knocked-out tooth by the crown, not by the root.

* Gently rinse, but do not scrub the tooth to remove dirt or attached tissue fragments.

* If possible, place the clean tooth back in its socket or in the injured person's mouth between the cheek and gum.

* If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk or cool water for short-term preservation.

* If the tooth is pushed out of place, either inward or outward, reposition it to its normal alignment with very light finger pressure. Do not force the tooth into the socket. Hold the tooth in place with a moist tissue or gauze. Again, it is vital that a dentist see the injured person within the hour.

A fractured tooth may be treated in different ways, depending on how badly it is broken. Regardless of the damage, a dentist should determine the appropriate treatment.

General dentists initially stabilize the tooth if it has been knocked out or dramatically loosened. Replaced teeth may be splinted, wired or sewn into place for a period of time determined by the dentist. Oral surgeons are needed if the bones around the teeth and jaw are fractured. To prevent further injury to splinted teeth, the dentist may recommend fluids and soft foods high in protein. Endodontists are often needed to perform root canals after initial dental emergencies have been stabilized and healing has begun.

The treating dentist will want to watch the injured tooth closely. If the tooth darkens, further dental work will be needed. In that case, aesthetic treatment options are available.

Not all dentists or emergency rooms are equipped to handle serious dental emergencies. An occupational health specialist can refer a company or patient to the type of facility needed for dental emergencies.

Randel D. Estep is with Saints Occupational Health Network/Reno Clinic. St. Anthony Hospital is a member of the SSM Health Care System.

Copyright 2002
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