KNOCKED OUT TOOTH

Dental trauma can occur at any time and when you least expect it. Trips, falls and blows to the face are all common causes of a knocked out tooth.
There are a number of other issues that can arise due to a traumatic injury to the body of a tooth, with avulsion (completely knocked out) being the most extreme. These include concussion (a knock), subluxation( a minor loosening), extrusion(the tooth has moved out of the socket and looks longer), lateral luxation(the tooth has been pushed backwards or forwards but is still in the socket), intrusion(the tooth has been pushed further into the socket and may look shorter than before).
What can you do to help a knocked out tooth?
There are a few things that you can do to help maximize the chances of your tooth being replanted, and minimizing the risk of complications.

How to fix a knocked out tooth
Teeth can be knocked out due to direct trauma through blows to the face, sports injuries and trips.

1. Assess other injuries. If the person who has sustained the injury requires further medical attention then this must be sought first. In the meantime you need to try keep the tooth clean and moist.
2. Keep the tooth moist. You can ask the patient to insert the tooth into the socket (if it is clean) or hold it in their cheek fold. Do not attempt to scrub the surface of the root-it contains very sensitive cells and fibers that are important for the healing process. Alternatively, you can keep the tooth moist in contact lens solution or milk. Allowing the tooth to dry out plays a big role in complications arising.

store knocked out tooth in milk until you get to an emergency dentist
Store your tooth in a moist medium until you can see an emergency dentist.

3. The highest chances of a successful replantation is to have the tooth professionally replanted within 1-2 hours. This minimizes the risk of complications and failure of replantation.
4. Arrange an appointment with the emergency dentist or 24 hour dentist, time is of the essence.
What will happen at the dental emergency clinic?
The emergency dentist will do a thorough examination. This may include x-rays and clinical photographs. They will also assess soft tissue injuries and injuries to adjacent teeth. You may also have an examination performed to ensure you have not broken or fractured your jaw.
An assessment will also be made of the likelihood of a successful replantation. This is dependent upon how long it has been since the injury, whether the root of the tooth has been damaged in any way, whether the tooth has been kept in a moist medium, how old the patient is and the stage of root development, and whether there are any further injuries to the supporting tissue of the root in the jaw.

Replantation of a knocked out tooth
1. You will be numbed using local anaesthetic
2. The socket will be gently flushed out with saline to ensure there is no foreign debris inside
3. The tooth may be allowed to soak in some special solution for 20 minutes to help its success at replantation
4. The tooth will be very gently replanted and an x-ray will be taken to confirm it’s correct positioning
5. The emergency dentist will place a flexible splint, it may look like a brace. This needs to be kept for 4 weeks to allow the tooth to replant with the bone and to keep it in position
6. You may be given antibiotics
7. You will be required to reassess the tooth regularly in order to make sure that no complications are arising. Complications can occur at any stage, even many years after the injury, so it is important that your regular dentist is routinely examining the tooth.

You will need to follow some basic instructions:
1. Avoid participation in contact sports.
2. Soft diet for up to 2 weeks. Thereafter normal function
as soon as possible.
3. Brush teeth with a soft toothbrush after each meal.
4. Use a chlorhexidine (0.1%) mouth rinse twice a day for
1 week.

What is a dental abscess?

 

A dental abscess is a collection of pus that forms around the tissues of the tooth and can spread into the surrounding tissues.

It is most often caused by a bacterial infection of the pulp of the tooth secondary to decay or trauma to the tooth.

They are not always immediately painful or symptomatic, such that you may not be aware of it’s presence for some time until it’s too late.

There are two main types of dental abscess, a periapical abscess (related to the main body of the tooth) and a periodontal abscess (related to the gum tissue of the tooth).

What are the signs and symptoms of a dental abscess?

  1. Severe, persistent, throbbing toothache that can radiate to the jawbone, neck or ear
  2. Sensitivity to hot and cold temperatures from the tooth
  3. Sensitivity/pain on chewing or biting
  4. Fever/raised temperature
  5. Swelling in your face or cheek or lips/chin, or the area under the eye. You may also develop a swelling in the gum besides the tooth, and this may develop a pimple like opening.
  6. Tender, painful and swollen lymph nodes under your jaw or in your neck
  7. Sudden rush of foul-smelling and foul-tasting, salty fluid in your mouth and pain relief if the abscess ruptures

    dental abscess and 24 hour dentist at emergency dentist
    A dental abscess causing a localised gum swelling.
  8. The offending tooth may feel loose and raised, such that you touch that tooth prior to any others when closing your mouth.

A dental abscess is something that you cannot ignore. Although symptoms may reduce, especially if any swelling bursts, they will not go away, may become more aggressive and may leave you open to dangerous complications.

You need to see a 24 hour dentist immediately. Left untreated the fluid may spread to other structures and cause difficulties breathing. There is also a risk of septicemia.

Signs of complications

  1. Difficulty in opening the mouth
  2. Very high fever
  3. Severe difficulty in breathing and or swallowing
  4. A raised tongue, such that your mouth feels smaller than usual
  5. In rare circumstances dental abscesses can spread to other organs including the brain
dental abscess
A swollen face can be distressing and debilitating. It is usually caused by a dental abscess

Treatment

The main principle is to manage the source of the abscess

  1. Opening the tooth to allow a portal for pus to drain (initiating root canal treatment)
  2. Removal of the offending to tooth
  3. Incisional drainage of any well-formed swelling. This is normally done inside the mouth, but in extreme cases may be required from the skin side.

    Drainage of dental abscess
    This procedure normally provides some immediate relief. Surface anaesthesia is used to numb the swelling, and a small incision is made to allow a path for drainage. a drain may be placed to help keep the incision open
  4. Prescription of antibiotics

Normally, a combination of some of these treatments is performed, the aim is to allow the abscess to resolve prior to definitive treatment.

Tips

  1. Do not ignore
  2. Do not hope that it will go away. You need to see an emergency dentist.
  3. Do not attempt to lance or drain the swelling yourself
  4. Do not attempt to remove the tooth yourself (yes, we’ve seen people try)
  5. Using your partner’s antibiotics that your girlfriend’s GP gave to her 2 years ago for a UTI will not help. You are just delaying appropriate treatment.
  6. If you are feeling very unwell, experiencing difficulties in breathing and running a very high temperature, then a trip to A/E may be in your best interest.

    emergency treatment of dental abscess
    Extra-oral drainage and drain placement

How to find a 24 hour dentist or an emergency dentist

emergency dentists in London, 24 hour dentist North London

 

Any unforeseen dental mishap can be classed as a dental emergency. You don’t have to be in pain-any situation that stresses you, has the likelihood of being to your detriment if left untreated, causes pain or affects not just form but function, can necessitate a visit to an emergency dentist.

There are some instances where it may be more sensible to go to hospital in the first instance. These include if you have suffered a trauma or medical condition that has caused other more serious injuries or loss of consciousness. It’s important to prioritize your health. In addition, if you are experiencing symptoms of a spreading infection like a very high fever or severe difficulties breathing, then a trip to hospital may be more appropriate in the first instance.

If you are fortunate enough not to require immediate medical help, then finding an emergency dentist can be fairly straight forward. Emergency dentist Essex and Emergency Dentist Hertfordshire can help with 24 hour emergency dental appointments for toothache, root canal treatments and teeth extractions, as well as swollen faces and dental abscess.

  1. Initially, call your own dentist and follow the advice on their answerphone. They may give details of emergency dentist arrangements in-house.

    Phone number for emergency dentists
    How to contact an emergency dentist
  2. If you are here in the UK, and you are a NHS patient, then call NHS emergency dental services. They may be able to help with dental emergencies, but do note that this service is often oversubscribed, they have limited slots available and they have a strict criteria for what constitutes a dental emergency. You will be assessed on the phone by a triage professional, and you may be offered an emergency slot at a clinic, but this may not be local to you and may not be on the same day.NHS England do provide a dental emergency helpline
  3. Private services are available and generally can deal with most dental emergencies. They will be more likely to provide you with an immediate appointment, and the costs although aren’t necessarily expensive, and should not be prohibitive. In order to minimise your cost and treatment, you are well within your rights to ask for all options available and the costs involved, and to do only what addresses your immediate concerns. Private services can be recommended by your own dentist’s emergency arrangement information, recommendation from a friend or by searching on the internet. A good guide if you want to find an emergency dentists near me. To find an emergency dentist in London, Yell is a very good source, and is also useful for finding an emergency dentist North London.

    Emergency dentists can be found online.
    Searching online for an emergency dentists needn’t be stressful
  4. Dental insurance providers. If you have dental insurance, try calling your provider, as some may be able to recommend clinics that they know of or are preferred providers. This also gives you an opportunity to ask exactly what kind of treatment, and how much you are covered for. Denplan, Dencover and Boots all have dental emergency insurance cover. Please retain all receipts and ask the dentist to provide an itemized invoice confirming that the visit was for an emergency.