Following recent COVID-19 Government restrictions, guidance from NHS England and the Chief Dental Officer we currently cannot treat any patient face-to-face. In addition to our emergency telephone service we have produced the following advice to help you to understand where to access care if you’re in pain and offer advice in managing problems from the safety of your home.
What Counts as a Dental Emergency?
Non-Urgent – Treat at home using the advice below or call our emergency line for further advice if you have any of the following problems: Lost/loose crown, bridge or veneer – problems with your dentures – broken or loose tooth – broken, loose or lost fillings – bleeding gums.
Urgent – Call our emergency line for advice if you have any of the following problems: Facial swelling extending to eye or neck – Bleeding following an extraction that does not stop after 20 mins solid pressure with gauze/clean handkerchief – Trauma – Significant toothache preventing sleep or eating, associated with significant swelling, that cannot be managed with painkillers
Straight to A + E – If you having any of the following problems: Facial swelling affecting vision, affecting airway/breathing, preventing mouth opening more than 2 fingers width. Trauma causing loss of consciousness, double vision or vomiting.
For pain relief we advise over the counter analgesics (painkillers) like paracetamol or Ibuprofen, unless for medical reasons you are unable to take these. Combining paracetamol and ibuprofen has also been shown to be effective.
All painkillers should be taken in accordance with instructions on the packet. Taking too many tablets WILL NOT IMPROVE YOUR SYMPTOMS and can cause serious stomach and liver injury which can be life threatening.
If the tooth is extremely sensitive to hot or cold, this may be a sign of decay and antibiotics will not help.
Good cleaning twice daily with fluoride toothpaste and reducing intake of sugary foods and drink, may/will help stop decay from getting any worse.
If there is a hole in the tooth, or the tooth has cracked and is now sensitive, a temporary filling material can be purchased both online and from supermarkets or pharmacies and placed onto the affected area.
Toothpaste aimed at reducing tooth sensitivity, such as Sensodyne Rapid Relief may also help reduce pain. Use the toothpaste as an ointment and rub a small amount directly on to the affected area and do not rinse it away.
Anaesthetic gels such as Orajel can be purchased from a pharmacy and may also help ease the pain.
Wisdom tooth problems are usually due to inflammation of the gum over/ around the erupting tooth, this can be made worse by the trauma of biting on the area.
Most flare-ups can be managed with good home care and should settle within in a few days to a week. It is important that you thoroughly clean the area, you can purchase an interspace brush online, in supermarkets or pharmacies to help clean around the effected area.
Rinsing 2 – 3 times a day with a warm salty mouthwash or Corsodyl mouthwash (if no known allergy), for a week will help with alleviating pain and aide healing.
If you have difficulty swallowing, swelling in your face or cheek or difficulty opening your mouth, please call your dentist for advice. You may need antibiotics if an infection is spreading.
Pain or bleeding after an extraction
It is not uncommon for there to be some pain for a few days after a tooth extraction. Taking over the counter analgesics (painkillers) like paracetamol or Ibuprofen (unless for medical reasons you are unable to) can ease the pain.
We cannot provide antibiotics for pain after extractions unless infection is present. We also cannot prescribe antibiotics without assessing you over the telephone first.
It is normal to have some slight oozing from the socket and a some blood in your saliva after a tooth extraction. If the socket is bleeding freely, bite hard on gauze or a clean handkerchief for 20 minutes. If bleeding still doesn’t stop, please call your dentist.
If you smoke or rinse too soon after an extraction you risk a dry socket. This can be very painful and regular painkillers are unlikely to be effective. You should call your dentist.
Bleeding from gums is NOT a dental emergency. Bleeding gums are usually due to gum disease and will not stop until your brushing technique improves. Brush twice daily with fluoride toothpaste for 2 minutes, paying particular attention to the areas that are bleeding. Remember to also use floss or interdental brushes to clean between your teeth every day.
If your gums are extremely painful and look infected (bright red/swollen) you should still try your best to brush them even though they will bleed.
Take over the counter analgesics (painkillers) like paracetamol or Ibuprofen as required and use a Corsodyl mouthwash (if no known allergy) for 7 – 10 days (please read instructions on the bottle carefully).
Clean and check the crown. If the crown is mostly hollow, you can attempt to re-cement it at home with a temporary material (purchased both online and from supermarkets or pharmacies), ensure you follow the instructions on the packet, and only attempt if you feel confident to do so.
Never try to force a crown or post onto your tooth, this can cause the root to fracture. If you cannot get the crown to fit, keep the tooth as clean as possible and wait to see your dentist.
Under no circumstance should you use SUPERGLUE to refit your crown.
Fractured or knocked out teeth
If a tooth has been chipped and is sensitive and/or sharp then applying a sensitive toothpaste or using an emergency repair kit is advised (see above).
If a baby tooth has been knocked out – do not attempt to put it back in. Clean the area, bite on a clean hankie or towel for 20 minutes if it is bleeding, give the child age appropriate pain relief medicine and keep to a soft diet until the area has healed.
If an adult tooth has been knocked out – handle the tooth by its crown (the white part), avoid touching the root, if the tooth is dirty, wash it briefly (10 seconds) under cold running water, try to re-implant the tooth in its socket and then bite gently on a handkerchief to hold it in position, if this is not feasible, store the tooth for transportation to the designated urgent dental care centre in milk (not water). Alternatively transport the tooth in the mouth, keeping it between molars and the inside of the cheek.
You need to telephone for an emergency dental appointment
Orthodontic / brace problems
The British Orthodontic Society advise that most orthodontic appliances can be left for some months without detriment if you continue with the usual after care instructions;
Exemplary oral hygiene – brushing 3 times a day with their standard toothbrush, followed by interproximal brush use.
Low sugar diet – where possible avoid snacking on foods and drinks with ADDED SUGAR. Fizzy drinks should be avoided in particular.
Avoid sticky and hard foodstuffs that could break the brace wire or fracture brackets off a tooth.
If you suspect that you may have swallowed or inhaled a piece of your brace, you must call for advice. – A small piece of brace will normally pass through even if you have swallowed it.
For advice on managing common orthodontic/brace problems and solutions visit the British Orthodontic Society website (www.bos.org.uk)
If you are currently undergoing orthodontic treatment at Claypath Dental Practice, please contact us if you are having any problems.
If you are a patient who has been referred to a local Orthodontic Practice for your treatment, you should contact them directly if you are having any problems as we do not have access to your treatment plans.
If you are in doubt and need to speak to a member of our emergency team please call on 0191 3865375 for further instruction.