Teeth can become fractured by trauma, grinding or biting on hard objects.  In other cases, fillings, crowns and other restorative devices can be damaged or fall out of the mouth completely.  If there is severe pain, it is essential to make an appointment with the dentist as quickly as possible. 

Types of dental emergency and how to deal with them

Avulsed tooth (tooth knocked out)

If a tooth has been knocked out of the mouth, it is essential to see a dentist immediately.  When a tooth is avulsed from the mouth, tissues, nerves and blood vessels become damaged.  If the tooth can be placed back into its socket within an hour, there is a chance the tissues will grow to support the tooth once again.

Here are some steps to take:

1. Call the dentist.
2. Pick up the tooth by the crown and rinse it under warm water.  DO NOT touch the root.
3. If possible, place it back into its socket – if not tuck it into the cheek pouch.
4. If the tooth cannot be placed in the mouth, put the tooth into a cup of milk, saliva, or water as a last resort.  It is important to keep the tooth from drying out.
5. Get to the dentist, quickly and safely.

The dentist will try to replace the tooth in its natural socket.  In some cases, the tooth will reattach, but if the inner mechanisms of the teeth are seriously damaged, root canal therapy may be necessary.

Lost filling or crown

Usually, a crown or filling comes loose while eating.  Once it is out of the mouth, the affected tooth may be incredibly sensitive to temperature changes and pressure.  Crowns generally become loose because the tooth beneath is decaying.  The decay causes shape changes in the teeth – meaning that the crown no longer fits.

If a crown has come off, make a dental appointment as soon as possible.  Keep the crown in a cool, safe place because there is a possibility that the dentist can reinsert it.  If the crown is out of the mouth for a long period of time, the teeth may shift or sustain further damage.

DO NOT use any kind of glue to affix the crown.

The dentist will check the crown to see if it still fits.  If it does, it will be reattached to the tooth. Where decay is noted, this will be treated and a new crown will be made.

Cracked or broken teeth

The teeth are strong, but they are still prone to fractures, cracks and breaks.   Fractures, cracks and breaks can take several different forms, but are generally caused by trauma, grinding and biting.  If a tooth has been fractured or cracked, there is no alternative but to see the dentist.

Where a segment of tooth has been broken off, here are some steps that can be taken at home:

1. Call the dentist.
2. Apply gauze to the area for ten minutes if there is bleeding.
3. Apply a topical pain reliever.

The nature of the break or fracture will limit what the dentist is able to do.  If a fracture or crack extends into the root, root canal therapy may be the only effective way to retain the tooth.  

Dislodged/loose teeth

When a tooth has been dislodged or loosened from its socket by trauma or decay, it might be possible to save it.  If the tooth remains in the mouth and attached to the blood vessels and nerves, there is a good chance root canal therapy will not be necessary.

It is important to call the dentist immediately to make an appointment.  In the meantime, use a cold compress and over-the-counter medications to relieve pain.  The dentist will reposition the tooth and add splints to stabilize it.  If the tooth fails to heal, root canal therapy may be required.

If you have questions or concerns about dental emergencies, please contact your dentist.