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By: Emergency Dentist London
A dental emergency is typically a condition that is causing pain, distress, loss of function or has the potential of worsening should it be left untreated.
There are many different type of emergency dental conditions, varying from typical toothache issue to minor cosmetic issues which typically have no pain.
Types of Dental Emergency
This is the most common dental emergency and is usually related to changes in the pulp of the tooth:
1. Reversible pulpitis. This is usually characterised by a mild and short type pain that can be triggered by changes in temperature and with sweet foods. It usually doesn't keep you awake at night, and normally requires a trigger. This type of toothache is normally well localised and you are able to tell which tooth it is. Treatment normally involves removal of any decay and placement of a sedative dressing.
2. Irreversible pulpitis. This can arise without any triggers, but sometimes triggers can be present as there can be a cross-over from reversible to irreversible pulpitis. The dental pain can be long-lasting, and typically can arise of its own accord disrupting sleep. You may find pain on biting, and occasionally pain being relieved with cold water. Definitive treatment normally is root canal treatment or extraction of the tooth.
Left untreated both of these types of pulpitis can progress, and form apical abcess- this can cause swellings and raised temperatures. Rarely, they can turn very nasty leading to hospitalisation.
Other causes of toothache include dentinal sensitivity which can arise from chipped/lost dental fillings, abrasion and gum recession.
DENTAL PROSTHETIC EMERGENCIES
1. Lost fillings and broken fillings. Both of these are very common. There may be sharp edges that traumatise your lips and tongue which can lead to oral ulcers. Treatment normally involves replacement of the missing/broken filling. There may also be sensitivity to hot and cold foods as well as sweet foods. Normally there is no pain on biting.
2. Cracked natural tooth. This can be very difficult to diagnose. Patients will normally complain of pain on biting which is relieved upon release of the bite. The presence and location of a crack can be very difficult to ascertain. Sometimes, a big cusp fractures off the tooth and the pain on biting almost immediately eases. Treatment normally involves placement of a crown or partial crown to help bind the tooth together. Occasionally cracks can extend through the entire body of the tooth and beneath the level of the gum, in these instances the prognosis of treatment is poor.
WISDOM TEETH AND PERICORONITIS
The gum overlying wisdom teeth can occasionally become inflamed and infected. In it's earlies stages it may be possible to treat the issue by cleaning and irrigation with some antiseptic solution. However, left untreated it may be progress to becoming quite debilitating and causing localised swelling, difficulty in opening the mouth and/or swallowing- at this stage antibiotics will be required.
Bleeding after an extraction
A minor oozing of blood from an extraction socket in the first few hours after an extraction is nothing to be alarmed about. However, if you are experiencing profuse bleeding you will need to see an emergency dentist, and this is a genuine dental emergency. In the meantime, you can try to stem the bleeding yourself by keeping sustained pressure on the bleeding site with a clean gauze, handkerchief or tea bag.
Pain after a dental extraction and dry socket
Discomfort, tenderness and swelling should be expected for about 3 days after an extraction. This normally reduces and responds well to ant-inflammatories(
In some instances, you may experience extreme pain after a dental extraction, and this may be accompanied with a bad taste/smell in the mouth and pain which is radiating to the ear and neck. This is a dry socket. It is much more common in smokers, dental extractions which were difficult to perform, and if you have a previous history of dry socket. It occurs when there is abnormal clotting, or a dislodged clot following the dental extraction. Treatment is fairly straight forward and entails irrigation of the extraction site with some antiseptic and placement of a sedative dressing. You may also be placed on an antibiotic course for a few days.
What can you do for your dental emergency?
For most emergencies it is best to be seen by a dentist as soon as possible.
For pain you can try over the counter painkillers like ibuprofen,paracetamol or paramo, as long as there is no health reason for you not to use them and you use as directed. Ideally avoid aspirin (unless you are taking it upon medical advice), this is in case you do see a dentist and an extraction is planned.
Dental emergency filling and recementation kits are available, but I find them ineffective long term
Further emergency advice can be found at: