02

Sep

Have you ever woken up to an intense, throbbing toothache? Or perhaps suffered an unexpected fall that left you with a chipped or knocked-out tooth? These experiences can be shocking, and you may wonder, ‘Is this a simple issue, or should I see a dentist immediately?

It is essential to know when a dental problem can wait and when it is a real emergency. Timely action will help you save your tooth, avoid additional complications, and eliminate the worst pain. This guide explains the signs of a dental emergency, allowing you to make informed decisions and seek professional help within the shortest time possible.

When to Visit the Emergency Room (ER) With a Dental Problem

Your immediate instinct when you are in pain is to dial the number of your dentist. Nevertheless, not all dental issues are merely toothaches. They may be life-threatening and require immediate treatment at an emergency room. Considering these red flags as the first step in a situation analysis and for your safety is crucial.

These are the red flags that require calling 911 or visiting the emergency room:

  • Swelling of the face, neck, or under the jaw that obstructs your airway or prevents swallowing. This may mean a fast-spreading infection, which may prove to be fatal.
  • Prolonged (lasting longer than 15 minutes) bleeding of the mouth, despite heavy pressure. Other complications may arise due to uncontrolled bleeding, which may cause severe blood loss.
  • Fever (a fever over 101 °F (38.33 °C)) with extreme tooth pain and swelling of the face.

This set of symptoms indicates the presence of a severe infection that needs to be treated immediately.

Any serious injury to the face or jaw, for example, due to a car accident or fall, could indicate a fracture. Facial trauma may not only result in dental injuries but also broken bones, concussions, and other internal injuries.

Your general health and safety should be your top priority. Although a dentist can diagnose most dental issues, any of the above symptoms mean that the condition is severe and has already escalated beyond the capabilities of a standard dental facility. The resources and experience of an emergency medical team are needed to treat this issue. Waiting too long to seek care can be fatal.

What the Types of Pain and Intensity Mean

Pain varies in intensity and could point to different issues. Let us look at each of them:

Intense, Consistent, Pounding Ache

An intense, consistent, and pounding ache is the kind of pain that is usually the most frightening, and rightly so. Extreme, persistent, and pounding discomfort usually signals a serious infection, like an abscessed tooth or severe pulpitis (infected nerve). This severe, persistent pain indicates that the problem is not on the surface. It is a deep inflammation or infection of the tooth or the surrounding tissue. The elevated blood flow causes the throbbing and pressure in the inflamed region, which increases the pain and signifies that a severe process is involved.

Pain That Keeps You Awake At Night

If dental pain causes you to lose sleep, it is a powerful pointer that the affected tooth's nerve is in serious trouble. Distractions and sitting straight may at times ease or conceal the real pain of the teeth during the day. But lying down, the blood pressure in the head is higher, the inflamed nerve is more pressurized, and the pain worsens. Night pain is a typical symptom indicating that the problem is severe and needs immediate professional help, as it indicates an extensive case of infection or inflammation in the pulp.

Pain Only When Biting

Unlike the nonstop aching, when you bite down or chew, you might have a sharp, sudden pain that indicates otherwise. This pain usually indicates a broken tooth, a loose or cracked filling, or a local problem with the periodontal ligament (the tissue anchoring the tooth).

The pain experienced during biting is exacerbated by the pressure applied to the compromised region, causing a brief but sharp sensation. Although it may not be as urgent as a throbbing pain, it is still worth the assessment to avoid further damage or infection.

Prolonged Sensitivity to Hot or Cold

People who experience prolonged sensitivity to hot or cold are sensitive to extreme temperatures. This is short-term, and it is usually after the consumption of some food or beverage. However, when this sensitivity persists longer than a few seconds after removing the hot or cold stimulus, it points to an inflammation of the nerves.

Sensitivity that lingers on shows that the pulp of the tooth is irritated or inflamed, and though it may not be infected yet, it is a sign that the inflammation may develop into an irreversible form unless acted upon. This symptom presents an urgent need to visit a dentist to evaluate the level of the inflammation and avoid the possibility of nerve death.

Common Symptoms that Warrant Visiting an Emergency Dentist

Although some are not dental emergencies, the following symptoms indicate a deeper problem that should be addressed before progressing.

Knocked-Out Adult Tooth (Avulsed Tooth)

An avulsed tooth is the most time-sensitive dental emergency. When the entire adult tooth has been dislodged from the socket, the reimplantation success depends on the immediate action taken. The window of opportunity to rescue the tooth is short, and the most significant probability of success is within the first hour following the injury.

Once the tooth is knocked out, you could take the following first aid measures:

  • Touch only by the crown—The tooth's root must never be touched, which will injure the sensitive cells with which reattachment is affected.
  • No scrubbing — If the tooth is dirty, rinse it gently with milk or saline solution for a few seconds. There is no need to scrub or apply soaps, which may wash away important tissue.
  • Re-insert the tooth (if possible)—If the individual is conscious and compliant, use an opportunity to re-insert the tooth into its socket. Keep it appropriately oriented. When it slips easily in, hold it with a slight pressure when it slips easily in or by biting a clean cloth or gauze.
  • Put the tooth in milk or saliva — When re-insertion is impossible, put the tooth into a small milk container or use saliva. If milk is unavailable, the individual may keep the tooth in their mouth next to their cheek (without swallowing it) or put it in a container with their saliva.
  • Seek emergency dental treatment—Take the individual and the tooth to an emergency dentist as soon as possible, preferably within 30 to 60 minutes.
  • Severely loose or dislodged teeth—A tooth pushed out of its normal position (luxated) or made quite loose by trauma is also a dental emergency. When in the socket, its stability is impaired, and the nerves and blood vessels inside the tooth are likely to be injured.

These teeth need quick stabilization by a dentist to avoid further displacement or loss and to determine the presence of nerve damage. The tooth may look extruded (forced out), intruded (pushed into the gum), or laterally displaced.

Major Crack or Fracture

Cracked or chipped teeth are not always urgent care, but a major crack or fracture is. This is when a significant portion of the tooth has broken off, and the sensitive inner part of the tooth (dentin or pulp) is usually exposed. This kind of injury typically results in extreme pain, particularly when the temperature changes or pressure is applied, since the exposed nerve, which was vulnerable, is now exposed or near the surface.

Moreover, the exposure site is much more vulnerable to bacterial infection, which may easily result in an abscess unless addressed promptly. Significant signs include notable damage, jagged edges that bite the tongue or cheek, and chronic pain.

A tooth has been knocked out in its entirety, is excessively loose, is displaced out of its correct place, or is broken with much pain or apparent exposure of inner tooth layers. These situations are direct threats to the viability and structure of the teeth and pose a risk of infection.

If it is a knocked-out tooth, preserve it according to the above steps and visit a dentist within 60 minutes to give the tooth the best chance of being saved. If there is other severe trauma, like severely loose teeth, dislodged teeth, or severely fractured teeth, contact an emergency dentist immediately.

The quickest professional help is crucial to stabilize the injury, control the pain, prevent infection, and try to rescue the tooth. A small, painless chip that does not reveal inner parts or cause any discomfort, in general, can wait until the next ordinary dental visit. However, it should still be treated to avoid complications in the future.

Swelling, Abscesses, Bumps

Once an infection is established inside a tooth or in the surrounding structures, it can usually be revealed by specific visual and sensory indicators. It is essential to know these signs to diagnose the infection quickly and avoid further development in the jaw, face, or blood system.

A significant indication of an emerging infection is observable swelling of the gum tissue surrounding the troubled tooth. Depending on the severity of the infection, this swelling may be localized as a puffiness or a more generalized swelling of the face. The affected region might also be tender or painful to the touch, and the gum tissue might be red or inflamed. This swelling is how the body reacts to the invasion of the bacteria, trying to confine the infection.

The other crucial visual manifestation is the presence of a pimple or boil on the gum. A dental abscess is often accompanied by this lesion, which is medically referred to as a fistula or parulis. It develops when the infection causes an opening through the bone and gum tissue to drain the pus that is building up.

This bump can occasionally secrete pus or blood, and this can cause a bad taste in the mouth or even bad breath that can not be washed away by brushing or rinsing. Although the drainage may temporarily relieve pressure and pain, it indicates an active and persistent infection that must be treated at its source. Neglecting this pimple will only enable the infection to continue and even aggravate it.

In addition to the local infections in the immediate oral cavity, an advancing infection may have systemic manifestations. You may feel soreness in the jaw or lymph node enlargement in the neck. These lymph nodes belong to your immune system, and their swelling shows they are busy combating an infection. This diffuse tenderness indicates that the infection is no longer localized to the area of the tooth, but it is spreading to adjacent tissues.

All these external manifestations, whether swelling in a localized area, a draining pimple on the gum, or tender lymph nodes, all indicate that a severe bacterial infection is present that cannot just go away. These infections need to be drained by a professional and treated, usually with antibiotics, and the source of the infection should be treated, like with a root canal or tooth extraction. Not paying attention to these symptoms increases the risk of the infection spreading, resulting in more serious conditions like cellulitis (a serious skin infection) or even sepsis, a life-threatening whole-body inflammatory reaction.

You notice swelling on the gums or face, or a boil-like bump on the gum, which suggests a possible abscess. These are evident indications of a growing and active infection.

Avoid making any attempts to pop or drain the abscess on your own. This may drive the infection further or lead to its spreading. Instead, call an emergency dentist as soon as possible. They can diagnose the problem correctly, drain the infection safely, and give the required treatment. If the swelling is significant or quick, or interferes with your breathing or swallowing, skip the dental office and head to the emergency department.

Lost Dental Restorations

When fillings or crowns fall off, the covering protecting the underlying tooth structure is lost. This exposure poses several immediate risks. Sensitivity is the most common and direct worry. The dentin, the layer below the enamel, has microscopic tubules that directly connect with the tooth's nerve. Without the protective filling or crown, heat, cold, sweets, or even air can directly stimulate these tubules, causing discomfort or sharp pain. This sensitivity may be slight and short-lived or intense and persistent, indicating a higher urgency.

In addition to being sensitive, the exposed tooth is highly susceptible to decay.

The surface of the prepared tooth, particularly one with existing decay, is now exposed to bacteria and food debris, which will hasten the decay process. This may cause new holes or aggravate the already decayed ones, making the tooth nonviable in the long run. The previously carefully cured area is exposed, and immediate re-restoration is essential to avoid further invasion by bacteria.

Moreover, when a filling or crown is lost, the remaining tooth structure may be exposed to fracture. The hole drilled to receive a filling or the tooth trimmed to receive a crown usually compromises the tooth's natural structure. The unsupported walls of the teeth can easily crack in the absence of the strengthening of the restoration, particularly under the pressure of biting.

If the damage is too deep to be treated under the gum, a small crack may grow into a large one, requiring a more radical and expensive treatment, a root canal, or even pulling it out. Furthermore, a sharp or jagged edge left by the restoration that was removed may lead to soft tissue injury, which is the cutting of the tongue or cheek.

Considering these risks, the main factor determining whether a lost filling or a lost crown is an emergency is the degree of pain that occurs and the physical trauma that results. Although you should always consult a lost restoration specialist as soon as possible to avoid further complications, the response timeframe may differ depending on the symptoms.

Contact an emergency dentist in extreme pain or with jagged, sharp edges as soon as possible. They can relieve pain, temporarily cover the exposed area, and schedule definitive treatment.

The issue is urgent when there is slight sensitivity to temperature, discomfort during chewing, or no pain. It is not an emergency, but you should contact your dentist as soon as possible to arrange an appointment. Doing so avoids further escalating the situation and the danger of new decay or fracture, and protects an exposed tooth. In the meantime, you may fill the sharp edges with over-the-counter dental wax or sugar-free gum, pushed into the cavity to temporarily reduce sensitivity.

Find an Emergency Dentist Near Me

Your health and well-being are the priority when you have a dental concern. It is important to remember that uncontrolled bleeding, intense and untreatable pain, severe swelling of the face or gums, and a knocked-out tooth are absolute emergencies that require attention. A dental expert will never want you to wait and develop a serious problem by the time you call to inquire about your situation. Trust your instincts. If something feels wrong, consult a professional.

If you have examined your symptoms and feel a dental emergency, contact The Whittier Dentist immediately at 562-632-1223 for professional help and treatment.