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Dental First Aid
Children, being children, have a habit of falling over, walking into furniture and banging heads with each other. Many parents and teachers will have experienced the feeling of helplessness as the now hysterical child staggers towards them, blood streaming from its mouth -What do you do?
It is essential to try to be calm and in control, or at least appear to be. Comfort the child and explain that ‘You just want to have a look’ first of all, to enable you, to assess the damage.
If the tooth or teeth are slightly chipped or loose there is little for you to do, but take the child to the dentist where X -ray examination of the roots of the teeth can be carried out. With small children, the upper front baby teeth can be pushed into the gums and disappear. There is no first aid for this but there is a risk that the underlying permanent tooth may be misplaced or damaged.
If any teeth have been fractured or lost try to find the tooth or fragments either in the mouth of the casualty (at the sides of the mouth or below the tongue) or at the scene of the accident and bring them with you to the dentist. Teeth and tooth fragments can be swallowed or inhaled or buried into the soft tissues of the lips and cheeks.
If the tooth is knocked out, it is possible to replant it in the original socket. Hold the tooth by the crown and do not touch the root.
Scrape the root. Wash, scrub or store it in any chemical disinfectant or salt solution. Wrap it in a dry tissue or handkerchief. If the root is clean, push it gently back into the socket but make sure it is the correct way round match it up to the teeth on either side.
If it is dirty – only rinse off the obvious sand or grit very gently in milk or water, but remember, do not scrub the root clean or be too fussy. The blood and fibres on the root must remain since these contain cells which will repair the damage. Attempt to replant as described above.
If you cannot replant it yourself, “store” the tooth in milk. For older children, get them to place the tooth in on of their cheek pouches, warning them not to swallow it! Go immediately to a dentist.
Be prepared to tell the dentist:
- When the accident occurred.
- If there was loss of consciousness.
- How the tooth was found
- How it was cleaned and stored on the way to the surgery.
Timing is important since re-implantation is only successful if done within 2 hours after the injury happened with the tooth stored in milk or in the mouth.
Be reassured that any trauma can be repaired to such a degree that only you, the patient and your dentist need ever know anything has happened!
Toothache can be described as producing a short, sharp pain to hot, cold or sweet foods and usually indicates exposure of the inner part of the tooth (dentine), a broken or leaking filling, a hole in the tooth or tooth fracture. First aid treatment is:
- Keep the wound clean -brush with warm water and use desensitising fluoride toothpaste such as Sensodyne F.
- Take your food at body temperature avoiding hot, cold or sweet food and drink.
- Report to your dentist as soon as possible, delay will only result in more extreme pain further destruction and a more expensive, time-consuming and complex treatment.
If the above signs of toothache are ignored a more intense form of toothache can occur, a continuous throbbing pain, this usually indicates abscess formation. This pain rarely disappears even with painkillers and you should seek dental treatment immediately. All toothache requires the services of a dentist and should not be treated with painkillers in the hope that the pain might just go away. If you delay, swelling can occur around the face and this can be quite serious and difficult to control.
Aspirin should not be given to children under the age of 12 years and aspirin tablets should not be applied to the offending tooth since aspirin burns will occur on the skin of the cheek. Limit any painkiller to the minimum since some can cause stomach pains. Sometimes the pain can be reduced if you sit with your head propped upright, reducing the blood pressure around the abscess. Lying down increases the pain as the blood pressure rises.
If you have problems with a partly erupted wisdom tooth, discomfort can be reduced by gently but carefully, brushing the teeth to reduce the amount of bacteria and using warm salted mouthwashes. Seek treatment as soon as possible especially if there is swelling.
Bleeding gums, with or without pain, can be restored back to health with regular and more meticulous tooth cleaning. Make sure your toothbrush is in good order and that you brush close to the gum margins (where the tooth disappears into the gum).
Only the fractured tooth, or tooth for re-implantation, can be described as an unexpected dental emergency, when dental treatment is urgently required. Almost all other dental problems give mild warnings which are usually ignored until the pain becomes unbearable. Do you have the odd twinge or a hole in your tooth which should be filled? If so, make an appointment as soon a possible.
The majority of dental problems can be prevented by sensible eating, good plaque control, and by visiting your dentist regularly.