Dental Emergencies

1. Minor Chip or Fracture

   Rinse the mouth with warm water, then use a cold compress to reduce swelling of the soft tissues. Most tooth chips and fractures are NOT URGENT and can easily be treated the next day.

   If the tooth fracture involve the nerve (if you see bleeding from the tooth, not the gums, the nerve has been involved), please give us a call immediately.

2. Lost Filling or Crown

   While it is not an urgent emergency, it is important to follow up with an evaluation during our normal business hours. Do not let any food or bacteria get into the hole that is now there to avoid infection risks. Rinsing with warm salt water often is recommended, as well as gently brushing the teeth after eating or drinking. Leaving a tooth exposed without its protective crown or filling increases the risk of decay, further damage, or fracture. Timely intervention can help preserve the tooth and prevent more extensive treatment in the future, so please call to schedule an appointment.

3. Bitten Lip, Tongue, or Cheek

   In most cases, a cut or bite to the tongue, lip, or cheek will not require stitches. Apply firm pressure to stop the bleeding. Clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling.

   However, if the bleeding lasts longer than 30 minutes and there is a severe pain and not better 2 hours after taking pain medicine, it likely warrants a trip to the emergency room to have the wound treated.

4. Object Caught In Teeth

   If your child has something caught between his or her teeth, use dental floss to remove it gently. Never use a metal, plastic, or sharp tool to remove a stuck object. If you are unable to remove the item with dental floss, please schedule an appointment.

5. Loose Tooth

   If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled. A loose baby tooth is NOT an emergency, though children will sometimes make it seem urgent! If the child is unable to remove the tooth on their own and you wish to have Dr. Kwak assist, encourage your child to eat a soft diet and call to schedule an appointment.

1. Avulsed Tooth (Knocked-Out Tooth)

   A knocked-out tooth is one of very few TRUE dental emergencies. The longer the tooth is out of the mouth the more likely it is that the vital cells of the ligament will die. Follow the protocol below in a timely manner.

   • Determine if the tooth is a baby tooth or a permanent tooth. (DO NOT reimplant baby teeth.)

   • Only hold the tooth by the white part. Avoid touching the root. If dirty, rinse for 10 seconds under tap water.

   • Replant the tooth (stabilize the tooth by biting gently on a cloth) OR place the tooth in cold milk.

   • Call our office.

2. Lateral Luxations (Tooth displaced from its usual position)

   When dental trauma occurs, it’s not uncommon for teeth to become displaced– either forward, towards the lips, backward, towards the palate/tongue, or extruded out of the socket. This displacement can become permanent if the tooth is not re-positioned in a timely manner. This is of particular concern if the tooth displacement results in the inability to function (i.e. The child can no longer chew because the displaced tooth inhibits full closure)

   • The parent or child can attempt to reposition the tooth on their own and then hold the tooth in place by gently biting on a cloth or call the office to reposition the tooth.

   • If the family performed the repositioning it’s important to call immediately for an evaluation to determine the best course of action moving forward.

   • Displaced teeth often require a splint to stabilize the tooth during healing. Please follow up with an appointment.

3. Medical Emergencies (Call 911 or go to the nearest ER)

   Please monitor your child closely after a head injury. If your child experiences any of the listed symptoms, we recommend seeking immediate medical help. These may be symptoms of concussion.

   • Loss of consciousness

   • Confusion

   • Nausea

   • Vomiting

Dental Pain (Toothaches)

Most toothaches are non-urgent but can seem that way when your child is fixated on it. Administer oral ibuprofen and/or Tylenol as indicated based on your child’s weight. You can alternate ibuprofen (Motrin) and Tylenol every 3 hours to manage pain. Do NOT apply aspirin or excessive amounts of topical pain reliever directly to the affected area, this can cause damage to the gums. Toothaches usually present after a stimulus is applied to the tooth (i.e. hot liquids, cold fluids, or sweets). If this occurs immediately refrain from eating excessively hot, cold, or sweet things and call to schedule an appointment. We will do everything in our power to see your child in a timely manner.

Apthus Ulcers (Cold-sores)

Cold-sores are ulcerations in the gums, cheeks, lips, and corners of the mouth that are usually caused by viral infections. The are brought on by primary infections by these pathogens or the are recurring episodes from an existing latent infection. Recurring episodes are usually brought on by stress, lack of sleep, or menstration. People who have chronic cold sores would benefit from relaxation techniques and in some cases an anti-viral medication that can be administered at the earliest signs of the lesion to reduce the healing time. Apthae self resolve within 7-14 days and do not require dentist intervention. During the first 7 days the lesions can be quite tender and sensitive to certain foods. Recommendations include a mild diet.

Facial Cellulitis
(Swelling under the eye or under the lower jaw or cheek)

Swelling, not associated with a known traumatic event, is likely due to an infection that has spread to the tissues of the face. Often these infections originate from the teeth, especially if there are dental issues that have been left untreated. Swelling can progress rapidly and can be LIFE THREATENING if it spreads to the cavernous sinus or to the tissues surrounding the airway. Therefore any facial swelling should be addressed ASAP. Call us for an evaluation and we will triage things over the phone. Depending on the severity of the swelling, you may need to go to the hospital for proper care. For severe swelling affecting breathing or swallowing, call 911 or go to the nearest ER.