Dental Trauma or Dental Emergency

What to do in case of dental emergency?
Trauma or injury to teeth or facial region can occur to anyone be it a child or an adult. There are few things which if taken care of can reduce the damage to the teeth and surrounding tissues, before you get medical attention. If due to the injury a tooth has come out of socket following things can be done-

• Reassure the patient and keep them calm.

• If the tooth can be found, pick it up by the crown (the white part). Avoid touching the root part.

• If the tooth is dirty, wash it briefly (10 seconds) under cold running water but do not scrub the tooth.

• Place the tooth back in the socket where it was lost from, taking care to place it the correct way (matching the other tooth)

• Encourage the patient to bite on a handkerchief to hold the tooth in position.

• If it is not possible to replace the tooth immediately, ideally, the tooth should be placed in Hank's balanced salt solution, if not available, in a glass of milk or a container with the patient's saliva or in the patient's cheek (keeping it between the teeth and the inside of the cheek - note this is not suitable for young children who may swallow the tooth). Transporting the tooth in water is not recommended, as this will damage the delicate cells that make up the tooth's interior.

• Seek emergency dental treatment immediately.

When the injured teeth are painful while functioning due to damage to the periodontal ligaments (e.g., dental subluxation), a temporary splinting of the injured teeth may relieve the pain and enhance eating ability. Splinting should only be used in certain situations. Splinting in lateral and extrusive luxation had a poorer prognosis than in root fractures. An avulsed permanent tooth should be gently rinsed under tap water and immediately re-planted in its original socket within the alveolar bone and later temporarily splinted by a dentist. Failure to re-plant the avulsed tooth within the first 40 minutes after the injury may result in very poor prognosis for the tooth.Management of injured primary teeth (milk teeth or baby teeth) differs from management of permanent teeth; an avulsed primary tooth should not be re-planted (to avoid damage to the permanent dental crypt). This is due to the close proximity of the apex of a primary tooth to the permanent tooth underneath. The permanent dentition can suffer from tooth malformation, impacted teeth and eruption disturbances due to trauma to primary teeth. The priority should always be reducing potential damage to the underlying permanent dentition.