Dental problem? You don't have to be MacGyver to save a lost filling or replace a crown.
By Denise Mann
Reviewed By Brunilda Nazario
On their wedding day, most brides hope for sunny weather and that the photographer and band show up as planned. Not me. My wedding day wish was that my mother would not experience a dental emergency.
Seem like a strange wish for the bride? It shouldn't. Growing up, there was rarely a special occasion, vacation, or even a long weekend when my mother did not, say, lose a crown, lose a bridge, or merely require an emergency root canal.
As a result, the trip or event was cut short so she could track down her trusted dentist. Recently, I feared this was genetic when an otherwise silent (but impacted) wisdom tooth became infected as my husband and I vacationed in Florida. Fortunately, I found a local dentist who prescribed a course of antibiotics to reduce the infection until I could have the tooth extracted.
Turns out it's not genetic as such dental emergencies are rather common. In most cases, however, there are things to do when you can't find the dentist - other than cutting your hard-earned vacation or leisure time short.
Like most other medical situations, an ounce of prevention and a little forethought is worth a pound of cure. "The better job you do at keeping up with the conditions in your mouth, the less likely dental emergencies are to occur," stresses Tom A. Howley Jr., DDS, president of the Academy of General Dentistry and a dentist in Perkiomenville, Pa. "If you are going to go out of the country or to a remote area, see your dentist far enough in advance so that you have time to get work done if needed."
For example, "if I were going to Europe with a temporary crown on my teeth, I would see my dentist prior to my trip to make sure everything is stabilized," says Warren Scherer, DDS, the chairman of the department of general dentistry and management science at New York University College of Dentistry in New York City.
But if a toothache should occur, a crown should fall out, your gums become inflamed, or any other dental emergency crops up, don't panic; there are easy things you can do to stop the pain and preserve the function until you can visit a dentist.
First things first, rinse the area with warm salt water to flush it out and make sure there is no debris that may be causing the discomfort, Howley says. Traditional over-the-counter pain relievers such as aspirin, acetaminophen (Tylenol), and Ibuprofen (Motrin, Advil, Nuprin) may also help curb the pain. "If the pain is due to the underlying layer of your teeth -- the dentin -- becoming exposed, you want to cover the area with sugar free gum or wax," he says. Some drug stores sell kits with material to plug up the exposed area. But, he cautions, such do-it-yourself sealants are usually only good for 48 hours. "Get to the dentist as soon as possible." If you should fall and break or chip a tooth, cover the exposed area in the same manner, he says. And don't fret if you swallow it because 99% of time it will pass uneventfully.
Find a Filling?
If a filling falls out, try and keep the lost piece to show your dentist. It's also important to keep the tooth clean by brushing gently with toothpaste and lukewarm water and to avoid eating in this area. "There are temporary restorative materials that contain zinc oxide that are sold over-the-counter that can plug up the hole until you see the dentist," says Warren Scherer, DDS, the chairman of the department of general dentistry and management science at New York University College of Dentistry in New York City. Two such products include Temparin and Dentemp OS. These products are the same as those that can be used to cover an exposed tooth surface.
Crowns or caps fully cover the portion of a tooth that lies at and above the gum line. But if you lose one, you have to try and put it back in, Howley says. Here's how: Clean it out thoroughly, and either buy paste in a drugstore or mix your own with Vaseline and corn starch. "Mix it to be a pretty thick paste," he says. Then, put the paste in the crown, place it on the tooth, and bite down gently until it's seated. "Wipe off extra glue that will seep out," he says. "It doesn't taste great."
"You can use crazy glue to replace a tooth off a denture, but that becomes more problematic because the consumer may have difficulty refitting that tooth," Sherer says. "If I were attending a wedding or had a meeting with the queen, I would crazy glue my tooth in, but if I could wait a day or so, then I would," he says. Partial dentures are mounted on a metal frame and fill a gap left by missing teeth. Complete dentures may be worn when all of the top or bottom teeth have been lost. They consist of artificial teeth mounted in a plastic base molded to fit the mouth.
Gauging Gum Pain
Over-the-counter pain-relieving gels and liquids such as Anbesol and Orajel can provide temporary relief, as can ibuprofen and other over-the-counter drugs that relieve swelling and inflammation. But "you have to get to the root of the problem, and sometimes you may have a gum infection brewing that may require antibiotics," Sherer says.
Howley agrees. "If there is swelling and bleeding around the gums, see a dentist as soon as possible because it may indicate something more serious," he says. "You may need antibiotics, or if there is an abscess, you may need to have it drained." This was exactly the case with my recent dental emergency.
The good news is that if you really need a dentist (as I did), "there are areas or facilities that you can visit over a weekend without necessarily waiting for your dentist," Sherer says. "Regional hospitals have dental residency programs and residents on calls and dental schools in the area have emergency facilities"
A root canal refers to damaged tissues in the tooth. If you suspect this is the issue, "keep cold and sweets away from the painful area," Howley says. "If you do this, the pain will typically go away, but if you also have sensitivity to heat, it's an indication of more serious problem." For example, "if you drink coffee and the tooth hurts even after stimulus is gone, this tends to indicate a problem with a nerve or that the tooth is dying or traumatized and you need to do something about it," he says. "It may be a simple as an antibiotic and Motrin, and sometimes it's as simple as keeping hot, sweet, and cold away until you can have it looked at by a dentist."
If you can't quite put your finger on the pain (literally or figuratively), go through a mental checklist to identify the culprit. "Is it a missing filling? A broken tooth? If so, you could try aspirin or ibuprofen. Is it gum related? If so, topical ointments may work," Howley says.
Make Your Own Dental Bag
While it's hard to plan for dental mishaps, it's a good idea to pack a small just-in-case bag replete with some tooth repair basics. It should contain:
- Salt packets
- Q-tips (in case you want to swab the area)
- Ibuprofen or another anti-inflammatory painkiller
- A small container (if you lose a crown or piece)
- A phone number of a dentist
- A pack of sugar-free gum
Published April 18, 2005.
SOURCES: Tom A. Howley, Jr, DDS, president, Academy of General Dentistry. Warren Scherer, DDS, chairman, department of general dentistry and management science, New York University College of Dentistry, New York City.
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