The History of Dentistry

5 Commonly Asked Questions about Dental Trauma and Emergency Care Answered

3 August 2016

Regina Carlson

Dental trauma following an accident must be attended to within the shortest possible time to avoid permanent damage to the teeth. Such injuries may spill over to affect the dental pulp and nerve system, which is the living part of the tooth. Treatment methods will differ according to the age of the patient and extent of injury. This article discusses some commonly-asked questions about dental trauma and how you can mitigate damage following an accident.

How is a chipped tooth managed?

Tooth chips can occur following unwanted impact such as falling down or knocking teeth against a hard surface. For chips, finding the fragment and soaking in water/milk can help to preserve it until you get to the dentist's office, where it may be reattached. If reattachment isn't possible, the dentist may suggest replacing using full crowns. More severe chips affecting the dental pulp will require root canal or endodontic treatment. Typically, your doctor will take X-ray images to ascertain the extent of damage.

How do I manage pain or swelling before getting to the dentist?

Dental trauma is almost always accompanied by pain and swelling. Using an icepack can help to numb the area as a natural way to calm nerves and reduce pain and swelling. In severe cases, taking pain medication is acceptable to deal with pain. However, only use paracetamol or acetaminophen pain-killers; aspirin has blood thinning effects and could make a bleeding injury worse.  You can also bite on a wet sterile gauze to relieve symptoms on your way to the dentist. Do not apply any topical pain ointments or put an aspirin on the injured area for pain relief.

How are fractured teeth treated?

The extent and type of fracturing will determine the intervention that is necessary to improve symptoms. A vertical fracture has little remedy apart from extraction. Dental crowns can be used to fill the space, with root implants to secure the crown in the gum. Minor fractures are treated the same way as chips – the dentist will smooth the tooth first, and use composite restoration to restore thickness if the tooth has worn too thin (to prevent tooth sensitivity). Root canal may be necessary for fractures extending into the pulp.

How do you deal with discolouration following dental trauma?

Depending on the extent of damage to the pulp, the tooth can have permanent discolouration from haemorrhaging in the pulp. Such teeth are not yellow or brown, which is how teeth look when externally stained. Instead, they may have a bluish or grey tint originating inside the tooth, so that regular bleaching/tooth cleaning can actually make the discolouration more prominent. Once your tooth is healed, you can talk to the dentist about getting dental porcelain veneers, which are the best way to conceal permanent discolouration.

What dangers are associated with dental trauma after treatment?

The way you treat your injury site and tooth/tooth fragment following injury will determine its viability and how long you take to recover. Tooth fragments should be rinsed lightly to remove dirt and carried in milk or water to prevent drying out. The site of injury should also be cleaned by rinsing the mouth with warm water and then biting on clean gauze to hold bleeding.

With timely treatment, a tooth can be replaced and return to normal function within a few weeks. However, there are rare cases in which the body rejects the tooth through a process called resorption. The body then eats away at the tooth, usually from the outside working inwards. As soon as you notice this, you should visit the dentist to see how much damage is done and whether it can be stopped. However, there are some times when resorption is unstoppable and the tooth cannot be saved.

Contact an emergency dentist for more information.

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