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What Constitutes Emergency Dental Treatment

Reasons for the deterioration of a restoration vary in different cases, the cause may be underlying caries or it could be occlusal trauma, caused from natural dentition during mastication Kenwood IL Illinois 60629. The longevity of restorative materials could also be a factor; the survival rates of amalgam are usually 10–15 years, composite 7 years, while gold and ceramic fillings have over a 20-year longevity.[2]

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Mild inflammatory swelling may follow dental extractions but is unusual unless the procedure was difficult and significant surgical trauma occurred. More significant swelling usually indicates postoperative infection or presence of a haematoma. Management of infection may require systemic antibiotics or drainage. A large haematoma may need to be drained.

Whilst haemorrhage from the oro-facial region may present spontaneously, particularly from gingival tissue as a result of a bleeding diathesis or a haematological abnormality such as leukaemia, the most common cause is in response to trauma or a post-operative haemorrhage following dental extraction.[2]

Dental trauma refers to an injury on hard and soft tissues of the oral cavity and face. This includes the teeth and surrounding tissues, the periodontium, tongue, lips and cheeks. It is more prevalent with children between 8– 12 years of age but can still happen to anyone. The prognosis of the tooth is worse the longer it is out of the mouth.[6]

Although you definitely need to seek a dentist’s opinion in the event of an emergency, you have to judge the situation for yourself in the immediate aftermath, which means discerning between a medical injury and one that is purely dental in nature. Basically, if you feel that you are suffering unnecessary pain or you think your teeth have been damaged after an accident, it’s up to you to contact the dental clinic and seek treatment. For more information on emergency services in the Kingston area of London, contact the Pearl Dental Clinic and speak to a member of the team today; there is always someone available to take your call and discuss the treatment options with you.

Dental Emergency

Within every healthcare profession, there will be specialists in their field. It would be impossible for every person to know every single problem that can occur and to be able to treat so many problems. This is why we have different areas in dentistry. This also means that you will get the best treatment as the specialist you visit will know all about your particular problem - they will be experts on it. Dental specialists include, oral surgeons, orthodontists, paediatricians and prosthodontics.

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Peri- radicular pain can be of pulpal origin, most commonly due to disease in the pulp extending into the peri-radicular tissues but can also be of periodontal origin due to periodontal disease.[4] Apical periodontitis is a term used to describe acute inflammation of the periodontal ligament surrounding the tooth. This can be caused by inflammatory mediators from irreversibly inflamed pulp, bacterial toxins from necrotic pulp, restorations that have not been property contoured and in some cases, from treatments such as endodontic treatment.[4] There is both an acute and chronic form of this condition.[4] Acute apical periodontitis features include moderate to severe pain, usually stimulated by touch and pressure and may also include spontaneous pain.[4] The chronic form of the condition can be asymptomatic but may also include pain from surrounding tissues when stimulated.[4] Apical abscess is a term used to describe an extension of apical periodontitis where the bacteria have infiltrated the peri radicular tissues and are causing a severe inflammatory response; there is also an acute and chronic form of this condition.[4] An acute apical abscess can cause facial swelling and can cause other systemic consequences such as a high temperature and feelings of malaise.[4] In some cases this condition can be life-threatening when the inflammation compromises the airway; this is termed Ludwig’s Angina.[4] A chronic apical abscess can be asymptomatic as the pressure from the inflammation is being drained through a sinus tract; a draining sinus can usually be seen clinically.[4] A periodontal abscess is a localised inflammation affecting the periodontal tissues.[4] It is caused by bacteria pre-existing in a periodontal pockets, traumatic insertion of bacteria or foreign body or can occur after periodontal treatment.[4] This condition has a rapid onset, is stimulated by touch and involves spontaneous pain.[4] It is important to note that an apical abscess may drain through the periodontal pocket giving a false interpretation of periodontal abscess or a periodontal abscess may appear at the apex of the tooth giving a false interpretation of apical abscess; a tooth may also have both lesions at one point in time.[4]

Dental Emergencies

A diagnosis of a cracked tooth is extremely difficult. Careful history and assessment of the symptoms presented needs to be taken into account; radiographs and certain tests will be conducted in the dental office. Most common symptoms are cold sensitivity, sharp pain when using force to chew, these pain results from the release of pressure and are very important indicators of a cracked tooth. However, the symptoms may differ from various patients, subject to the depth and orientation of the crack.

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Some define a dental emergency in terms of the individual's willingness to attend for emergency dental treatment at any time at short notice, stating that persons who are fussy about when they are available for treatment are not true emergency cases.[1]:702

Scheduling an appointment, emergency or not, is easy. Simply contact our team directly. You can call our Junction Drive location at 956-242-6745 or our Winfield location at 956-517-2695. You can also send us a message using our online contact form, though this form of contact is recommended for non-emergency appointments only. We will be happy to help you.

Loose fillings – No filler material is completely impervious to harm, a strong impact or steady wear and tear can cause damage and the filling might break free from the tooth; although this may not be painful to start with, it could leave the pulp chamber open to bacteria. If you are unable to get to the dentist straight away, one good tip is to take some sugar free gum and press it over the damaged area; this will create a temporary shield until the filling can be repaired or replaced.

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Broken Tooth — Save any pieces of the broken tooth and rinse your mouth out with warm water. Apply a cold compress to the area to decrease swelling and pain until you can be seen by an emergency dentist.

Crowns can become broken by a fracture, non-retentive preparation, secondary caries, weak cement, excessive occlusal forces, decementation or loosening of the crown.[8] The consequences of a crown becoming loose include the risk of ingestion and less likely, inhalation. The management of the loose crown includes immediate recementation or a replacement crown, depending on the assessment conducted by the dentist.

A crack, fracture and the mobility of a tooth are all interrelated as the pain and symptoms experienced from a tooth that has been cracked are very similar to that of a tooth that has been fractured.[2] A tooth crack is defined as an incomplete fracture of enamel or dentine and therefore is not usually associated with noticeable mobility.[8] The cause of a tooth crack can be by excessive force applied to a healthy tooth or physiologic forces applied to a weakened tooth. The teeth most commonly involved are usually the lower molars, followed by the upper premolars and molars. The condition is extremely common in the age range of 30–60 years.[2]

What Constitutes A Dental Emergency?

During the emergency appointment the dentist will need to take a set of radiographs to assess for any underlying caries, bone loss or possible abscess. The clinical examination will detect the reasons behind the failure of the restoration. Upon treatment the dentist will provide options on the tooth’s prognosis, these may include a new restoration, extraction, root canal or placement of a crown. The tooth prognosis includes the tooth’s vitality and restorability.

Emergency dentists are not available to help with regular treatment – such as check-ups – because their primary area of expertise is with sudden injuries or on-going problems that need attention right away, so for this reason you should only approach them for treatment if you have had an accident or you are suffering discomfort. Things like broken or knocked-out teeth are quite common at an emergency clinic but you won’t be able to make an appointment to get your teeth whitened or just checked-out as a matter of routine dental care; for these things you should speak to your regular dentist. Other painful developments that an emergency clinic should be able to help with include; abscesses, loose fillings, cracked teeth, broken braces, gum disease, and lots more besides.

In some cases, immediate reconstruction of the abutment may be deemed inappropriate, if the underlying structure is deemed deficient due to caries or a fracture then this issue needs to be addressed. The treatment plan may vary with the addition of a root canal treatment or a temporary crown for the reconstruction of a new crown.

Management includes cleaning all the cement and residues, to carefully inspect for any underlying caries or fractures. Details that need to be assessed include margins, gingivae and contact points; occlusion needs to be checked in both ICP and in lateral and protrusive excursions, before the crown can be re-cemented. Stronger cement should be used than the original such as resin cements, especially in cases of heavy occlusal forces.

What Constitutes Emergency Dental Treatment

Analgesics such as aspirin, paracetamol (acetaminophen) and ibuprofen are also commonly used; aspirin and ibuprofen have the additional benefits of being anti-inflammatories. Ice and/or heat are also frequently applied .[citation needed] A dentist may prescribe an anti-inflammatory corticosteroid such as Dexameth for pain relief prior to treatment. [1]

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Immediate management includes a chair side repair of the fractured veneer with composite material. Bonding composite to the exposed metal will involve achieving macro mechanical retention by making grooves and notches or abrading the surface. Bonding material back onto exposed porcelain involves abrading, hydrofluoric acid etching and silanating then followed by a conventional bonding procedure. Composite patch will remain a temporary solution as the longevity of composite restorations is not predictable as well as the colour of composite is not as stable as porcelain for aesthetical reasons.[2]

Dental Treatment Information Guide

Dental Abscess — If you notice a painful, pimple-like swelling on your gums, rinse with salt water and immediately contact an emergency dentist. Dental abscesses can lead to more serious infections if not treated promptly.

Loose crowns – Crowns are normally placed over teeth that have been root-treated to protect them and keep the compromised structure in one piece; if the crown works loose over time or after damage, it needs to be repaired immediately. A loose restoration leaves space for bacteria and food debris to gather, which could cause serious damage to the reduced tooth beneath it.

Implant success is relatively high, the rate of implant survival is between 85-95%,[9] although it is not uncommon for emergency management of a failing implant or one of its components. The failure is most likely due to infection of the implant. It is highly recommended to visit or refer patient to the specialist who provided the implant.

There are often divergent opinions between clinicians and patients as to what constitutes a dental emergency. E.g. a person may suddenly lose a filling, crown, bridge, etc. and although they are completely pain-free, still have great cosmetic concerns about the appearance of their teeth and demand an emergency treatment on the basis of perceived social disability.

What Is Emergency Dental

Bacterial infection in the oro-facial region can lead to abscess and swelling. The rapid spread of this infection through connective tissue spaces, is often referred to as cellulitis. The clinical features of cellulitis are a painful, diffuse, brawny swelling. The overlying skin is red, tense and shiny. There is usually an associated trismus, cervical lymphadenopathy, malaise and pyrexia. Cellulitis usually develops quickly, over the course of hours, and may follow an inadequately managed or ignored local dental infection. If the infection spreads to involve the floor of mouth and pharyngeal spaces, then the airway can be compromised. Initially, the floor of the mouth will be raised and the patient will have difficulty in swallowing saliva; this pools and may be observed running from the patient’s mouth. This sign indicates the need for urgent management. Cellulitis involving the tissue spaces on both sides of the floor of mouth is described as Ludwig’s angina [10] Such presentations require immediate attention.

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