Dental 911: What to Do When Trouble Strikes

During his 35 years as a dentist in his hometown of Tujunga, Calif., Dr. Rick Diamond saw just about every dental emergency there is, sometimes uncomfortably close up.

There was the time his then teen-aged son got into an altercation that resulted in the temporary removal of three teeth. Solution: “We ran to the orthodontist, gave him some Novocain and stuck ’em back in. He’s 38 now and he’s still got ’em.”

Then there was the day his own hygienist got a dental tool stuck between Dr. Diamond’s teeth during a cleaning—and broke it off. Solution: “Well, I have to say, it took 20 minutes of hard work between the two of us, but we got it out.”

The moral of these stories, says Dr. Diamond, author of a sprightly guide to mouth care called Dental First Aid for Families, is that accidents will happen. It’s how you respond to them that separates the grinners from the groaners.

Most dental injuries occur during sports or as the result of an accident, says Dr. Matt Messina, a spokesman for the American Dental Association who practices in Cleveland and conducts workshops for athletic trainers.

Knowing that, he says, be prepared. Wear a mouth guard during high-contact sports such as football, soccer, basketball, kick-boxing and even baseball and softball, especially if you’re the pitcher and apt to be hit by comebackers to the mound. And cultivate a relationship with your dentist. That way, Dr. Messina says, you not only can ask for advice when trouble strikes, you’ll know what number to call when the problem occurs outside of regular office hours.

In the meantime, here’s what to do while you’re on the way to your appointment.

Tooth Knocked Out

The thing about injuries in the mouth, says Dr. Messina, is they bleed “like crazy.” This quite naturally panics people, especially parents if it’s their young children who are doing the bleeding. So the first step in just about any common dental emergency, Dr. Messina advises, is don’t panic. Stop the bleeding using direct pressure so you can see what’s going on.

If a permanent tooth’s been knocked out, find it immediately. If you can get to a dentist (or, failing that, an emergency room) within an hour you’ve got a good chance of saving the tooth. The sooner you get to a dentist, the better chance you'll have that the tooth will retain living tissue and will attach successfully. In some cases, knocked-out teeth require a root canal, after which the dentist will most likely bond the tooth to nearby teeth to keep it in position.

You want to preserve any tissues that are still attached to the roots of the tooth. So if it’s dirty, hold it by the crown and clean it carefully by rinsing it or dipping it in a bowl of water. Don’t scrub the tooth.

If you can, put the tooth back in its socket. If possible, cover it with a bit of gauze or a wet teabag and bite down gently to keep the tooth in place. If you can’t put the tooth back in the socket, place it in a small container of milk or warm, salty water. You can also stow the tooth between the lower lip and lower gum, but be very careful not to swallow it. That’s the last thing you need in this situation.

If your child has knocked out a baby tooth, says Dr. Diamond, the ill effects are likely to be temporary. Because a tooth will eventually grow in to take its place, you can consider a lost baby tooth as an early gift from the tooth fairy.