Dental Trauma and Emergency

Fortunately dental trauma is fairly rare, but when it happens it is very distressing to all concerned. Dental trauma is best resolved by a caring dental professional in a calm and caring dental surgery. We have all the equipment required to handle most dental trauma and dental emergencies. You should always save pieces of fractured teeth or completely knocked out (avulsed) teeth and remember to keep them moist.

Other dental emergencies we treat include dental abscesses, pulpitis, root canal treatment, teeth extractions, wisdom teeth and Temporo-Mandibular Pain Dysfunction Syndrome (Commonly known as TMD).

If you are after emergency dental advice please see the information below or contact us on (07) 3359 1996.

Emergency Dental Trauma

Fortunately dental trauma is fairly rare, but when it happens it is very distressing to all concerned especially for us parents of children and adolescents! Dental trauma is best resolved by a caring dental professional in a calm and caring dental surgery. We have all the equipment required to handle most dental trauma except where there are broken bones involved. If that is the case specialist care in the hospital situation is the best place to get attention. However save pieces of fractured teeth and if teeth are completely knocked out save them too! Broken pieces of teeth or completely knocked out (avulsed) teeth must be kept moist! The body only ‘recognizes’ the tooth as being part of the body because it has a layer of specialized support cells on its surface. If these cells die the tooth will be rejected. These cells must be kept alive by keeping them moist.

Follow these steps:

  1. Handle the tooth only by the crown of the tooth (the whiter enamel that you usually see in the mouth. Pick it up and clean it – the best place is in the victims own mouth if they are conscious, capable and won’t swallow it! If not it can carefully be rinsed in milk Never use Water. Remember that the longer the tooth is out of the mouth the more chance that those cells will die and that the re-implantation will not be successful.
  2. After a tooth is knocked out the socket is surprisingly not a painful area to handle. Holding the tooth by the crown carefully wiggle the tooth back into the socket letting any blood or blood clot come out and get it into what seems to you to be the normal position, you can push it quite firmly and things will be fine. Hold it there or get the child to hold it in place and come and see me now! We will always prioritise trauma patients and see them as soon as possible.
  3. If you can’t bear to replant the tooth then bring it with you as soon as possible. Every minute counts, again keep it moist if possible in the patients mouth, if not in milk.

Phone our surgery on (07) 3359 1996 for more information.

Dental Abscess

Dental Abscess or Apical Periodontitis

If the pulp tissue dies it invariably becomes infected by bacteria because it is warm, moist and is a source of bacterial nutrients. These bacteria can come from the decay or surprisingly enough by bacteria that occasionally can be found in the bloodstream. Once the pulp chamber is infected the bacteria multiply and the bacteria and the toxins they produce exit the tooth tissues at the tip of the root and cause an inflammatory response. White blood cells called into the area engulf the bacteria and kill them or produce enzymes and antibodies to kill them. The mass of dead white cells and bacteria is called an abscess.

This abscess starts locally but migrates through the tissues trying to drain into the mouth. This causes the gum to swell and eventually burst releasing pus. Before that happens it is can be exquisitely painful. The quicker you see your dentist the better. On occasion this abscess enters the tissues around the face, tongue, throat or neck and cause a red swelling, which is usually painful. See your dentist as soon as possible if this happens as there can be serious complications. High fever and feeling generally under the weather are other signs that need to be treated urgently! Don’t put it off!

Pulpitis

This is the word that we use to describe the pain the originates from the inflamed inside tissues in the tooth. If bacteria invade the pulp (commonly called the nerve) tissues they become inflamed, and normally painful. The problem with this is that the blood supply of the pulp tissues is quite small and if compromised results in death of the pulp tissue. Before this happens the pulp becomes sensitive to cold and/or hot and often throbs uncontrollably. It can also be sensitive to sweet, but this is normally only during the early stages of cavity formation. At this stage there are many proprietary pain killers on the market that can help remove the pain, but it is sensible to see the dentist as soon as possible.

Root Canal Treatment

Why are most people scared of root Canal treatment? Modern root canal treatment has been revolutionized recently by the use of rotary nickel titanium files that speed treatment and give a more predictable finish. Most people are scared of root canals! It never surprises me how much people love to distress each other with bad stories about root canal treatments.

I care about my patients and don’t like to hurt any one. If the dentist is caring there is little reason for pain during the procedure. I do everything I can to make this procedure pain free and often have my patients fall asleep during root canal therapy. Communication is the key, and if you understand what is going on everything becomes much easier to cope with. At the surgery here we would expect to get a success rate of well above 95%, this is achieved as always by taking time and not rushing! A job well done usually involves much preparation and the same is true with root canal treatment.

Teeth Extraction

We provide the full range of extractions normally offered in the dental surgery and in addition remove wisdom teeth under Local Anaesthetic. After I qualified in England I worked as an Oral Surgery House Surgeon at King’s College Hospital. During that time I worked in Operating Theatres assisting with major Oral Surgery procedures. This time gave me much experience at removing wisdom teeth. I am happy to remove most wisdom teeth under Local Anaesthetic here in the surgery. This is an advantage for you because it is much less expensive than having them done under General Anaethetic.

In all our work we take time over your care, and make sure that you are as comfortable as possible, and give you as much control as we can in your treatment. Happy patients come back to us and end up being regular attenders. We look forward to helping you get over surgery as quickly as possible. It means so much to us when patients leave the surgery saying; “That wasn’t half as bad as I thought it would be!” My reputation of being a “Sensitive Dentist” is really important to me.

Tempero-Mandibular Pain Dysfunction Syndrome (TMD)

This is surprisingly common especially in young adults with females predominating about 4:1. It is a complicated name that describes pain that arises either because the chewing muscles cramp, or because the joint between the jaw and the base of the skull doesn’t function properly. The muscles that move the jaw have a different type of muscle fibres compared to say the leg muscle. When you get a cramp in the leg muscle which most of us have experienced from time to time it you get an acute pain that makes you jump around in agony having to stretch the muscle to relieve it. When you get a cramp in the muscles that move the jaw it is a low grade pain like a headache most commonly felt in the cheek (masseter) muscle or the temple area on the side of the head (temporalis muscle).

If you over using the muscles because of clenching your teeth – which commonly happens during the day, or grinding your teeth – which usually happens at night the muscles cramp and cause the headache type of pain. If it occurs in the cheek people commonly think that the wisdom teeth are causing the pain! Other symptoms include clicking grating or locking of the temporomandibular joint (TMD), and other pains around the shoulder girdle, and sometimes more bizarre symptoms like tinnitus (ringing in the ears).

Come and see me and I will help you to settle the problem, we do this by analyzing your bite, helping you to understand the consequences, giving you ways to prevent the problem and occasionally fabricating an custom made occlusal splint for you to wear at night.

Wisdom Teeth

Wisdom Teeth or Pericoronitis

Erupting wisdom teeth are a common cause of pain, in people of European origin wisdom teeth usually erupt into the mouth between the ages of 17 to 21. These teeth can erupt much earlier in people of African origin. The developing tooth has a bag around the crown called the dental follicle. As the tooth comes through, this bag opens into the mouth and bacteria can enter. If the tooth becomes jammed in place because of lack of space you can get an ulcer under the flap of tissue covering the tooth and it becomes acutely inflamed and painful. This is made much worse if the opposing tooth bites into the inflamed tissue! Treatment involves assessing if there is enough room for the wisdom tooth. If there is the flap of tissue can be carefully removed, if not the wisdom tooth should be removed.

Do you have a question?

If you have a question regarding Dental Trauma or Dental Emergencies ask Dr Martin Jest directly.  Simply fill in the form at the side and we will get back to you as soon as possible.