What is considered a dental emergency?
A dental emergency is anything from a toothache to a fractured tooth to a crown that popped off. Where we really start to get into emergencies is when we're now experiencing swelling and fever. We have difficulty swallowing. All those things are versions of emergencies. We'll dive more into the details of each of those types of emergencies and when and how you should treat those.
When should you go to an emergency room, have an emergency dental visit, or schedule treatment for later?
Now that we kind of have an idea of the different types of emergencies we can experience, what I want to start off by talking about is when we go to an emergency room, have an emergency dental visit, or can we just schedule to have this treated at a later time?
Actually, there are very few dental emergencies that really should constitute an emergency room visit. It's very interesting. Emergency rooms are not really equipped for handling dental emergencies. Even in San Antonio, our own city, we have one hospital in town that even has an oral surgeon or dentist on staff. Most emergency rooms don't know how to manage dental emergencies. They're just going to give you antibiotics and send you home and have you go see a dentist.
Really, I would say the first thing you should do if you're having some type of emergency is to call us at (210) 972-0768. You should call us with your emergency. That way, we can handle your issue and get you in right away.
Where emergency rooms do become beneficial is if someone has had an infection that's gone on way too long. Now there's a huge swelling in the person's face, or you're having trouble breathing because that swelling is now spreading to your throat. That is when you should go to the emergency room. That is a true medical emergency at that point. But if we're before that stage, we need to see you in the dental office. If you have fever, swelling, toothache, all of those things, we want to see you, and we're going to get you in right away for that kind of thing. If you have pain and the tooth is throbbing, we're going to get you in right away.
I would say things that can be kind of scheduled out would be maybe we had a dental crown that popped off or something like that. Now, if it's your front tooth, I want to see you right away, but if it's a back tooth and it's not sensitive or causing you pain, then we want to get to it, but it doesn't necessarily have to be an emergency or urgent that we get to it that moment. Those would be the different examples of when we are going to use an emergency room, come to the dental office, or schedule it out to have it treated.
Common Dental Emergencies
Toothaches and Tooth Pain
The first type of dental emergency I would like to describe and go into is going to be toothache and tooth pain. That's the most common type of dental emergency. A toothache can take various forms. There can either be a really short-acting pain where you kind of feel a little zap, a little zing, but then it goes away. There can be a really sharp pain where it feels like someone's stabbing you. There can even be a throb where it just lingers and throbs and kind of aches.
Then another type is one that's called referred pain, where you actually are feeling pain in one area, but the actual problem is located in a different area. Those are the most uncomfortable because then it can just radiate and throb, and you kind of feel it all over. Those would be the different types of toothaches or tooth pain that we experience and feel.
Tooth Abscess or Gum Swelling
The second is going to be an abscess or swelling. An abscess is where the tooth has now become infected. The way a tooth becomes infected can happen in different ways. It can be infected from a cavity. It can become infected because the tooth gets a crack in it. The tooth could break, and now the nerve is exposed. It becomes infected that way. As well, gum disease can actually create a tooth infection.
What infection does is, when bacteria gets into the tooth, it kills the tooth because the tooth is actually an organ, and a lot of people don't realize or know that it's an organ. When the tooth dies, what happens is it starts to rot and become infected. The infection takes the path of least resistance, which often means that the infection goes down the roots of the tooth into the bone. When the infection gets down into the bone, that's when it creates what's called an abscess.
Now, there are different types of abscesses. There are abscesses that are contained within the bone, which means your immune system, your body, is trying to wall off the infection. Then other times, the infection can actually eat through the bone, and then it starts to drain through the gum, and we get what's called, like people will notice, a little pimple on the gum, and that's another type of abscess. It can drain through the gum, and that's another type of abscess.
Now, the worst type of abscess is when it gets through the bone into the soft tissues. Soft tissues would be like your cheek, but there's never a draining point because when there's a draining point, that infection can drain on its own. It's still not good, but it's your body finding a way to get that infection out. But when it gets into the soft tissues, it forms what's called cellulitis. Cellulitis is a medical emergency because the infection has now spread into the soft tissues. From there, it can go to the throat, it can go to the eye, and even worse, it can go to the heart because it gets into our bloodstream. Those would be the different types of abscesses and infections that we experience in dentistry.
What are common causes of dental pain?
I would say the most common types of tooth pain we experience are wisdom tooth pain. In the modern era of man, our jaws are smaller than those of our predecessors, our ancestors. A lot of it has to do with the diets and foods that we eat. But because we have smaller jaws, oftentimes people don't have space for wisdom teeth. So what happens is the back of the jaw curves upward. As it curves upward, the wisdom teeth oftentimes come in on that curve. When they're coming in on that curve, they'll come in at a weird angle. That angle they come in at means they don't usually come in all the way, or they can start to grow into the tooth in front of it. Oftentimes, because of those reasons, we end up with wisdom tooth pain.
The simple treatment for it is pulling. A lot of times, people are afraid of the idea of getting a tooth pulled, which is completely understandable. I don't want to get my tooth pulled. But at the same rate, if we let it linger on, now we get into the world of what I was talking about before, and we get these ugly infections. If you're starting to feel pain from your wisdom teeth, that's your body warning you, like, hey, it's time. Actually, you're kind of getting late to the time. The time is coming, and we need to get to it right away. That would be one of those emergencies that we experience with wisdom tooth pain.
Another type of pain that I would say is probably the most common type of pain is actually bleeding and inflamed gums. The most common dental disease that we face as we get older is gum disease. It's the number one reason why people actually lose their teeth. If you are starting to feel like your gums are a little sensitive or you're noticing some bleeding, it's not necessarily an emergency at that point, but again, it's a warning sign of an emergency that is to come.
The best thing is to come into the office and get scheduled to have that first phase treated, so that way you don't end up with a dental emergency because, like I mentioned before, there are tooth infections that can come from gum disease. Of course, we want to get that before the actual emergency arrives and the infection occurs.
Why shouldn't I ignore sensitive teeth?
What is so important is that our body does a good job, for the most part, of warning us when something's happening. One of those warning signs is sensitive teeth. Not every sensitive tooth means that there's a dental emergency, but again, it's our body warning us. It's like, hey, something's happening. It's really important that we don't ignore those subtle little signs because oftentimes, what happens is an infection can form, and we don't even know it.
I can't tell you how many times I share this story. I had this little 11-year-old girl in my office, and she came in with maybe a little sensitivity, but really not major pain, just for a routine dental visit. We take a dental X-ray, and we see she has an infection in her tooth. Lo and behold, as you're looking at the dental X-rays, you can trace that infection where it has eaten through her jaw. Now the infection is actually draining out of her cheek. You look at her and, sure enough, you see where it's draining out of her cheek. We asked the mom of the child, like, "Hey, did you notice this?" And she's like, "Oh, yeah. The girl's 11. I thought she was going through puberty. I thought it was a pimple." And that's what was crazy, because the infection was actually draining from her tooth.
That's why it's so important when you have some type of sensitivity. Your body is warning you of something that's occurring because it may not always end up with severe pain. Normally, by the time that it is at that severe level, it's too far gone. So don't ignore any type of sensitivity because it is pointing to the fact that a problem exists, and we've got to figure out what that problem is.
What if I have a broken, fractured, or cracked tooth?
Some of the most uncomfortable types of dental emergencies we have are broken, fractured, or cracked teeth. A lot of times, these things can kind of be caught early on. You can start to see some stress fractures forming in the tooth. But sometimes it just happens by accident. We could get hit in the mouth. We could be eating some food and there's a hidden little bone or something hard within the food that we didn't know about. We bite on it and break our tooth. But that is a type of emergency that does occur.
Now, the good news is that the majority of the time when those types of situations happen, we can save the tooth either with a filling or a crown. Sometimes we have to do a root canal. The worst case, unfortunately, is when we have to pull the tooth. But anytime that happens, again, if something breaks, it doesn't mean it's always going to hurt. But if you have a tooth that is broken, that's urgent. We want to see you because we want to help protect your tooth so it doesn't develop into a major emergency.
What should I do if a filling breaks or falls out?
Now, when a tooth has a filling, say it had a cavity before and needed a filling, or maybe it broke before and had to get a filling or a crown. Anything we do in dentistry is man-made. It's not permanent. Occasionally, when we have a filling, fillings can break just like our natural teeth can break. Very often, I have patients tell me, "Well, I thought once you fix it, it lasts forever." It's like, unfortunately, not. It'd be awesome. I would love that. But unfortunately, that's not the case.
Even a filling can break. Just like when a normal tooth breaks, when a filling breaks, we want to see you right away because very often I'll have patients whose filling pops out or breaks, and it's not hurting that bad, so they just tolerate it. Then by the time it does start to hurt, the new decay has set in. The decay is often down to the nerve now because you have this open, exposed tooth. Now I'm having to go in and do much more invasive procedures to get that person out of pain and save their tooth. Many times I've run into a situation where I can't even save the tooth now because it's just too far, too deep. Again, the biggest takeaway from this video today is don't ignore these things. Handle them while they're small so that way they don't become big.
Can dentures have dental emergencies, too?
Now we've been talking a lot about gum disease, infections, and broken teeth. Another type of emergency is, well, what if I don't have teeth? What kind of emergencies can happen in that situation? They can. Say you've had your teeth replaced and now you have a set of replacement teeth, like dentures. Sometimes dentures can wear down over time, and they can break while we're eating or when we accidentally drop them. That too is an emergency. Why? Because you don't have teeth now. Your teeth are broken. For that type of thing, we want to see you in the office.
Now, depending on what your schedule and our schedules look like, we don't always have to see you immediately. Of course, we want to get you in and get your teeth fixed and repaired. That way, you can go back to eating and go back to your normal day of life. That too would be a type of emergency.
What if you have a loose or broken dental crown, veneer, or bridge?
Now, the last one that I want to cover briefly is when we have a loose crown, a broken crown, or a loose or broken veneer, bridge, etc., because they're all similar types of things in dentistry. These are all types of restorations that we do to cover a tooth. The first sign is that we feel it start to come loose. Very often, I have patients come in and say, "Oh, yeah, I noticed my crown, my bridge, or my veneer. It seems a little bit loose." If it feels loose, come in right away.
The reason being is if it's loose, it means stuff can leak under and start to decay underneath. That's very important because, again, if it stays like that too long, then it's going to decay and we can't even see or tell because that tooth is covered up. That's always the best time to come in because if it's loose, we'll just pop it off, clean it up, and cement it right back on. It's good as new. Easy peasy. But if we do wait too long, where it now starts to decay, and it's popping off because it has become so decayed, many times we have to now replace that crown, veneer, or bridge, and that becomes very expensive.
I always, my biggest thing I like to preach to my patients is prevention. If you notice anything at the earliest sign, don't hesitate to come in because when we get things early, we save you a lot of time, a lot of pain, and a lot of money, and all those things matter. I know you are more than just a mouth, and I don't want your dental problem to control and rule your life because we waited too long to get to it. That would be the last little thing that we run into that I would say constitutes some urgent care.
What happens if I have a tooth that has to be pulled?
When we start to see those things, say you're at that position where you had an emergency, and it's the worst-case scenario, the tooth has to be pulled. There are a lot of different scenarios that fall into that. Like we talked about, wisdom teeth already.
Another one would be that there are various types of extractions. A lot of times, again, we as patients think, oh, extraction is extraction. Actually, it's not. The worse a tooth gets, the way you approach it is different.
The easiest, simplest one is probably what you're thinking. It's called a simple extraction, where you just pull the tooth. But if a tooth is very broken down, now it could become surgical, where say the top part broke off. Well, there's nothing for me to grab. So now I have to drill down into the bone to remove that. It's very scary, right, as a patient to think about. For me, it's very simple because I'm very skilled in this. But again, we don't want things to get to that extreme because, naturally, as it gets to that extreme, it becomes more expensive. It's more involved, more recovery.
Oftentimes, when we do an extraction, now we've taken the tooth out, well, now there's a hole. We don't want to leave that hole because what happens is if you leave the hole, your body knows there's no tooth there and says, "I don't need this bone." Actually, the hole itself will collapse on itself, and you'll be left with a huge defect and divot in your jaw. So it is important that anytime we do an extraction, we want to replace it with bone. Where do we get this bone? There are medical companies out there that sell bone grafts, or oftentimes the bone minerals that are needed for your body to take in those minerals and create new bone from them. So that's often what we need to do after we do a tooth extraction.
Then becomes the planning. What do we want to do? Do we want to leave you without a tooth, or do we want to plan for a replacement tooth? There are a lot of different options that fall into that, that we can do for replacing teeth. That's for another video. But the most important thing is when you have a tooth out, you want to replace the foundation of it.
When would I need a bone graft?
Now the only time I would say that we don't need to replace the foundation of a tooth is when we're doing usually a wisdom tooth because wisdom teeth are usually so far in the back that it is not necessary to have to bone graft in those areas. The reason I like to cover that in this video is because I have seen many, many times where patients have gone places and doctors are recommending bone grafts for wisdom teeth, and it's like, for what? Your body can heal without a bone graft. If it's a wisdom tooth that's so far in the back, your body is going to heal normally without the bone graft. I don't need the bone graft. I'm also not going to be putting a tooth there. It's also not going to impact the overall structure of your jaw.
Where the jaw does get impacted, as far as structure-wise, is when we're moving more toward the front or in the areas that we chew. That's where we really want to reinforce the bone, and that's where a bone graft would be beneficial.
When would an emergency root canal be needed and how does it differ from a traditional root canal procedure?
Now, oftentimes when patients come in, if the tooth extraction is not necessary, it might mean that an emergency root canal is necessary. An emergency root canal is pretty much the same as a regular root canal except that instead of completing the root canal all the way through, a lot of times we have to put an antibiotic in the tooth because many times when a root canal is needed for an emergency, it means there's a big infection in the tooth and in the jaw, and when that happens, I or a dentist cannot complete the root canal at that time. The reason why is there's still going to be an infection.
What we do is, okay, your tooth is infected. We drill in the tooth, and we can, from within the tooth, remove a lot of that infection, but the research shows it's impossible to get rid of all the infection there. What I do is, well, the source of infection was the tooth. So I put an antibiotic down into the tooth, and I leave that there for one month. I leave that there because now that the antibiotic is going to work on killing the remaining bacteria as well. It's going to help the bone grow back because the type of medication I put in the tooth has calcium in it.
So what's neat is that's actually the sign that we got rid of the infection, that I'll see the bone growing back where the infection was. That bone growing back is in part due to the calcium that's in this medication. That is the number one sign that, okay, good, I got rid of the infection, and now I can complete the root canal as normal and then seal the tooth off. That would be the reason why there's the need for an emergency root canal, and kind of how the emergency root canal differs from a regular root canal.
Emergency Dental Care at Inspire Dental
Do you offer same-day emergency dental care at Inspire Dental?
Now, if you're having a dental emergency, what is so important is finding a place that offers same-day care. At Inspire Dental, your emergency is urgent to me. It really is. In my practice, we book out, we set aside time specifically if we have patients who have emergencies that day, because I don't want you to go a day. I don't want you to go a long length of time feeling the way you feel. In my practice, we will be able to accommodate you because we are here to serve and care for you. That is incredibly important to us.
If you feel like you are experiencing all these things I covered, or even one of the things, call us at (210) 972-0768. You can also reach out to us through our website as well, which is inspireddentalsa.com. Those are all ways that you can reach us so that we can get you in, get you comfortable, and treat this urgent matter for you.
Do you offer later appointments for dental emergencies Inspire Dental?
Now, many times we cannot control the time of day when these emergencies happen. So I get a question like, "Well, do you offer later appointments?" I have a family. Unfortunately, I do not. My office hours are typically normal hours. Our earliest appointment is usually 7:00 a.m., and then we close at 5:00. So those are the usual hours in my office.
However, we do have an answer service, and I have an emergency line. I don't care what time of the day it is. I may not be able to physically see you sometimes, but I will be available by phone to help you through what's going on, and that way, we can get you in first thing. There are occasions where the emergency is so bad that I will make an exception and I will see you. I've even seen people on the weekends or late at night to help accommodate you. So it is kind of case-by-case, depending on what the situation is. The number one thing you have to do is call me. Like I said, if you call me, then we can work through the situation and get you taken care of immediately and get you seen right away.
Want to learn more? Call Inspire Dental at (210) 972-0768 or email [email protected]. Our team is happy to answer your questions and help schedule your visit.