First Aid for Dental Emergencies
http://www.drsklar.com/ptinfo/firstaid.htm

Tooth Knocked Out
     Find the tooth.  Handle the tooth by the top, not the root portion.  Make sure that you do not touch the root of the tooth with your hands.  The root is the portion of the tooth which is usually embedded in the gum and not normally seen.  You may carefully rinse the tooth in cool water, but DO NOT clean or handle the tooth unnecessarily, DO NOT scrub it or clean it with soap -- use just water!  Try to reinsert it in the socket.  Hold the tooth in place by biting on a clean gauze or cloth.  If you cannot reinsert the tooth, transport the tooth in a cup containing milk.  The tooth should not be wrapped in tissues, handkerchiefs, or gauze.  Call us IMMEDIATELY!  Time is a critical factor in saving the tooth.  The faster you act, the better your chances of saving the tooth - if replanted within 30 minutes it has the best chance of survival.
    Once the tooth is replanted, it should be splinted.  The tooth should be re-examined within a week to 10 days for possible removal of the splint.  Two of the most common complications of replanted teeth that have been knocked out are:  1) nerve of the tooth dying, and 2) the root dissolving.  Treatment for both of these is a root canal.  For several weeks after the accident, the tooth or teeth should be monitored in how they appear and what shows on x-rays weekly.  If signs and/or symptoms that the nerve is dying or the root is dissolving are evident, a root canal should be started, if it had not already been done.
    Prognosis is variable.  We may not be able to judge the success of reimplantation for many years.  If the root continues to dissolve after root canal, the tooth will most likely be lost.  Then, a bridge, partial denture, or an implant will be needed to replace the missing tooth to prevent problems associated with missing teeth.
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Toothache
     Clean the area around the sore tooth thoroughly and gently by brushing, flossing and rinsing. Rinse vigorously with warm salt water or use dental floss to dislodge trapped food or debris.  DO NOT place aspirin on the gum or on the aching tooth.  If your face is swollen, apply a cold compress.  Take a pain reliever and contact us as soon as possible if the toothache does not subside.  Click here to see more about whether you may require a root canal.
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Chipped Tooth
    If there is pain or sensitivity in the affected tooth that persists, contact us immediately as this indicates the tooth nerve may be injured.
    If no pain or sensitivity is experienced the situation is not as critical.  You should contact us to double check, but in most cases, you can simply schedule a future appointment to replace the lost portion of the tooth.
    For comfort where a tooth is rough, you can gently use an emery board to smooth the tooth until it is no longer bothersome to the tongue.  This serves two purposes, one for comfort, the other to lessen the chance of continual chipping where the tooth is rough.
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Something Stuck Between Teeth
    Sometimes something gets stuck between teeth.  It could be a piece of floss, or food, or something else.
    If after trying flossing normally the item is not removed, try putting a knot in the floss.  With the knot in the floss, place the floss between teeth normally by gently sliding it back and forth past the tight spot, then carefully pull the knot through.  This will often catch what is stuck.     If despite your best efforts you cannot dislodge the item, try this.  Teeth have the capability to move just slightly, that is for safety and gives teeth just a little "cushion".  Take a toothpick and put it in between the teeth where the item is stuck.  Push firmly on the toothpick and let it stay in place for a couple minutes.  The teeth will slightly move.  Again push on the toothpick, allowing the teeth to move a little further.  After a few more minutes remove the toothpick and try flossing the item out.
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Mouth Sores
    Canker sores (aphthous ulcers) occur inside the mouth usually not right next to teeth, but under the tongue or between the gums and cheek.  These often occur during times of stress, and some people feel that acidic foods bring them on (oranges, tomatoes, and such).  Once the canker sore appears, it will take about a week to heal, but in the meantime one of the best over the counter treatments is called Kanka - available in the drugstore.  Applied directly on the sore, it makes it more tolerable until healing is completed.  For regular canker sore sufferers there is a prescription ointment that works very well:  Kenalog in Orabase.
     Fever blisters, also called cold sores (caused by the herpes simplex virus) occur usually on the lower lip, but can also occur on the upper lip.  These always occur in the same place on the lip.  These often appear during stress, sick times with cold - flu - other, pregnancy,  but also with prolonged exposure to sun or cold  These are contagious and if the blister breaks, direct contact with other people should be avoided to prevent transmitting the virus that causes the sore until it is healed.  Keeping the sore area covered with and ointment until healing is completed will make things more comfortable.  Ointments may be aloe vera, medicated vitamin E, or the prescription Denavir.
     Other different sores can occur, but these are the two most common.  Mouth sores should heal within two weeks, and if they don't contact us for further evaluation.
     Denture irritation spots and retainer sore spots can be treated like canker sores, but you will usually need to contact us for an adjustment to prevent the sore spot from continuing or re-occurring.
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Cut
     Apply firm but gentle pressure with a clean gauze or cloth. If bleeding does not stop or slow after 15 minutes or it cannot be controlled by simple pressure call us or go to the emergency room.
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 Bleeding After Baby Tooth Falls Out
     Fold and pack a clean gauze or cloth over the bleeding area. Have the child bite on the gauze with pressure for 15 minutes. This may be repeated.
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 Prevention - Mouth guards custom mouthguard
    Mouth guards are highly recommended for any contact sport where there are high incidents of serious injuries to the teeth, and prevention is the key.  Not only do mouth guards protect teeth but they also protect lips, gums, and cheeks as well.
     Commonly there are two types of mouth guards.
    Semi-formable mouth guards are available in sporting good stores and in many drug stores. Often these mouth guards can be boiled to fit allowing them to sit snugly against the teeth.  This is ideal while baby teeth are still present, before all the permanent teeth are in the mouth.
    Dentist made mouth guards are custom made.  A mold of the mouth is used to create the mouth guard, and consequently, these mouth guards fit more securely against the teeth affording the best protection.
    See more about custom made mouth guards that we prescribe, see 

    Glidewell Laboratories
    4141 MacArthur Boulevard
    Newport Beach, CA 92660
    (800) 854-7256 
    FAX (949)
http://www.glidewell-lab.com/products/Playsafe/Playsafe.html
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Andrew M. Sklar, DDS, PC
http://www.drsklar.com
Family and General Dentistry
4901 Seminary Road, Suite 120
Alexandria, VA 22311
Tel: 703-931-3141
Fax:703-845-1512
email: office@drsklar.com

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