Emergency Dentistry

Have you ever experienced that awful moment when you are chewing something and hear a cracking noise? Or have you ever fallen and then realized you have knocked out part of a tooth? These situations can be painful and embarrassing if the broken tooth is visible when you speak. Luckily, teeth that are broken can usually be saved. If you contact our office, we can almost certainly see you as soon as possible. If it is a small or less significant chip or break, your dentist will use a white filling to mend the tooth back together, or use a crown or cap which is a permanent covering or extension of your tooth to make it match your smile. If the break is more severe, you might need a root canal procedure to repair it.

My tooth broke – Now what? | When a tooth breaks, it is important to schedule a dental appointment as soon as possible. If the break is due to a fall or any other type of trauma, first make sure that you are okay – if you have injured yourself elsewhere, you may need a visit to the emergency room. Like any other injury, there are different levels of severity with broken teeth. A small fracture may not need any treatment at all, just smoothing out the sharp edge. Some breaks may compromise the nerve of the tooth and require root canal treatment. A large break may leave little tooth structure behind to the point where the tooth cannot be saved.

Steps to take if you break a tooth | If you can find the piece of your tooth that has broken, you can bring it to our dental office. Sometimes, depending on how the tooth has broken, we may be able to reattach the broken piece. Or it may give clues to the reason for the break.

Will I need a crown? | Once a tooth has broken, it is recommended to place a crown – also known as a cap. Crowns can help prevent future tooth fractures due to the way they circumferentially protect the tooth. This is especially important in teeth with root canals as they are more brittle than teeth with healthy nerves.

What can I do to prevent my teeth from cracking? | While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks:

• Do not chew on hard objects such as ice, unpropped popcorn kernels, or pens
• Do not clench or grind your teeth (If you clench or grind your teeth while you sleep, talk to your dentist about getting a custom-made mouth-guard to protect your teeth)
• Wear a mouth guard or protective mask when playing contact sports

Children lose their baby teeth all the time, but if the tooth that has been knocked out is a permanent tooth, we may be able to put it right back into place. Time is of the essence!  If you put the tooth back in place inside of ten minutes (do not touch the roots), it has a good chance of repairing its original roots.  If that is not possible, or if you are in danger of swallowing the tooth, put it in a glass of cold milk and bring it to our dental office as quickly as possible.

The sooner you seek help, the higher the chances are that the root will reattach itself.  The reason to use milk to preserve your tooth as opposed to ice or something else, milk’s high calcium content. The cooler temperature of milk, combined with calcium (a bone-friendly substance) makes for an excellent method of preserving both the tooth and the freshly broken root.

Dental crowns | If you have a temporary crown, or a permanent one, and it falls out, bring it into the office as soon as you can and we may be able to recement it or just make you a new one. In the meantime, make sure to stay away from foods that are too hot or cold as they may cause sensitivity and damage to the pulp of the tooth. Also beware of eating hard foods, stick to foods that are softer until the crown is repaired.

Dental fillings | In the unlikely event of losing a filling, you can buy yourself some time by putting a piece of partially chewed, sugarless gum over the spot where the filling fell out.  Putting a soft, pliable substance over the damaged area of your tooth will prevent further damage from occurring to the tooth. Obviously, this is only a temporary solution until you can see your dentist.

What if I cannot make it into the office? | If your next appointment is within a few days, or even up to 1-week, and you are not in any pain, it may be okay to wait until your appointment. However, be careful! With your tooth left unprotected, it may be more prone to breaking and sensitivity. Call our office for advice on caring for your tooth until your next dental appointment.

Wisdom teeth are the four teeth at the very back of your mouth. They are also known as third molars. Wisdom teeth are the last teeth to erupt, usually between the ages of 17-21, although sometimes they erupt much later. Wisdom teeth may never erupt at all and can remain covered by your gums. This is called impaction.

Impacted wisdom teeth are usually fine to be left alone if they are asymptomatic and not associated with any pathology. Sometimes wisdom teeth only erupt partially and therefore are half covered by the gums. This is called partial impaction. This can sometimes be associated with a painful infection called pericoronitis. This occurs because the pocket created by the gums is a great place to harbor bacteria and is difficult to clean. If your wisdom teeth continue getting infected, then it is a good idea to think about having them removed before they cause harm to neighboring teeth. Usually, this only happens on the lower wisdom teeth.

If we remove your lower wisdom teeth, it is a good idea to remove the upper opposing teeth because otherwise they are prone to over-eruption. This means that they will continue to grow since there is nothing blocking their path. This can create biting issues and discomfort. If your wisdom teeth do erupt fully and are in function, it is also okay to leave them in your mouth. However, do not forget to care for them because they are hard to reach.

Some people are born without their wisdom teeth. It is believed that this may be due to our jaws getting smaller over time as humans evolve. Others claim it is due to the western diet or exposure to growth hormones in food. Whatever the cause, being born without wisdom teeth does make things a bit easier for you.

Wisdom tooth removal is recommended earlier on because the surgical procedure is easier. Also, the earlier they are removed, the less time they have to cause problems. Wisdom teeth are extracted because:

• They erupt in abnormal positions, such as tilted, sideways, or twisted
• They are trapped below the gumline due to lack of space
• An infection has developed from trapped food, plaque, or bacteria
• They alter the biting surface and can cause jaw misalignment
• The erupted wisdom tooth lacks proper hygiene, because it is hard to reach, resulting in decay

To remove your wisdom teeth, the area is first numbed. Then the tissue and bone covering the tooth are removed, the tooth is loosened from any connective tissue in the tooth’s socket, and once the tooth is loose enough, it is removed with dental forceps. It may be necessary for your dentist to use stitches to close the tissue to aide in the healing process. To ensure a speedy recovery, it is imperative to follow the instructions given following your surgery.

Braces and Wisdom Teeth? | There is no evidence in studies that says wisdom tooth removal affects the alignment of straightened teeth. Also, if there is crowding in the front of your mouth, removal of the wisdom teeth will not fix it. Sometimes, orthodontic treatment can relapse to the position of the teeth before treatment, but this is usually due to not wearing a retainer.