There are emergencies when it comes to dental care, just as with any other kind of health care. But up until now, few people have really cared about what “counts” as a dental emergency. The COVID-19 pandemic changed all that.
Across the country, dental practices have had to cancel patient appointments and in some cases, close their offices due to the COVID-19 crisis. Routine checkups and consultations have been postponed, along with cosmetic procedures like tooth whitening. The dentists whose offices are open are taking extra precautions and only seeing patients with dental emergencies.
How does someone decide if their problem is a dental emergency or if it can wait? The American Dental Association has offered its recommendation about emergency and non-emergency procedures. We will summarize their guidelines here.
A Note on Avoiding Dental Visits at Any Time
Knowing whether or not an issue is a dental emergency is important even when the country isn’t on stay-at-home orders. Even under normal circumstances, dental offices aren’t open 24/7. If a patient has a problem on a weekend or a holiday, they will need to judge how serious it is.
Some patients may also try to avoid going to the dentist for other reasons unless they know it’s an emergency that shouldn’t wait. They may be concerned about the cost of treatment, are afraid of the dentist, or don’t have a dentist. (If not having a dentist is the problem, our online search tool can help you find one nearby.)
One very good reason for not going to the dentist is if a patient is sick. Whether they suspect they carry the current virus or have an ordinary cold or flu, the best thing to do is stay home unless the emergency is truly dire. Close contact like the kind with a dentist or oral hygienist can spread any contagious illness.
If a patient has a problem with his or her teeth or gums, but is purposely avoiding the dentist or can’t get in to see one, it’s important to know how serious the problem is. The problem with many dental issues is that if left alone, they won’t go away. Instead, they will often get worse. For this reason, a true dental emergency needs to be taken care of as soon as possible.
Worrisome Symptoms that Might Mean Dental Emergency
Dental symptoms that could point to a dental emergency typically fall into four main categories: Pain, bleeding, swelling, or trauma such as a loose, broken, or knocked-out tooth. Deciding if and when to go to the dentist is a matter of balancing caution (or reluctance) with the degree of discomfort and the seriousness of the potential problem if it’s left untreated.
There are some dental issues that are so severe that patients may wonder if they should go to the hospital emergency room. This is generally not recommended. Emergency room doctors are not dentists and aren’t equipped to do dental procedures. Patients may be able to get some treatment for the problem if there is a medical aspect to it. For example, they could get pain medication, fever reducers, stitches, or having a broken jawbone set. But in almost all dental cases, they should attempt to see if a dentist can provide emergency services instead.
Dental Emergencies that Need Attention
If it wasn’t for the current restrictions placed on dental care, we would normally recommend seeing a dentist as soon as possible for these dental emergencies. While stay-at-home orders are in place and dental practices remain closed, however, this may be difficult. The following conditions are serious enough to justify a call to the dentist to seek emergency treatment.
Severe Pain
The first thing a patient can do for a painful tooth is to examine it and floss and clean around it. A seed or other food particle stuck between two teeth can cause a surprising amount of pain. If this is the case, the problem is solved by removing it, and there is no emergency at all.
Toothache pain can also indicate a cavity or an infection like pulpitis though. It often means that the cavity has worn away enough of the tooth’s enamel to hit the root. The pain can be intense and interfere with eating and chewing. An emergency root canal procedure and crown placement might be necessary.
Pericoronitis is the painful condition experienced when wisdom teeth start to erupt. If the teeth do not have room to come in (as most wisdom teeth do not) they can hurt a lot as they try to push neighboring teeth out of the way. A dentist might advise having them removed as soon as possible.
The early stages of any toothache pain can be treated with over-the-counter ibuprofen or acetaminophen. An old wive’s tale advises placing an aspirin tablet directly on the tooth, but that’s not recommended. Not only will it not work, but it can also burn the surrounding gums.
If the pain doesn’t go away or gets worse, it should be considered an emergency and a dentist should be consulted.
Bleeding
Bleeding gums can be the result of brushing too hard or a scrape or cut caused by a piece of hard food. It is also a symptom of gingivitis or periodontitis. These are a cause for concern, but are not an emergency. If the bleeding doesn’t stop, however, or if it comes along with a toothache or swelling, it could be something more serious. Severe periodontal disease can cause irreparable damage to the gums and should be examined promptly. A dentist or periodontist is the best judge of the level of urgency the patient is facing.
Gums may also bleed a lot if they have been torn or cut due to some type of trauma. Sutures might be necessary to stop the bleeding and prevent infection. This type of injury should be addressed right away.
Signs of Infection
An infected or abscessed tooth results in a number of possible symptoms. A patient can be in severe pain that makes it hard to eat. There could be a boil-like bump on the gum filled with fluid. There can also be swelling in the surrounding area, or even in the face. Sometimes the infection is bad enough to cause a fever.
Infection or abscesses are considered dental emergencies. Left alone, an infection in a tooth can spread to neighboring teeth or the jaw. In the worst cases, an infection can get into the bloodstream and cause death.
At home, a patient can try ice packs, over-the-counter pain medication and analgesics for the pain and fever until they can get to a dentist. The dentist will need to lance and drain the abscess—something that should not be attempted at home. If there is any trouble breathing or swallowing, the patient should go to an emergency room instead of waiting to see a dentist.
Loose or Broken Teeth
Loose teeth in adults are not normal and could indicate a dental emergency. They could be the result of a trauma like being hit in the face or the sign of an infected tooth. Losing a tooth can affect the patient’s bite alignment and ability to chew. A dentist should be consulted about loose teeth to see if they can be saved.
A broken or chipped tooth does not necessarily count as a dental emergency. It may not look nice, but it can probably wait unless it causes other issues. For example, if the remaining tooth is jagged or sharp, it can cut into the lips and gums. A broken tooth can also affect the bite alignment and ultimately cause jaw problems. And, if a break goes too deep into the pulp of the tooth, there is a risk of bacteria and infection.
The same goes for broken or missing fillings and crowns. They can let harmful bacteria into the core of the tooth, causing much more serious problems than the ones they were meant to fix.
How to Handle Dental Emergencies
The best thing to do if you have what you think is a dental emergency is to contact your dentist. This should be done by phone, as walk-in visits are most likely restricted. Many practices are still taking emergency calls even if they are closed for routine visits.
Discuss the problem with the dentist. You may also be able to take advantage of teledentistry, where you can consult with the dentist on the phone or on an internet video conference. If they feel the issue is a dental emergency, together you can come up with a plan for treatment options. Be aware that under current guidelines related to COVID-19, your dental visit might be different than what you’re used to. Dental offices are using new procedures to treat patients. They will be able to let you know what you need to do.
Depending on a patient’s problem, there may be things they can do at home to delay their visit to the dentist. It’s important to remember, however, that with dental issues, waiting too long can cause more pain and discomfort. The procedure needed to fix a problem might also be more complicated and expensive. Even with strict restrictions on in-person contact, dentists are there to help with your dental emergency.