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What we're going to do now is look at dental emergencies. If something's happened to your tooth, maybe you got it knocked, now the best person to talk to this would be a dentist. So, if somebody was maybe playing rugby and they got their tooth broken, what would you want them to do before they actually got to you in the dental practice?
Alright well, depends largely on at what level the tooth is broken. Dental injuries tend to be classified as to how far down they're broken. So, there's just an enamel chip, which would just be the edge of the tooth. That can go into the dentin, the second layer of the tooth. And, or then into the pulp, which is the nerve in the middle of the tooth. All three of those really, it's just protecting it and keeping your mouth closed probably so it's not too cold, and then getting to see a dentist get it repaired and patched up. The worst-case scenario is, of course, knocking a tooth out completely. And in those cases, it's, first of all, finding the tooth. Now, that may be on the floor in a pile of mud, and in which case that tooth needs to be cleaned before it's put back in. So, if it's something that can be cleaned... And I don't mean scrubbing it with a toothbrush or anything, this is irrigating it off, so using saline or to hand perhaps some milk to wash it off, because the best thing to do is to get that tooth straight back into the right place, push it home as far as you can, and close your teeth together so you know it's seated into the right place. And obviously get it 'round the right way 'because it has been known to be put in the wrong way around.
So, if they've actually got that tooth back in place, is there a matter of holding it in place, applying pressure, or is it just a matter to try to leave it?
If you can do anything... For example, you've got a gum shield, that put in over the top is going to keep that tooth in the right position until you get to see a dentist. And your dentist is then likely to then stick that tooth to the neighbouring teeth using a little bit of white filling material usually. Perhaps with a little bit of wire as well, just to keep it in the right place while the bone and the ligament that holds the tooth in place heals itself. The tooth will probably need to be root filled then, in due course, but the initial emergency is to get that tooth back in place.
So, getting the person to you is important. Is there anything they should or shouldn't do in pain relief at that stage? Is it best to avoid anything for pain relief at that stage?
Not particularly, it's going to be tender no doubt, because it's as much the lip. If the tooth's been impacted, the lip's usually in the way, so it's really just getting that initial trauma dealt with. So, paracetamol, or ibuprofen, whatever people would normally take for a headache really is the best thing. And then just trying to see a dentist as soon as possible. In the absence of being able to see a dentist, then casualty will be the next port of call because they'll have oral surgery staff who will be able to deal with avulsion of the tooth, which is what it's known when a tooth comes out completely. But for the more minor injuries involving the other layers of the teeth, that's going to be a general dentist sort of area to deal with. In which case, it may well be painkillers until you can get an appointment.
So, one thing my mother always used to say was, use some clove oil or whiskey perhaps on the tooth. Is this correct?
Well, it can help. Anything that's going to provide you with the initial pain relief... Whether the whiskey helps or not is a different matter. Perhaps take a bottle to the dentist that's coming out to see you, that might be as well. You know, anything that will give you pain relief is fine. If you're driving obviously the whiskey may not be such a good idea.
And then finally, if you're dealing with perhaps a child, and the child is the one who's had the injury, children would be very upset about anything like this. Are there any tips on trying to calm them down? Because A, they're going to be upset about hurting the tooth itself. And B, they're probably going to be more scared they're coming to see you. Are there any ways you can calm children down?
In the initial phase really, it's cleaning them up. So, if there's a lot of blood about... You know with any sort of head injury there's going to be a reasonable amount of blood, and especially if it's around the mouth as well. And children feel a lot better about it if when they look in the mirror, okay they've got a tooth that's damaged but if their face isn't also covered in blood then they tend to calm down. The blood does tend to make them panic a little bit. And then it's just being calm with them really, and try not to make it into a big issue, and make it as a matter of fact as it can be. "Oh, that's fine, we'll take you to the dentist and they'll be able to sort it out for you." And don't make it into a big issue for them. If you certainly all arrive and there are about four adults accompanying a child, it's going to make it into a big event for them. Whereas if it's just whoever's with the child at the time, takes them along to the dentist straight away, doesn't make a big issue of it, it's going to be a more relaxed thing, a more normal thing for the child to deal with.