Essential tips to navigate dental emergencies during the celebrations
By: Dr. Natrah Ahmad Fuad
The Eid festivities be it Eid al-Fitr or Eid-al-Adha, is a celebratory event observed by Muslims worldwide. These celebrations include a variety of cultural religious customs such as Eid prayers in the morning, communal gatherings, feasting, gift-giving and charitable activities. Eid al-Fitr commemorates the completion of the holy month of Ramadhan, honouring the victories of fellow Muslims who faced various hardships over the month. Sweet and savoury delicacies are frequently exchanged, and generosity is emphasized as a means of sharing blessings with those less fortunate. Eid festivities are marked by joy, appreciation and unity as families gather to commemorate religious observances and deepen bonds with the loved ones. Unfortunately, dental emergencies can happen at any time, more so during these festivities. We cannot allow the dental emergency to ruin this enjoyable time. Therefore, it is important to address the dental emergencies accordingly, to ensure a comfortable and pleasant celebration.
What are the common dental emergencies? This include severe toothaches, knocked-out tooth (tooth avulsion), fractured teeth and facial swellings (abscess). Ideally, the best management is prevention, by attending routine dental check-ups to address any dental problems in a timely manner, to minimise any potential dental emergencies during the festivities. Unfortunately, most individuals are symptomatic dental attendees, only seeking dental treatment when pain is felt. So, what should you do when you experience the following dental problems?
1. Severe toothache
Nobody loves pain. Pain especially in the mouth, can destroy one’s mood as well as one’s nutritional intake considering the difficulties that will be faced in eating when severe toothache is experienced. A severe toothache usually signifies tooth decay (dental caries) which has extended into the nerve of a tooth (dental pulp), injuring the pulp irreversibly, which most likely requires a root canal treatment or tooth extraction, depending on the condition of the tooth. However, it is not always possible to see a dentist immediately when the toothache is felt. Therefore, as an immediate measure to manage the pain, painkillers such as Paracetamol (Acetaminophen) or Ibuprofen (Non-
steroidal anti-inflammatory drug), taken in the correct dosage in a timely manner, can be very helpful in the pain management before a dentist can be seen. However, be sure that you are not contraindicated from taking the mentioned medication or allergic to the medication. Additionally, a toothache does not require antibiotics as this will not help with the pain control, nor the elimination of infection within the tooth.
2. Knocked-out tooth (tooth avulsion)
Tooth avulsion is defined as the complete displacement of a tooth out from its bone socket (jaw), leading to the exposure of the whole tooth to the external environment. It is one of the traumatic dental injuries (TDI) reported by the dental trauma guidelines, one of the few real emergency situation involving the permanent dentition (adult teeth). This can then lead to damage to the pulpal (nerve of a tooth) and periodontal ligament tissues (tissues attaching the root of a tooth to the surrounding bone). The incidence of tooth avulsion ranges from 0.5% to 16% of all traumatic injuries with the upper central incisors as the most frequently affected teeth, mainly affecting children aged 7 to 10 years old. Tooth avulsion is a time-sensitive injury, requiring a prompt and correct emergency management for the best outcome. The faster you act following a tooth avulsion, the better the outcome of the tooth following the management. Reimplantation of the avulsed tooth is almost always the treatment choice. Nevertheless, it is important to note that only permanent teeth should be reimplanted, while primary teeth (baby teeth) should not be reimplanted.
What should you do when you, your child or anyone that you know, has an avulsed adult tooth? (only for avulsed permanent teeth)
1. Find the avulsed tooth, pick it up by the crown part (the white, top part of the tooth). Avoid touching the root of the tooth.
2. Attempt to place the tooth back immediately into the socket (jaw).
3. Rinse the tooth gently if it is dirty, ideally in milk, saline or the injured person’s own saliva prior to reimplantation.
4. If reimplantation at the accident site is not possible, place the knocked-out tooth immediately in a storage medium such as milk, saliva or saline. Water is a poor storage medium but it is better than leaving the tooth dry.
5. See a dentist or dental professional immediately! Hospitals typically have on-call dentists available in their Accident and Emergency (A&E) Department to handle such emergencies.
The reimplanted tooth will require further management by a dentist, which in a matured adult tooth, would include root canal treatment within 2 weeks following the injury. Consult your dentist regarding the additional treatment that is required following the
injury. For pain control, just like any other pain management, painkillers can be consumed at a dose-dependent manner.
3. Fractured teeth
Tooth fractures are a common phenomenon, particularly during celebratory seasons when food serves as the primary means of connection for everyone. When this happens, pain ensues. Moreover, the presence of fractured teeth in the front region might result in an aesthetic impairment, which is particularly undesirable during festive occasions when photographs are the mainstay of social gatherings. When pain is the main outcome following the fractured tooth, pain can first be managed by over-the-counter painkillers, such as Paracetamol or Ibuprofen. Additionally, prior to any dental appointments, it would be advisable to avoid food or drinks that would trigger the pain and to avoid chewing on the side of the pain. Nevertheless, these recommendations are merely provisional until a dental appointment can be secured. It is highly recommended to promptly contact the nearest dental clinic to assess and treat the fractured tooth, such as by filling it with a dental filling material, in order to prevent any additional complications. Nonetheless, never attempt to apply materials that are not approved by dental professionals such as vanilla extract, that previously has been the reported method of pain control as this extract is high in sugar content and would only lead to or worsen dental caries. In terms of the aesthetic management of a fractured tooth, never reattach a broken tooth and/ or filling fragment with a glue as this not only worsens the condition, but also hazardous to one’s health. The main management is to contact the nearest dental clinic for its management.
4. Facial swellings (abscess)
A facial swelling (abscess) is a result of an infection in the mouth. This is another true dental emergency, especially when airway obstruction is involved. When this happens, immediately head to the Accident & Emergency Department (A&E) at the nearest hospital, to get prompt treatment. Antibiotics will be required as an emergency management. However, be sure to inform the attending doctor and healthcare staff regarding any antibiotic and other drug allergies. The source of the abscess will need to be identified and further treatment will be required, which will be attended to by a dentist once the acute symptoms have been managed.
Prompt and rapid management are necessary for dental emergencies. Some dental emergencies can be detrimental to one’s life. Nevertheless, the majority of dental problems can be prevented by having regular dental check-ups, thereby preventing the
progression of dental diseases. Additionally, it is very important to maintain regular oral hygiene practices and avoid excessive sugary treats during this festive season. Nonetheless, it is appreciated that traumatic dental injuries cannot be anticipated. Therefore, the most effective preventive measure is to acquire the necessary knowledge to promptly manage the injury, ensuring a more favourable outcome. When in doubt, always consult a dental professional!
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The author is a Dental Lecturer (Endodontist) at the Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya. She may be reached at natrahfuad@um.edu.my
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