Tooth Trauma and Dental Emergencies

Dental emergencies that are the result of accidents such as when a tooth gets knocked out or pushed up into the gums require immediate attention. There are other dental problems like swollen gums or cracked teeth that may not seem urgent but it is critical to call a dentist right away if you experience them.

We know getting a tooth accidentally knocked out is a dental emergency. What is the first thing someone should do if this happens?

Dr. Darren McKeever: It’s actually funny that we’re talking about this topic today because literally last night I was giving a first aid lecture to the local Boy Scout troop and we were talking about what happens if somebody gets a tooth knocked out, like on a baseball field or basketball court. The first thing, if you don’t happen to have a Boy Scout handy who knows how to handle that, is try and find the tooth. If the tooth is knocked out, try and find it. If a piece of the tooth is knocked out, don’t just disregard it. If you can find it, you really want to find that as well.

The first thing you want to do if a tooth is knocked out, you have to protect the tooth. There’s a couple ways to protect the tooth. You want to keep the tooth sort of alive, so to speak. You want to get to the dentist within 30 minutes to an hour. If you can bring that tooth and keep it either in cold water, or if you happen to have saline solution handy, most people don’t, but a lot of eye products have saline solution. If you can’t find something like that to keep the tooth in, put it in cold milk. Milk is actually very, very good to put a tooth in to transport it to the dentist. Then one thing that can be done, but it is a little bit risky, you can literally keep the tooth under your tongue. I don’t really like that option because unfortunately you have a chance of swallowing it, but the key is, try and get the tooth or the fragment to the dentist as quickly as you can.

If a tooth gets cracked or seriously chipped, what should people do?

Dr. Darren McKeever: A lot of times people will think that because there is no pain, they can just sort of sit on the issue. Anytime there is an issue with a tooth, it’s worthy of at least a phone call to the dentist. Let the dentist figure out if this problem is going to be something that is significant and needs urgent care or emergent care, but don’t just sit on it. Very often when a tooth is cracked or it’s chipped, the dentin is exposed because the enamel is missing. Dentin is not the same in terms of protection of the tooth as enamel, and bacteria can actually get through the dentin. You can find that they’ll get into the nerve a lot quicker. You can actually get a root canal out of something like that without even getting a cavity. Really, I always tell people, “Just call the dentist. Let us figure out whether or not it’s something you can delay because of your schedule or whether, you know what, I know it’s inconvenient, but you really should come in as soon as possible.”

What should people do if a tooth is pushed up into the gum?

Dr. Darren McKeever: Obviously, again, call the dentist. A tooth that has been pushed up into the gum means that the bone around the tooth has probably cracked. This is not a good situation. Without treatment, that tooth will definitely be lost. Very often, what we can do is apply some traction to the tooth, fix it in place with something similar to a minimal amount of braces, and see if the tooth will re-bond to the bone around it. That way, you get to keep your tooth, but one thing you don’t want to do in a scenario like that is sit on it and think, “Well, it’s been pushed up, but I really don’t have pain, so I’ll get to the dentist maybe Monday or Tuesday.” Always call.

Is tooth pain considered a dental emergency that should be looked at right away?

Dr. Darren McKeever: Pain is a really, really interesting word. People will call us up and say that they are having pain, and then really what they mean is they are having sensitivity; something is going on with the tooth that is more inconvenient. Legitimate pain is definitely something that you want to be seen by the dentist as soon as possible. A tooth that is waking you up in the middle of the night, a tooth that is throbbing and you can feel your pulse in the tooth, those are things that absolutely need to be seen as soon as possible. Certain times, though, we have sensitivity that may give a tooth a shock, but it goes away rather quickly, or something stimulates the tooth and you feel it intensely, but it goes away. Those are things you still want to be seen, absolutely, but they may be at the discretion of your schedule. Still, let the dentist figure out what is an emergency and what might just be an urgency.

What are some other dental emergencies that people experience?

Dr. Darren McKeever: The things that we tend to see that are really emergencies are swelling. We see swelling, an abscess, a gum abscess, a tooth that has had a cavity for so long that all of a sudden the bacteria are eating away at the bone. That is a serious emergency. Other things we see periodically, which are still an emergency, are maybe crowns or bridges may have come out, the cement may have failed, and now it’s in your hand. Those are still important to have them looked at as soon as possible. A lot of people think that, “Well, I don’t have any pain. My crown came out. I’ll see them next week”, and then we try and put it in and it’s been three or four days down the road and now the crown or the bridge doesn’t fit anymore because the neighboring teeth have shifted. It is not worth taking the risk. Always, always let the dentist figure out what is a problem and what might just be something that you can fit into your schedule and be more convenient for you. Don’t try and do it yourself.

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If you are interested in speaking with Dr. Darren McKeever, visit or call 973-839-8180 to schedule an appointment.

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