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COPING WITH DENTAL EMERGENCIES
BY ANDY HEALY, PALL MALL DENTAL
Every dental practice in the UK has been closed since March 23rd in
response to the guidelines from the Department of Health relating to the
COVID-19 pandemic.
During this time Dentists have only be allowed to do remote triage and
provide the three A’s – Advice, Antibiotics and Analgesics. As of the first
week of May we are no closer to knowing when we can re-open and
even what types of treatment we will be allowed to perform when we
eventually do.
Until then here is a guide which I hope provides some helpful advice
until normal service can be resumed.
WHAT IS A DENTAL EMERGENCY AND
WHAT SHOULD YOU DO?
STRAIGHT TO A&E
•
Facial swelling affecting vision or breathing, preventing mouth
opening more than 2 fingers width.
•
Trauma to the teeth that has also caused loss of consciousness,
double vision or vomiting.
All the above can be life threatening so please go straight to A&E.
URGENT APPOINTMENT
•
Facial swelling extending to eye or neck.
•
Bleeding following an extraction that does not stop after 20 mins
pressure with a gauze/clean hankie. A small amount of blood is
normal, just like if you had grazed your knee.
•
Bleeding due to trauma.
•
Tooth broken and causing severe pain that prevents sleep.
•
Significant toothache preventing sleep, eating, associated with
significant swelling, or fever, that cannot be managed with
painkillers.
If you are experiencing any of the above call your dental practice in the
first instance for advice (or call your nearest one if you do not have a
current dentist). They may opt to remote prescribe antibiotics and
painkillers or refer you to one of the newly created Urgent Dental Centres
(UDCs). These are extremely limited in number and have been set up to
provide only limited emergency treatment (extractions) for severe cases.
You cannot attend an UDC without being referred from your dentist and
60 wirrallife.com
they are there to look after both NHS and private patients.
Please remember the following:
•
Have you or anyone in your house been self-isolating?
•
Do you have any symptoms?
•
High temperature or continuous cough?
If YES to any of the above, explain this when you contact your dentist.
They will be able to direct you to your local emergency care facility with
appropriate protective equipment which will allow staff to treat you
safely.
MANAGING TOOTHACHE
Have a painful tooth that is sensitive to hot/cold?
Antibiotics will not help with sensitivity. Usually extreme sensitivity
means that there is decay that is irritating the nerve inside the tooth, and
that decay must be removed, and the tooth filled. These home measures
may help make symptoms manageable until care can be arranged:
•
Regular cleaning with fluoride toothpaste after meals.
•
Desensitising/sensitive toothpaste (like Sensodyne repair and
protect). Rub toothpaste directly on the affected area and do not
rinse afterwards.
•
Reducing sugar intake stops decay worsening.
•
If there is a hole/crack in the tooth, a temporary filling can be
packed into the space. These are widely available from supermarkets
and pharmacies.
•
Anaesthetic gel such as Orajel can help ease pain.
MANAGING WISDOM TOOTH PAIN
Painful tooth and sore/inflamed gums?
Wisdom tooth pain is usually due to inflammation of the gum over the
erupting tooth, which can be worsened by trauma from biting. Most flare
ups should settle in a few days to a week, and can be managed with good
home care:
•
Excellent cleaning (even if it is painful to brush, the area must be
kept clean to disperse food particles and bacteria, so to encourage
healing).
•
Corsodyl mouthwash (avoid use for more than one week as this
may cause staining).
•
Soft diet (soft food will reduce trauma from biting).