•  Broken Tooth •  Dental Emergencies •  Dental and Oral Problems •  Losing a Permanent Tooth

Ads for teeth whiteners and bleaching strips, celebrities with blaring smiles, vanity braces and veneers. With all the emphasis on looks these days, it's easy to conclude that fixing your teeth is largely a cosmetic matter. The fact is, however, waiting to see the dentist about repairs is gambling with your health -- and your bank account.

How's that? Well, that darkening eyetooth you'd written off as a simple sign of aging could actually be evidence of internal bleeding in the tooth. And that nagging toothache -- the one that only bothers you when you're drinking iced tea? It may mean you need to choose between repairing a cracked molar now, or paying for expensive root canal work later. Indeed, studies show that the longer you wait to treat dental injuries, the higher the cost of resolving them in the future.

Chipped teeth are by far the most common of all mouth injuries; almost everyone chips a tooth at some time. Chipping a tooth usually means you've knocked off a small piece of enamel, the hard surface material that covers your teeth. With a minor chip, your dentist can simply sand the surface smooth. The injury may cause you more discomfort or sensitivity to cold or heat if the dentin (the more fragile inner layer) has been exposed. If it hurts, take an over-the-counter painkiller such as ibuprofen and make an appointment to see your dentist. The chip may need to be filled in with a synthetic material to protect you against further damage.

Accidentally biting or cutting your lip, cheek or tongue is another common occurrence and in most cases, it's not one to worry about. If it's a more serious laceration, you may need to get stitches. (Medical providers like to keep oral stitches to a minimum, though, since they can interfere with eating, and in rare instances cause infection.) Wash the area with warm salt water, then apply pressure with a cold compress to try to stop the bleeding. If bleeding is severe or doesn't stop, go to the emergency room of your local hospital.

A cracked or broken tooth (fracture) is a more serious injury. If the fracture has reached the dentin or pulp, rinse your mouth with warm water, and get to your dentist quickly. You'll want to get treatment to prevent infection while the pulp is still healthy. Remember, even fractures that aren't visible can worsen and require more extensive -- and costly -- dental care down the line.

A knocked-out tooth (avulsion) needs to be considered a dental emergency because your chances for reimplanting the tooth -- having it take hold again in the tooth socket -- depend on how quickly you get dental treatment. Try to see a dentist within 30 minutes of the accident -- you're more likely to save the tooth. Front teeth make up 80 percent of all knocked-out teeth. Among adults, most teeth are dislodged playing football, baseball, or other sports. Among small children, the precarious job of learning to walk is responsible for the majority of knocked-out teeth. If your tooth is knocked out, immerse it in milk or a saline solution (never carry it dry) and take it with you to the dentist or emergency room. If those liquids aren't available, you can tuck it between your teeth and your cheek and gum (be sure not to swallow it). Don't scrub or wash it, because you can injure the living tissue.

Displaced teeth -- that is, teeth shoved out of alignment -- are also a serious dental condition. If your tooth is pushed inward or outward but is still attached, gently reposition it with very light finger pressure. Moisten a clean cloth and hold it in place. See your dentist within 30 minutes of the injury.

Upper and lower jaw injuries can occur after a traumatic event, such as a car accident or a bad fall. If you're unable to close your mouth normally and bring your teeth together, your jaw may be broken. Jaw injuries need immediate dental and medical attention, and you may need to go to your local emergency room.

Many minor cuts and soft-tissue injuries, for example, can often be resolved at home by rinsing them with warm salt water. But the mouth injuries listed below require professional dental attention. Treatment will depend on the type of trauma you have, where it's located, and how severe it is. In the case of more serious injuries, such as knocked-out teeth, a successful outcome often depends on how fast you make it to the dentist's chair.

Some dental injuries -- a torn gum, a broken tooth -- are obvious. Others, such as deep abscesses or dead or decaying dental pulp, may not be visible when you look into your mouth. Yearly check-ups and semi-annual cleanings are a must for preventing these types of dental injuries. Most dentists have special imaging equipment that can magnify and illuminate problems that can't be seen with the naked eye -- but that can cause troublesome and costly damage.

Chipped and cracked teeth -- no matter how minor the injury appears -- are not simply a cosmetic issue. They can lead to more serious infections and damage to the teeth. Cracks not visible by simple examination can continue to crack due to continued pressure, or wear and tear; they also offer an open door for bacteria to pass into the tooth. If you have a dental injury, you'll need to monitor it over time and may need to repair it again as you age. Taking care of it sooner will minimize your costs.

Interestingly, the same rule applies to a tiny crack in an artificial crown -- though you may be tempted to wait to fix it, the crack can allow bacteria to infiltrate and grow underneath the crown, even in teeth where you've had a root canal: You can end up with a serious -- and often hidden -- infection.

•Toothache and jaw pain

•Pain when chewing or with a change in temperature

•Facial swelling accompanied by dental pain

•Isolated bleeding from a particular area of the mouth

•A change in tooth color (sometimes)

Yes. Even when small children lose baby teeth, they need to be seen by a dentist. Your dentist can determine whether damage to the gums has occurred and if damage to the tissue has led to infection. As the child grows up, your dentist can also monitor to see that the new, permanent teeth are coming in properly aligned.

•Always wear a seat belt and avoid eating or drinking in a moving car. Have your children follow your example.

•Make sure you and your kids wear helmets when skating or riding bicycles, scooters, and skateboards. If they're playing contact sports, make sure they use mouthguards and face masks as well as helmets. Ask your child's coach or sports group leader about her plan to handle dental emergencies.

•Place your dentist's telephone number where it's readily available. Find out your dentist's 24-hour on-call arrangements, especially if you have kids.

•If you or your child have dental caps, bridges, dentures or implants, note it on your emergency ID card.

-- Diana Reiss-Koncar is a freelance health and medical journalist and illustrator living in the San Francisco Bay Area. She has written for Hippocrates, Time Inc. Health, Salon, and other outlets. She currently works as a medic in the Berkeley Free Clinic.

References

Last updated January 15, 2009
Copyright © 2003 Consumer Health Interactive

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