Emergency Dentistry

Most of the time our teeth and gums are healthy and don’t require any treatment. If problems do arise then we can usually contact our local dentist.

This is fine if you are registered with a dentist, but if you’re not then you may have to resort to emergency measures. This can mean contacting your nearest dental clinic and obtaining an appointment via their emergency service. This is usually an ‘out of hours’ service which is designed to cater for the unexpected, such as toothache or an abscess.

If you are in severe pain or have a serious dental problem then go to your nearest Accident and Emergency (A & E) department.
This includes the following:

• Swelling in the face or neck: this could be due to an abscess or an infection that is rapidly spreading. If left untreated then it can block the airway.
• Fractured jaw: if you have received a blow to your chin or have been involved in an accident then your jaws may need to be reset.
• Loss of consciousness: if you have received a blow to the head or have been ‘knocked out’ then this will require further investigation.
• Severe bleeding: this can happen following an extraction and is often due to an infection or the use of certain drugs. If bleeding cannot be controlled then seek medical attention.

These will require the attention of a specialist oral surgeon.

What are classed as ‘dental emergencies?’

The following conditions are classed as dental emergencies:

• Toothache
• Abscess
• Root canal problems
• Broken or chipped tooth
• Swollen gums
• Broken dentures
• Decayed tooth roots
• Loose crowns
• Lost fillings
• Wisdom teeth problems
• Painful mouth ulcers

Another option, especially if you are suffering from toothache is to use a temporary measure such as a ‘toothache kit’ which is available from your chemist or supermarket. These kits contain dental cement and an anaesthetic gel.

Other treatments include:

• Painkillers such as aspirin and Ibuprofen. Avoid codeine as this tends to make you drowsy. Paracetamol is another option. Tempting as this may be, do NOT exceed the maximum dosage.
• Oil of cloves: a few drops of this on a cotton wool bud can help to ease painful toothache. The only problem with this is that it is washed away by your saliva.
• Antiseptic mouthwashes: this is good at treating bleeding or infected gums and mouth ulcers. Avoid ‘Listerine’ as it contains alcohol which is not advisable plus it can cause you to fail a breathalyser test!

Salt mouthwashes are useful if you have had a tooth removed. They can help with the healing process and are also good at soothing mouth ulcers.

• Topical anaesthetic gel: this type of gel is useful for treating mouth ulcers around wisdom teeth and soft tissue injuries. However, like oil of cloves it can be washed away by your saliva.
• Antibiotics: these work for gum diseases and abscesses. If you have an abscess then you may be prescribed antibiotics beforehand to remove any infection before dental treatment.

They are useful as a short term measure but are not a replacement for professional help. What they can do is to temporarily ease your toothache whilst you try to find a dentist.

If you are a private patient then you can contact your dentist and be treated right away. This means no waiting until you find a dentist or having to adopt one of these emergency measures. This is why patients opt for private care as it gives you a wide range of options.

Except that you do pay more for this service.

But, it has become increasingly difficult to find an NHS dentist and if you are lucky enough to find one then there is the added problem of registration. Many dentists find that they simply cannot take on any more patients and unfortunately, have to turn people away.

Currently, around 50% of the UK population are not registered with an NHS or private dentist. This is extremely worrying as it means around half of the population could be facing long term health problems. Prevention is better than cure which is why dentists recommend twice yearly check ups.

If you require emergency treatment but are not serious enough to need your local A & E department then try NHS Direct. This 24 hour helpline can offer help and advice which is useful as a temporary measure. At the end of the day you will still need professional dental treatment but they can help in the meantime.

What is the most common dental emergency?

Unsurprisingly, toothache is the number one dental emergency. It is a very painful condition and one that needs treating as soon as possible. There are two types of toothache:

• ‘Alive’ nerve in the tooth root: this can become sore and inflamed. If it does then you will notice that your tooth hurts when you consume hot or cold drinks.
• ‘Dead’ nerve in the tooth root: if the nerve ‘dies’ then it can form an abscess at the end of the root. An abscess can be very serious if left untreated so please seek help right away.

Toothache is caused by tooth decay and gum disease which they themselves, are caused by the build of tartar and plaque. Both of these are preventable if you follow a daily oral hygiene routine combined with check ups at your dentist.

Your teeth can also be damaged when playing sport (such as rugby), falls, road accidents and accidents at home (doing DIY for instance). Accidents do happen and we can’t legislate against every activity that we do but we can take precautions. For example, if you play a contact sport such as rugby or hockey then wear a protective mouth guard (similar to the ones worn by boxers).

I need emergency dental treatment how does it work?

If you are already registered with a dentist then you can contact your local surgery either during office hours or via their out of office system. Normal office hours are usually 9am to 5pm.

If you are phoning out of hours then they will have an Answerphone with details on emergency dental treatment.

You will find that your surgery will provide treatment if you phone before 10pm in the week and between 9 and 5 on weekends and Bank Holidays.

Note: if you contact your surgery out of hours then it is unlikely that you will see your own dentist. If this is the case then he/she will not have your medical records. If so then provide him/her with as much medical information as possible as well as details of any medicines you are taking.

If you are not registered with a dentist then your first port of call is to phone NHS Direct. This 24 hour helpline can be contacted on 0845 4647 and will be able to give you details of an emergency dentist. You will have to wait to be treated but you should be treated on the same day.

Another option is to find a private dentist. If you are already a private patient then you will be treated by your own dentist a.s.a.p. If you are not then you can still see a private dentist although this can be expensive. However, you will be treated immediately. It depends on whether you are able (or prepared) to pay a large sum of money to be treated right away.

Non-UK residents who have been in the country for less than 6 months are not entitled to NHS treatment. They will have to seek private treatment instead. If you are a non-UK resident then check your medical insurance policy to see what dental treatment you are covered for. See if you can claim for the cost of dental treatment from them or your travel company.

If you are in this situation then contact NHS Direct or look for a private dentist.

If your condition is serious then go to the Accident & Emergency (A & E) department of your local NHS hospital.