According to a survey, 22% of the population in a period of six months is affected by dental emergencies. This proves that dental emergencies are very common in the United States. Dental emergencies are of mostly dental rather than non-dental causes.

Dental emergencies

Dental emergencies can be because of carious, periodontal, wisdom tooth and dental trauma causes. It is advised to see the dentist immediately on each dental emergency case.

Carious origins of dental emergencies

Bacterial attack on the teeth can cause dental caries. It does not show any symptom until the patient feels the pain when the illness reaches the inner tissues and causes inflammation.

Inflammation of the inner tissues or pulp is called reversible pulpitis. It is a dental emergency where hot, cold and sweet stimuli cause temporary pain lasting for a few seconds. Immediate treatment should be done because this may lead to complications such as periapical abscess and cellulitis if treatment is not implemented. Treatment may include removing of affected cloth and restoration or filling.

Severe inflammation on the tissues or pulp that is caused by untreated reversible pulpitis is called irreversible pulpitis. Pain is usually worse, impulsive and continuous, and persistent and is not centralized. The only options to treat the disease are root canal treatment where infected tissues of pulp id removed and empty pulp chamber is filled or tooth removal. It is upon the level of pain to determine the urgency of dental examination, which will be managed until the examination by appropriate implementation of analgesias, or a weak opoid combined with analgesia or acetaminophen. In this phase periapical abscess and cellulites may also develop if remained untreated for a long period of time.

When an acutely affected tissue develops into inflammation around the apex of the tooth, apical abscess will develop. Pain is intense, impulsive and relentless, but contained only on the affected tooth. Teeth are sensitive to beating with metal things. The patient must visit the dentist if there’s inflammation or increase of infection. Apical abscess needs antibiotics simply if cellulitis develops. The last treatment is root canal treatment or extractions.

When apical abscess infects the surrounding tissues, cellulitis develops. Painful inflammation of the tissue occurs. If the infection reaches into major fascial spaces of the head or neck it can be life threatening, carrying the risk of airway compromise. In worse cases where the periorbital area is affected, the patient’s vision and the central nervous system is threatened.

The first examination is done to see if the cellulites is localized or has spread. Outpatient treatment with oral penicillin, erythromycin or clindamycin is given if cellulitis is localized. The ultimate therapy is root canal treatment or tooth removal. Otherwise, the condition requires hospitalization where imaging, scanning, and drainage (if abscess is detected) will mandatory. Intravenous broad spectrum antibiotics are immediately administered.

Treatment of caries in the primary and permanent teeth is done on the same manner. The systemic effects are more common in children with rapid rise in temperature, higher threat of dehydration, and rapid spread of infection.

Periodontal origin of dental emergencies

Periodontal disease is swelling and damaging of the periodontal ligaments and the cavity bone by bacterial plaque. Severe periodontal abscess is common in patients having chronic periodontal disease or in patients having a foreign object stuck in the gingival. Symptoms include throbbing pain with erythema and inflammation of the affected tissue. The abscess may break if left untreated, or less likely develop into cellulitis.

Wisdom tooth origin of dental emergencies

The inflammation of the pulp around the crown of frequently partially erupted wisdom teeth is called pericoronitis. It happens when food fragments collect under the flap of the gum covering the partly erupted tooth. Inflammatory edema secrets pus can cause pain and bad taste in the mouth. Cellulitis and inability to open the mouth can occur. Oral airway can be compromised in worse cases.

In most cases, localized pericotonotis can be treated by warm salty mouthwashes and irrigation below the flap. The acute non-localized cases may require penicillin and pain treatments, and surgery to eliminate the flap.

Trauma origin of dental emergencies

Dental trauma is very frequent and more likely to affect children. Tooth injury caused by dental trauma is divided mainly into three types. Broken tooth results to these tooth fracture. Tooth luxation results to loose tooth and tooth avulsion results to missing tooth. All traumatized teeth require extensive care to avoid further complications.

The crown and/or root with or without tissue or pulp exposure are involved in tooth fractures. Fractures involving the enamel and little amounts of dentine are not serious. But urgent dental examination is required when pulp is involved that may cause pain. For detection, radiography is often used.

Loose teeth that are primary are extracted. But permanent loose teeth require repositioning, splinting or root canal treatment. Any permanent loose tooth requires immediate examination to avoid pain and later complication.

Missing teeth are a true dental emergency. Re-implantation should be done as soon as possible when missing permanent teeth. Losing primary teeth is natural.