CHAPTER 16 Dental Emergencies
Most dental emergencies relate to trauma or pain from a tooth affecting a person at home, work, while studying, or while doing leisure activities. The conditions that commonly cause dental pain are listed in Table 16.1 and these appear to be increasing.
Examination then focuses on signs of jaw injury (displacement or fracture), soft tissue injuries, and the dentition. The teeth are examined for any loosening, displacement, fracture or complete loss. In addition, the location of any lost tooth or other fragments should be noted.
Jaw fractures can be severely disfiguring and can cause the patient a lot of anxiety. However, management of injuries such as these is only undertaken after the patient’s general condition has been assessed and stabilised by a clinician.
ORIF: this is a surgical procedure to set and fix a fractured bone in certain situations (not all fractures require ORIF). First, the site of fracture is opened by making an incision in the skin and tissues overlying the bone (open surgery) and the displaced segments of a fractured bone are set in place. Second, the segments are rigidly fixed in place with screws and/or plates to prevent any movement and allow healing to occur.
Any lacerations in or around the mouth and face usually bleed heavily because of the rich supply of blood to the area. However, the injuries may not be as severe as they seem at first sight. Cleaning the area with weak aqueous chlorhexidine or hydrogen peroxide solution (one part hydrogen peroxide and one part water) often reassures the patient, relatives, and healthcare staff.
If there is bleeding, apply pressure with a clean gauze for at least five minutes under supervision. If the lip is swollen or bruised, apply a cold compress to limit swelling, bleeding, and discomfort. To do this, wrap crushed ice in a clean gauze or a clean piece of cloth, and hold it inside the cheek or lip.