When a tooth dies due to decay, or the gum around a tooth becomes blocked with food or plaque the bacteria and foreign bodies present can cause the body to react by pouring in tissue fluid full of anti-bacterial substances. Some time the body reacts so violently that the soft tissue of the face head and neck can be physically distorted. This produces the once familiar "fat face" of a dental abcess. When the swelling occurs at the back of the mouth it is possible that the air way can be blocked ( Ludwigs Angina), and the patient suffocate. I must say now that this is so rare in the Western World, due to the availability of anti- biotics, that I have never seen a case in my 16 years in general practice! However, if the patient has a swelling that is affecting the back of the mouth such that the swelling is enlarging and there is a danger that the air way will be blocked, then immediate attendance at a hospital accident and emergency department is required.
The gums may bleed after being brushed or flossed, this is not an emergency, but you should attend your Dental Surgeon for a routine appointment as soon as possible because you may have gum disease. Bleeding after a dental extraction is , however, a true dental emergency. Please follow the advice as set out below. After 2-4 hours, if the bleeding has not stopped then you must attend your local hospital accident and emergency. Tell them that you have followed the advice and that the bleeding still has not stopped. You may require an injection of a clotting agent.
It is permissible to take the maximum dose of two different pain killers, i.e. paracetamol and nurophen. Make sure that each one only contain one pain killer as there are commercially available mixtures and you may end up taking an over dose of one of the drugs.
Thus it is permissible to take a combination of the above up to the maximum for each drug, for a short period i.e. 1-2 days, until a visit to a dentist can be made. Under no circumstances should pain killers be taken in high doses without dental or medical supervision, for more than a few days.
Most problems that patients suffer are really not true emergencies, they are more of a "problem" that occurs out of normal surgery hours have tried to give advice on the main areas that patients express concern about. If you feel that other areas should be covered then e-mail me and I will include them.
A recently lost or broken filling is very unlikely to cause sever pain. Some sensation may be felt with hot and cold, so tepid food and drink should be consumed. Brush the cavity vigorously with a fluoride tooth paste and book an appointment as soon possible with your dental surgeon.
It is very unlikely that the loss of a crown or bridge will cause sever pain. Some sensation to hot and cold is more likely. The problem is more likely to be an aesthetic one. Clean the teeth that supported the crown or bridge carefully 2-3 times a day with a fluoride toothpaste and use tepid water. It is possible, in the case of a bridge a keep it in place and remove it at night. Book an appointment as soon as possible with your dental surgeon, I would suggest that a crown or bridge should not be left off the teeth for more than a few days as the teeth will move and it may not be possible to refit it.
A broken denture will not cause pain but it is a functional and aesthetic problem. Out of normal hours and at the week-end it is unlikely that any dental laboratories will be open. If you look through your local yellow pages it might be possible to find a technician who is open and can make the repair. It is illegal for a technician a take an impression or carry out any treatment in a patients mouth, therefore it may be unavoidable to wait until your dental surgeon re-opens. Never be tempted to use "supa glue" as this is toxic, it may also bond the denture to the soft tissues!