Back to School 2009 Newsletter
Dental Emergencies 101
In This Issue
How to Handle Dental Emergencies
Golf Outing Update
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It's Back to school.... that busy time of year as we adjust to new schedules and new activities.  In the spirit of learning, we would like to teach you how to handle dental emergencies in this newsletter.  You will receive some very important information and we encourage you to print this out and keep it on hand in the event that something unfortunate occurs.  In addition, we will be following up on some events and information that were discussed in our previous newsletters.
So read on, get educated and stay safe! 
How to Handle Dental Emergencies

Tooth knocked out in a dental accident
When it's a Baby Tooth...
Most often, when a primary/baby tooth is lost to dental trauma, the tooth is not replaced back into the mouth.  It is simply handled as though the tooth were shed naturally on its own.  Immediate treatment consists simply of handling the soft tissue injury that may have occurred.  This includes cleaning the tissue wound with rinses such as warm water or diluted hydrogen peroxide.  If stitches/sutures are needed or if there is significant facial trauma, it is best to proceed to the emergency room. 
It is important to have a dental x-ray taken of the injured area within a few days.  This x-ray can be used to visualize the injured site and the underlying permanent tooth.  The x-ray also helps to determine if there are any fragments of the baby tooth left behind that may need to be removed.  A soft tissue exam can also be done at that time to monitor the healing process.  Occasionally, the space may need to be maintained with a retainer if the permanent tooth is not expected to erupt for several years.  This can be determined at this exam appointment.
When it's a Permanent Tooth...
When an entire permanent tooth, including the root is lost, it is crucial to get emergency care.  The tooth should be stored in liquid, such as milk or "Hank's Solution" (found at the pharmacy).  The tooth can also be held in the mouth coated in saliva, though swallowing or aspirating the tooth is a concern - so take care if this option is chosen.  If conditions are right, the tooth can be replaced back into the socket and left to heal back into the bone.  If this is not possible, the tooth may be replaced with a dental implant, bridge or partial.  
Fractured Tooth/Lost filling
When an adult or baby tooth is fractured, the need for immediate dental treatment depends on the size and location of the fracture.  If a large portion of the tooth is missing or if you have significant discomfort, the fracture may be into the pulp/nerve of the tooth.  You should receive emergency care to protect the vital portion of the tooth in this situation.  If the fracture is not large, and you are not in discomfort, immediate care is not absolutely necessary, though you should be seen by a dentist within a reasonable period of time to have the tooth repaired to prevent further problems.
If a filling comes out of your tooth, it is handled in the same way as discussed above.  The amount of discomfort and location of the lost filling will allow you to determine if immediate care is required.  It is important in either situation to keep the area clean and see a dentist to have the tooth repaired.
Permanent Crown Off
When a permanent crown falls off, there is a chance that the crown may be able to be re-cemented, so keep it in a safe place.  It is normal to feel some slight sensitivity on the exposed tooth, therefore try to avoid anything that may further aggravate the tooth.  You should see a dentist within a few days (and sooner) if you are experiencing pain.  The dentist  will examine the tooth and crown; then determine if it can be permanently cemented back on the tooth.  Sometimes the crown cannot be reseated, as there could be a problem with the underlying tooth, the fit of the crown or another factor.  If this is the case, appropriate treatment will be completed and a temporary crown can be placed to make you comfortable until a new crown can be made or other treatment is provided.  
Temporary Crown Off
If the temporary crown is in one piece, save it and call to have the temporary reseated.  If you are unable to be treated immediately, you can put a small amount of toothpaste inside the temporary crown and firmly place it back on the tooth.  If the temporary crown is broken, it must be remade, so contact us.
Tooth Ache/Dental Infection/Pain
There are several situations that can produce dental pain.
  Pain can occur from an infected tooth, in which case an antibiotic may be appropriate prior to root canal therapy or extraction.  Sometimes the infection can originate in the gum tissue, in which case an antibiotic may still be appropriate and further treatment may involve a deeper cleaning around the tooth/involved area.  Either situation needs immediate attention and/or medication, therefore contact your dentist.  In addition, an anti-inflammatory, such as Ibuprofen / Motrin / Aleve can be quite effective.  A stronger medication can be prescribed if needed.  If you are experiencing facial swelling, this is an extreme emergency and could be life-threatening... immediate attention is mandatory.  Facial swelling can close the airway and cut off your ability to breathe, so it is crucial to get immediate help!
 Facial/ Soft Tissue Trauma
This can occur with any dental emergency and should be addressed with the other concerns as well.  The most important treatment is to clean out the tissue with an antimicrobial rinse or a 50:50 hydrogen peroxide/water solution.  A cool compress can be applied to control swelling in the area and an anti-inflammatory may help.  Stitches are rarely needed, but if this is the case call your dentist or proceed to the emergency room. 
TMJ/ Joint Pain
If your jaw is "locked" and you are unable to close your mouth, this is an emergency.  It is most appropriate to procede to the emergency room.  If the jaw spontaneously relaxes and you are able to close your mouth after this type of episode, contact us for a full TMJ examination.   In the meantime, use cool compresses to reduce swelling, take anti-inflammatory meds for inflammation and pain, and place yourself on a soft diet. 
Other generalized TMJ discomfort does not require immediate treatment, though it is recommended to use cold and hot compresses, anti-inflammatory meds and a soft diet until you can be seen.
Any TMJ discomfort should be followed up with a thorough TMJ examination to determine the appropriate treatment that may be needed.  Common modes of treatment include a bite splint/night guard, bite adjustment, bite correction or physical therapy.
Golf Fore Kids -   Another Successful Year!
Hornseth & Curless Dental Instrumental in Fundraising
We would like to thank all of those who participated in the 2009 Golf Fore Kids Fundraiser, held at Ridgeway Country Club in Neenah.  The entire event raised over $35,000, our office sponsored 20 golfers, and our hole event took in an additional $540 for this great charity.  We appreciate all of the hard work from our team members who organized our office's involvement in the event and made our participation memorable.  Thanks also to Dr. Erin's husband, and golf professional, Ryan Helminen for hitting some great tee shots and getting several teams some birdies and eagles!  Thank you again for everyone's generosity in sponsoring, planning, and supporting this fun and worthwhile event! 
Thank you for taking the time to stay in touch with us.   We hope you found our newsletter informative and helpful.  We are always open to feedback and future newsletter ideas and topics.  Have a great fall season!
Hornseth & Curless Dental