Emergency Dentistry

At Ethical Dental, we take our responsibility to provide reliable dental care to our patients very seriously. Sometimes dental problems, such as an accident that damages the teeth or acute pain can happen on a weekend or holiday when your dentist wouldn’t usually be available. We are happy to provide an emergency service to our patients to give you the peace of mind that if you are in trouble and need us, we will be here for you.

Common dental emergencies include:

  • Trauma and accidents
  • Swelling due to infections
  • Dental or maxillofacial pain

If you are affected by any of these dental emergencies, contact us immediately to schedule a priority appointment.

Note: the below information is intended as background, and guidance for understanding dental emergencies.

  • If the patient has suffered head or facial trauma and has lost consciousness, call an ambulance or proceed directly to Coffs Harbour Base Hospital accidental and emergency.

  • If the patient is experiencing jaw pain, as well as chest pain, call an ambulance or proceed directly to Coffs Harbour Base Hospital accident and emergency.

Trauma

Dental trauma is broadly classified in 3 ways;

  1. A chip or break to a tooth that remains firmly positioned in place
  2. A dislocation or luxation that has altered the position or loosened the tooth
  3. A removal or avulsion of the whole tooth
Each type of trauma requires immediate action, and may require term followup.
Dental trauma is an important emergency that often requires immediate treatment.
  1. A chipped or broken tooth that remains firmly in place;

In many cases, as long as the tooth pulp (nerve and blood supply) is not exposed, this problem can be addressed by reattaching the broken fragment, or restoring the broken tooth with a filling or crown. If the tooth pulp is exposed (this will look like a small red or bleeding spot in the middle of the broken tooth), root canal treatment may be required to save the tooth. In some cases, root canal treatment can be avoided by immediate treatment.
Immediate action: Find and salvage the broken tooth fragments if possible, and present for emergency dental assessment as soon as possible.
  1. A dislocation or luxation that has altered the position or loosened the tooth

This type of trauma may also be associated with a chip or break, and potentially a fracture to the jaw bone. Immediate treatment of this condition is associated with repositioning and stabilising the affected teeth, and in most cases root canal treatment will be required to retain the teeth long term.
Immediate action: Find and salvage any broken tooth fragments if possible, avoid touching, wobbling, or biting on any loose tooth, and present for emergency dental assessment as soon as possible.
  1. A removal or avulsion of the whole tooth

This type of trauma may also be associated with chip or break to the tooth, and potentially a fracture to the jaw bone. Immediate treatment of this condition involves cleaning, and placing the avulsed tooth back into socket, with splinting and stabilisation. In most cases root canal treatment will be required to retain the tooth long term.
Immediate action: Find and salvage the tooth (and any additional fragments).
Note: If you feel confident to attempt tooth replacement, ensure that the root is cleaned of any visible debris by washing the tooth in milk or the patients own saliva. In a trauma situation it can be difficult to determine the correct orientation of the tooth. If the tooth does not reimplant relatively easily, rotate the tooth 90, or 180 degrees and try again.
If you do not feel confident to attempt tooth replacement, store the tooth in milk, or in the patient’s own saliva (place the tooth inside the patients mouth, between their cheek and back teeth and ensure they do not swallow it).

It is recommended that in the event of dental trauma, the patient present for emergency dental assessment as soon as possible.

Swelling

Serious oral, facial or neck swelling of dental origin can be potentially fatal. If the patient is having difficulty breathing then immediately call an ambulance, or present to Coffs Harbour Base Hospital accident and emergency.

Typically swelling is associated with an active infection that may be located around or under a tooth. Swelling from an oral infection is also often associated with significant pain, difficulty eating, or limited opening. Commonly swelling is associated with a broken or previously painful tooth, or a partially erupted wisdom tooth.

Dental swelling is an important emergency that often requires immediate treatment.

Immediate action:

In most cases addressing the acute symptoms of swelling is the first priority, and this is best achieved through a prescription for antibiotics. In some cases, clinical intervention is required as the swelling must be drained. Present for an emergency dental assessment as soon as possible

Note: Antibiotics will not solve the underlying cause of the infection, so follow up will be necessary.

Pain

Dental, oral, or facial pain can be associated with a number of causes and conditions, and can be broadly grouped into 4 categories.
  • Dental pain from a live tooth
  • Dental pain from a dead tooth
  • Dental pain caused by a sinus infection
  • Musculoskeletal pain from clenching, grinding, or stress
Dental pain is an important emergency that often requires immediate treatment.

 

Dental pain from a live tooth:

In most cases, pain from a live tooth is typically reported as very strong, sharp, acute, and can also be stimulus dependent (as a reaction to cold, hot, sweet, or pressure). This pain can be caused by deep decay, a crack or chip, or a previously placed filling. In this situation, the tooth pulp (nerve and blood supply) is inflamed and may become necrotic. If this occurs, root canal treatment or removal of the tooth will be necessary.
Immediate action: If the tooth is responding to hot or cold, limit exposure to these stimuli. If the patient is not allergic to Non-Steroidal Anti-Inflammatory medication (Ibuprofen, Neurofen, Advil), this medication may be effective in reducing pain. Present for a dental assessment as soon as possible.

Dental pain from a dead tooth (no swelling):

If the pulp (nerve and blood supply) of a tooth has died (typically from deep decay, a crack, or a previous large filling), it can become painful from proliferation of bacteria (usually referred to as an abscess). This pain is typically reported as a strong, deep ache and is not usually impacted by hot or cold stimuli. In this circumstance,  root canal treatment or removal of the tooth will be necessary.
Immediate action: Treatment with an antibiotic will typically resolve this pain within 24/36 hours, however antibiotics will not solve the underlying cause so present for dental assessment as soon as possible.

Dental pain from a sinus infection:

The nerves supplying the upper back teeth typically pass close to the lining of the Maxillary Sinus, therefore an active sinus infection can feel remarkably like a tooth ache. Typically this pain is described as pressure around the cheeks, pain on biting or eating, sensitivity to hot and cold, and an inability to determine the precise location or source. Sinus infections sometimes feel worse when lying down and may be on both sides of the patients mouth.
Immediate action: Treatment with sinus sprays, and saline rinse is typically recommended, but it is important to present for a dental assessment as soon as possible to delimitate a dental cause.

Musculoskeletal pain from clenching, grinding, or stress:

In many cases, this type of pain is multifactorial and chronic in nature. It is often associated with pain radiating from the Temporomandibular Joint (TMJ, jaw joint), and may spread up towards the temple, and down to the lower jaw. This condition is sometimes associated with limited opening, pain while biting or eating, headaches, and a clicking or locking jaw.
Immediate action: Minimise jaw movements or actions which cause pain or discomfort. If the patient is not allergic to Non-Steroidal Anti-Inflammatory medication (Ibuprofen, Neurofen, Advil), this medication may be effective in reducing pain. A heat pack may also be beneficial in reducing discomfort. Present for a dental assessment as soon as possible in order to eliminate an acute dental cause (infection, or pulpitis), and to discuss long term treatment and management options.

If you have experienced an emergency, dental trauma, swelling, or pain click here to schedule a priority appointment with a dentist at our Coffs Harbour or Dorrigo locations, or phone us on 6652 3185.

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