AARP Bulletin Online Article: When Your Toothache Becomes a HeadacheWeb Exclusive

When Your Toothache Becomes a Headache

By Bethanne Kelly Patrick

March 2004

Even if you’re a devotee of your dental routine, an unexpected accident or illness can wreak havoc with your mouth if you don’t know what to do. The following information is designed to help you make the best of a worst-case scenario, whether on the scene of an emergency or in the dentist’s chair.

What should you do if you’ve knocked out a tooth—whether from a blow, a fall or another accident?

Shake off debris (rinsing or scrubbing could remove important periodontal ligament), place it in a container of milk or its socket and try to reach the dentist within 30 minutes. Unfortunately, not all teeth can be saved, cautions Glenn Wolfinger, a prosthodontist. “Alternative methods, such as a bridge or implants, may need to be considered.”

What should you do if you’ve broken a tooth?

Again, if you’ve lost the broken piece, just get to the dentist. If you have it, gently shake off surface dirt and definitely keep it, says Chris Kammer, CEO and head dentist at the Center for Cosmetic Dentistry in Madison, Wis. “Even if the piece can’t be bonded back to the original tooth, it can be used to help re-create the look of that tooth.”

If you have something (food, other foreign matter) wedged between your teeth, should you try to dislodge it?

Gentle flossing or brushing is fine, but if the object doesn’t respond to that treatment and the surrounding gum begins to swell, make an appointment with your dentist. “A bit of broken filling or chipped enamel can throw your bite off and make you panic, but popcorn husks are the worst—they occasionally need to be removed by a dentist,” says T. Bob Davis, a Dallas-based general dentist in private practice.

What should you do if you lose a filling or crown?

If you lose a filling, it’s not worth saving. However, just cover the hole with temporary material—don’t try to put the old filling back in the tooth. If you lose a crown, you’ll want to try and salvage it (you can use Temparin or Dentemp, available in pharmacies, to put the crown back in place until you can reach a dentist). In either case, visit the dentist as soon as possible, says Catrise Austin, a dentist with VIP Smiles in New York City. “Many people don’t realize that when a filling falls out, there’s a reason for that, whether it’s a cracked tooth or something else. You need to see a dentist.”

How do you know when it’s time to take your toothache in for examination?

If the pain becomes persistent, intense and localized, you may have a serious problem, and need to see your dentist. The American Dental Association urges patients not to apply aspirin to the tooth or gum tissue because it may burn the gum tissue.

When are bleeding gums a cause for immediate concern?

“If it’s been more than six months since you visited the dentist and your gums are bleeding, you need to come in,” says Davis. “Pink toothbrush” is sometimes seen in patients taking aspirin for their heart conditions; if that’s the case, the oral antibiotic rinse chlorhexidine kills off irritating bacteria, allowing gums to remain healthy and tight, Davis says.

How can you make unexpected time in the dentist’s chair less frightening before you go in?

Dress for comfort, keeping in mind that you’ll be lying back in a chair and that ultra-clean dentists’ offices can seem chilly. However, Kammer says, “We’ve really eradicated the fear component these days; there’s no need to worry, because if you wish, you can be given a small dose of a sedative to take right before you come in.”

What can you do during your visit to the dentist to keep fear and anxiety at bay?

Talk to your dentist and his employees—you’ll gain information on equipment available to beat stress. Many offices have earphones, stereos and televisions available. “Especially if it’s an emergency situation, make sure you get your dentist to walk you through the procedure step by step,” Austin says. “You’ll feel much more comfortable knowing what is going to come.”

How can you reduce anxiety between dental visits—and help make sure those unexpected visits will be few and far between?

Davis recommends scheduling your next appointment as you exit the current one. He also urges everyone to brush and floss at bedtime: “That’s the time of day when it makes the most difference.”

Pi Dental Center, Fort Washington, PA