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How To Manage Minor Dental Problems At Home Until You Can See A Dentist (COVID-19 pandemic)

The guidance

To prioritise emergency dental treatment and to reduce the risk of virus transmission to you, our staff and the public.

Please note: We will remain open for telephone emergency advice only and to prescribe antibiotics if required in line with the current guidelines issued by the UK Government and Public Health England. We will continue to closely monitor the evolving situation and keep you informed. The health, wellbeing and safety of our patients, team and loved ones are our priority so please only call if it is a genuine dental emergency listed below.

What is a dental emergency?

· Facial swelling that extends to your eye, neck or floor of mouth

· Bleeding after a tooth extraction that does not stop after 30mins of firm pressure being applied with a gauze

· Bleeding due to a dental trauma

· Your tooth has been knocked out or you have severely broken a tooth

· Toothache preventing sleep or eating combined with swelling or fever, not relieved with pain relief.

Please do not hesitate to call the practice if you experience any of the above dental emergencies.

If you experience any of the following, go straight to A&E:

· Facial swelling affecting your vision, breathing or preventing your mouth opening more than 2 fingers width

· Trauma causing loss of consciousness, double vision or vomiting.

Non-urgent dental care that does not require urgent treatment:

· Loose or lost crowns, bridges or veneers

· Broken, rubbing or loose dentures

· Bleeding gums

· Broken, loose or lost fillings

· Chipped teeth with no pain

· Loose orthodontic wires.

Due to current lockdown advice, you may need to wait until normal opening resumes. Please call if you require any advice.

If you are self- isolating due to the COVID-19 pandemic and develop a minor dental problem (non-urgent dental care), there a few things than you can do at home to help. Below are a few ways to help you manage dental emergencies, until you are able to see us.

Managing pain

· Take regular over the counter painkillers if you need them, ensuring you follow instructions on the packet and do not exceed maximum dose

· Patients who have confirmed or suspected COVID-19 should take Paracetamol not Ibuprofen.

Please call for advice on the appropriate dosage for you if you are unsure.

· Good oral hygiene with a fluoride toothpaste and reducing your intake of sugary foods will help to prevent decay getting any worse or causing new non-urgent dental issues

Tooth sensitivity

If you are experiencing sensitivity when eating hot or cold food, the following may help:

· Desensitising toothpaste, such as Colgate Sensitive Pro-Relief or Sensodyne Repair, used twice daily. Do not rinse with water or mouthwash as the toothpaste will form a barrier to protect you from pain.

· Apply the above recommended toothpaste directly over the affected area like an ointment and leave it on overnight (do this for at least 7-14 nights for prolonged relief)

· Continue using the sensitive toothpaste to prevent the symptoms returning.

· Painkillers (as directed above)

· Avoid sugary foods/drinks

· Avoid extremes of temperature (e.g. drink luke warm or cool drinks)

Other methods of relieving pain

· Anaesthetic gel such as Orajel applied to the area can help to numb the pain

· Clove oil can be applied to the painful tooth using a cotton bud to provide short term relief

Wisdom tooth pain

Most flare ups can be managed at home and last 5-7 days if you follow these steps:

· Thorough cleaning around the wisdom to disturb the gum (even if it is painful or bleeds)

· Corsodyl mouthwash twice daily for 7 days

· Rinse your mouth with warm salt water frequently

· Painkillers (as directed above)

· Eat a diet of soft food to reduce the risk of further trauma from biting

Ulcers

Most ulcers heal on their own within 7-10 days are not an urgent emergency. To ease the symptoms:

· Warm salt water mouthrinses frequently

· Difflam (Benzydamine) spray or mouthwash (can be bought from pharmacist)

· Corsodyl mouthwash twice daily for 7 days

· Pain relief gel such as Bonjela applied to the ulcer

· Painkillers (as directed above)

· Soft diet

· Avoid spicy, salty or hot foods that will irritate the ulcer

· Thorough cleaning and good oral hygiene

Bleeding gums

Bleeding gums are NOT a dental emergency. Bleeding gums is usually due to gingivitis (swollen gums) or gum disease and will not stop until brushing improves.

· You must brush your teeth and gums twice a day with a fluoride toothpaste for 2 minutes.

· Concentrate on brushing the part of the tooth that meets the gum, even if it bleeds.

· Spend more time on the areas that are bleeding and brush gently (ensure you are not brushing hard).

· Use interdental cleaning aids (e.g floss or tepe brushes) to clean in between your teeth every day to prevent build-up of plaque and food debris

Problems after extractions

· Bleeding tends to respond well to pressure. Bite firmly on a clean handkerchief (not tissue) for 30 minutes. If bleeding continues, please call us. Pink coloured saliva and a little bit of oozing from the extraction site is normal.

· Pain after an extraction can be managed with painkillers (as directed above), warm salt water mouth rinses and corsodyl mouthwash twice daily for 7 days.

Swelling

Sometimes tooth pain can lead to swelling.

· Use a cold compress to reduce swelling and offer some temporary pain relief.

· Do not put heat externally on your face as this can worsen the swelling

· Take over the counter painkillers (as directed above)

Lost filling, broken or fractured teeth

· Any sharp edge can be smoothed carefully with an emery board if causing soreness or ulcers on the tongue or cheeks

· Keep any holes as clean as possible, remove food that might be trapped and use mouthwash

· Temporary filling kits are available from Boots, pharmacies or supermarkets in an emergency. Follow the instructions and place the temporary filling inside the cavity (only do this if absolutely necessary, as if the tooth is not clean enough then further problems may develop from trapping bacteria in the cavity)

· Painkillers if required (as directed above)

Lost crowns or bridges

Lost crowns do not need to be recemented urgently, unless it is visible or causing discomfort. If put back in incorrectly, further problems may develop

· Clean any food or debris out of the crown

· Temporary cement kits are available from Boots, pharmacies or supermarkets.

· Try the crown in first without cement. If it does not fit in or the bite does not feel correct then do not cement.

· Dry the tooth as much as possible and re-cement the crown back in

· Gently remove any excess cement with a Tepe brush or toothpick

· Do not use superglue or the equivalent in your mouth.

· If your tooth has broken in the crown, it is unlikely it can be re-cemented.

Problems with dentures

· Loose dentures can be secured with denture adhesive e.g Fixodent (available from Boots, pharmacies or supermarkets).

· Seabond denture pads may also make a denture more stable or comfortable

· Sharp edges causing ulcers can be smoothed with an emery board

· Leave your denture out of the mouth as much as possible if they are causing ulcers or pain

· If ulcers develop, treat as directed above.

The above tips are to help you at home while you are self-isolating. If the nature of the problem changes or if you require further advice or assistance, please do not hesitate to contact us and we will be happy to help.

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