If the crown has come off the tooth, without or just a small amount of the tooth in the crown and it looks mostly hollow, you should be able to recement it at home. Just follow these instructions:
1.Remove any debris from the crown, using a tip of a paper clip or something similar. Clean the tooth thoroughly with your toothbrush. There should be no debris in the crown or on the tooth.
2. Place the crown on the tooth without any cement. Gently bite together making sure that the crown is not too high and the rest of the teeth meet. If the teeth don’t meet correctly then DON’T force it down. Check to see if there is any debris, if there is then remove and try again. If it still does not feel right, keep the tooth as clean as possible and see your dentist when face to face consultation can restart.
3. The Crown should be recemented using the temporary cement issued by the practice, or use a dental cement from a pharmacy, for example RECAPIT©
DO NOT USE SUPERGLUE OR ANY HOME MADE CEMENTS OR DENTURE FIXATIVE
4. Practice placing the crown on the tooth a few times. Once you are confident, dry both the tooth and crown, mix the cement as instructed and place a thin layer in the crown. Place the crown on the tooth and then bite firmly, maybe on a tissue or cotton wool roll.
5. Remove any excess cement with an interproximal brush especially in between the teeth, using both interproximal brush and floss.
WISDOM TOOTH PAIN is usually due to inflammation of the gum that is behind the erupting tooth, it can swell and start to cover the tooth. This can be made worse by trauma of the opposing tooth when biting or chewing.
Most flare ups can be managed with good hygiene and pain relief.
CLEAN the tooth gently but thoroughly especially around the back of the tooth.
A SOFTER DIET - soft food will reduce trauma from biting.
Rinse the area with a HOT SALT MOUTHWASH (a teaspoon of salt in a tumbler of hot water, as hot as you can stand) for at least 30 seconds. Do this a couple of times after meals.
PAIN RELIEF take ibuprofen or paracetamol - please read the instructions on the pack (See PAINKILLERS below).
IF YOU HAVE DIFFICULTY IN SWALLOWING, HAVE SWELLING IN YOUR FACE OR CHEEK, OR DIFFICULTY IN OPENING YOUR MOUTH, CALL THE PRACTICE. You may need antibiotics.
Toothache can come in many forms, sensitivity to sweet, cold or hot, sharp stabbing pain or dull throbby ache.
Some simple home measures may help. (SDCEP advice on emergency dental care):
- Avoid stimulus that precipitate or worsen the pain such as hot or cold foods/drinks or cold air
- If you have sensitivity to sweet or cold in all teeth and it is not specific to a certain area use of desensitising/sensitive toothpaste(Sensodyne Repair and Protect©, Colgate Pro sensitive relief©) may help. Brush teeth especially before going to bed but spit out excess DO NOT RINSE. If the sensitivity is in a more specific area then either of the above toothpastes or Sensodyne Rapid Relief© can be rubbed on to the area after brushing and once again DO NOT RINSE
- Holding cooled water or crushed ice around the tooth can help some types of toothache
- Severe pain from the mouth or teeth sometimes feels worse when lying down flat: therefore try lying propped up might ease the pain.
- Use painkillers that have provided pain relief for you before (more details on pain killers will be provide later)
- Avoid taking aspirin if there is any bleeding
PLEASE ALWAYS FOLLOW THE DIRECTIONS ON THE PAINKILLER PACKETS FOR MAXIMUM DAILY DOSE AND ADVICE ON PRECAUTION IN SOME MEDICAL CONDITIONS (e.g. patients who are asthmatic should avoid ibuprofen)
CALL THE EMERGENCY ADVICE LINE IF THE ABOVE PROVES INADEQUATE AND WE TRY TO ARRANGE A URGENT REFERRAL TO THE URGENT DENTAL TREATMENT CENTRES
If you have lost a filling/part of the tooth or the tooth has cracked and is sensitive or sharp, a temporary filling can be packed in the hole.
The practice can provide this or they are widely commercially available from supermarkets or pharmacies. If accessed from the practice you will be given detailed instructions, if bought from the supermarket or pharmacies please read and follow the instructions carefully.
IF THE TOOTH BECOMES HYPERSENSITIVE TO HOT OR COLD, CONTACT THE SURGERY AND WE WILL TRY TO ARRANGE AN URGENT REFERRAL TO THE URGENT DENTAL TREATMENT CENTRES,
If you have your tooth knocked out, if it is an adult tooth, only touch the tooth by the crown, don’t touch the root. Store it in fresh or long life milk. You will need emergency treatment to see a clinician as soon as possible.
If it is a primary(baby) tooth leave it out. Contact the surgery and we will try to arrange an urgent appointment to assess any potential trauma to the developing teeth. If pain relief is needed see advice below on PAINKILLERS.
Anti-inflammatories (like ibuprofen) and/or paracetamol can reduce pain and sensitivity from teeth. Each can be taken alternately to extend the period of effectiveness without exceeding the recommended dose.
There has been concern raised about the use of ibuprofen in patients with COVID-19. In the light of this and the lack of definitive evidence, NHS England has recommended that only paracetamol should be taken in a patient with confirmed COVID-19 or those that may have the virus. For up to date information go to https://www.gov.uk/government/news/ibuprofen-use-and-covid19coronavirus
Painkillers should always be take according to the instructions of the health care professional, or on the painkiller packet, or information leaflet.
TAKING TOO MANY TABLETS OR TAKING INCORRETLY WILL NOT IMPROVE THE SYMPTOMS AND CAN CAUSE SERIOUS STOMACH AND LIVER INJURY WHICH CAN BE LIFE THREATENING.
Pain or bleeding after an extraction
If you have pain after an extraction take regular pain relief. It is normal to have some pain up to 3-4 days later. There may be some oozing of the extraction site, this is normal. If there is more bleeding from the socket, then bite hard on gauze or tissue to create pressure on the socket for about 20 minutes.
DO NOT SMOKE/VAPE or RINSE for 24 hours after the extraction. This combined with a difficult extraction may lead to a “Dry Socket”. This is a slight inflammation of the exposed bone. This needs dressing to cover the exposed bone.
PLEASE CONTACT THE SURGERY FOR ADVICE
These can be very painful but will usually heal within 7-10 days. If they last for more than two to three weeks PLEASE CONTACT THE SURGERY.
Initially hot salt mouthwash may help. If the ulcers have been caused by a rubbing denture, try to leave the denture out until the ulcer heals. Sharp edges on the denture can be removed with an emery board. Difflam© spray or mouthwash may also help with pain relief.