When it comes to emergency dental services, ice hockey players have one distinct advantage: They fully expect to chip, crack or even lose a few teeth over their careers. The rest of us have to scramble when an accident happens involving our pearly whites. But the reality is that emergency dental services aren't as readily available as your neighborhood hospital emergency room or freestanding emergency center.
Even though everyone has a different pain threshold, there are times when a toothache, abscessed tooth or related dental discomfort requires immediate attention. The primary goal of the emergency dentist is to address the pain issues and make certain the injured teeth and surrounding soft tissue are stabilized, preventing further damage.
These are often "temporary" fixes, allowing enough time for a permanent repair to be performed later. For example, if a root canal is required, the emergency dentist might relieve the pain symptoms by removing nerve tissue but instruct the patient to contact his or her regular dentist for the complete procedure [source: Top Dentists Online].
So where do you turn? Well, if you already have a family dentist, the first thing to do is anticipate a potential problem (like car problems, dental issues rarely happen at opportune times), and check to see if he or she provide emergency services. Many simply don't, for a variety of reasons, including inconvenience or scheduling issues to a lack of expertise or even insurance headaches. Conversely, an emergency dentist may not have the expertise, or access to the specific tools, to make the required permanent repairs.
The key point to remember is that all emergency dentists are dentists, but not all dentists provide emergency care. It's best to find out beforehand, especially if you're a parent. Often, private-practice dentists will form loosely associated partnerships or "networks" with other practices in order to provide "on call" assistance for their patients, tethered together by an answering service. However, this won't guarantee that you'll see your specific dentist in the case of an emergency. Some large-scale dental practices may even provide an emergency specialist on staff.
There's also an increase in affiliated "emergency dentist" companies, such as Aspen Dental, 1-800-DENTIST, Emergency Dental Service and the Philadelphia-based Emergency Den+ist 24/7. These companies have offices throughout the United States and can be invaluable if you spend considerable time on the road. However, their coverage isn't complete, so you may want to check before your next business trip or family vacation.
Is your dental issue really an emergency?
Top Dental Emergencies
So what, exactly, qualifies as a dental emergency? In many cases, it's the level of pain or discomfort you're experiencing. Other times, it's a situation that, if not treated immediately, can lead to more complex problems. A third scenario may require an initial visit to the emergency room, followed by an appointment with an emergency dental specialist. In all instances, if you're suffering severe pain, call your dentist immediately, especially if you have a:
- Lost tooth: When a tooth gets knock out (known as an avulsed tooth), the first thing to do is find it, and clean it (rinse, but don't scrub, the tooth). If you can, put the clean tooth back in the socket, but don't force it. Otherwise, save the tooth in a clean cloth, or a glass of cold milk or pure water with a little salt if possible [source: WebMD].
- Toothache: Generalized tooth pain can be difficult to diagnose. A gentle brush, floss and rinse may dislodge hidden substances. If the pain persists, it could indicate a more serious problem, including infection.
- Cracked or fractured tooth: Often hidden, usually painful, a cracked or fractured tooth can be the proverbial tip of the iceberg, leading to root canal work or even a crown if left untreated. If the pain is unbearable, don't hesitate to contact an emergency dentist. If not, you run very little risk by having it examined during normal business hours.
- Chipped tooth: A chipped tooth may not require immediate emergency care, but ought to be diagnosed quickly after the accident. Assessing the corresponding pain is a good guideline. If the pain isn't driving you to distraction or causing you to lose sleep, make an appointment.
- Broken jaw: Any injury serious enough to break your jaw can have an impact on your dental work, too. Ice will reduce the swelling, but you'll want to get to the emergency room immediately. From there, doctors may recommend additional dental care.
- Broken braces: Dental apparatus such as braces and wires can quickly turn from friend to foe when damaged. If the equipment is cutting into the soft tissue of your mouth, try to gently push it back into place. Then call your dentist and orthodontist to arrange for a more permanent repair.
Remember, this is a partial list. Other injuries can include, but aren't limited to: loose crowns, lost fillings, items caught between your teeth or between your teeth and gums (such as popcorn kernel shells), inflamed or bleeding gums, an extruded tooth (a loose tooth that's been pushed from its socket, but is still being held by soft tissue), or even a bitten tongue and/or lip (which can typically be repaired in a more traditional emergency room setting, if stitches are required).
How prevalent is the need?
Emergency Dental Care for All Patients
Existence of local emergency dental services doesn't always translate to access. Cost is always going to be an obstacle for a certain segment of the population, but researchers have also found that not all insurance agencies are created equal when it comes to providing emergency dental services, or reimbursing for those services.
According to a multi-agency study conducted by the University of Pennsylvania and Columbia University College of Dental Medicine, researchers found that dentists in Illinois, including those participating in state-sponsored Medicaid, were far less likely to see a child patient suffering from an acute oral injury if the family had public insurance, compared to a family with private insurance, such as Blue Cross. Based on those findings, researchers concluded that the study had "implications for developing policies that improve access to oral health care" [source: Bisgaier].
Dr. Tegwin Brickhouse wrote for Medscape News that the study indicates "the issues for reducing disparities in access to care are complex" [source: Brickhouse]. Specifically, Brickhouse noted that the divide in access between publicly and privately insured patients will "continue to demand the collaborative attention of policymakers and dental providers."
Robert Gist, president of the American Dental Association (ADA), said the study "supports the ADA's longstanding position that better funding for public assistance programs is critical. Lack of funding is among the greatest barriers to better oral health in America" [source: Gist]. Furthermore, Gist said the study substantiated concerns about "chronic underfunding that afflicts most state Medicaid programs," but also revealed that many patients need help "navigating an often complicated bureaucracy and overcoming other barriers."
But Gist added that, even if fully funded, the programs couldn't reach their full potential without a reduction in red tape or other obstacles to proper care [source: Gist].
Established traditional dental practices are also recognizing the need to provide some form of emergency care, as they risk losing patients if they're not available to treat when an untimely accident occurs [source: Top Dentists Online]. The bottom line? Maintaining good oral hygiene is the best way to prevent dental emergencies. But accidents can still happen. Be proactive, and talk to your dentist about how to handle an emergency.
Need more information to help you prepare for your next dental emergency, wherever or whenever it may strike? We've got lots more information on the next page.
- American Academy of Pediatric Dentistry. "Emergency Care." (Oct. 21, 2011) http://www.aapd.org/publications/brochures/ecare.asp
- Bisgaier, Joanna, and Cutts, Diana. "Disparities to Child Access to Emergency Care for Acute Oral Injury." Pediatrics (abstract only). American Academy of Pediatrics. Accepted Feb. 11, 2011, published May 23, 2011 (Oct. 22, 2011) http://pediatrics.aappublications.org/content/early/2011/05/19/peds.2011-0011.abstract
- Brickhouse, Tegwyn. "No Shortcuts: Addressing Dental Disparities in Children." July 8, 2011 (Nov. 3, 2011). http://www.medscape.com/viewarticle/745872
- Emergency Dental Service. "FAQs" (Oct. 21, 2011) http://www.emergencydentalservice.com/faq/
- Emergency Den+ist. "Emergency Dentist Frequently Asked Questions." (Oct. 22, 2011) http://www.emergencydentist247.com
- Gist, Robert F. "Disparities in Child Access to Emergency Care for Acute Oral Injury." American Dental Association. May 23, 2011 (Oct. 21, 2011) http://www.ada.org/5871.aspx
- Healthwise. "Mouth and Dental Emergencies." WebMD.com. Sept. 26, 2008 (Oct. 21, 2011) http://www.webmd.com/oral-health/tc/mouth-and-dental-injuries-emergencies
- Mann, Denise. "Do It Yourself Dentistry." WebMD.com. June 18, 2008 (Oct. 22, 2011) http://www.webmd.com/oral-health/guide/do-it-yourself-dentistry
- Palmer, Craig. "NIDCR funds emergency room dental care study." American Dental Association. Jan. 19, 2011 (Oct. 20, 2011) http://www.ada.org/news/5245.aspx
- Top Dentists Online. "The Pros and Cons of Being an Emergency Dentist." 2010 (Oct. 22, 2011) http://www.topdentistsonline.com/Emergency-Dentist/emergency-dentists-pros.php
- Top Dentists Online. "What to do in an emergency dental situation?" 2010 (Oct. 22, 2011) http://www.topdentistsonline.com/Emergency-Dentist/emergency-dental-situation.php
- Top Dentists Online. "When Should You Use an Emergency Dentist?" 2010 (Oct. 22, 2011) http://www.topdentistsonline.com/Emergency-Dentist/when-to-use-an-emergency-dentist.php
- Top Dentists Online. "Who Is an Emergency Dentist?" TopDentistsOnline.com. 2010 (Oct. 22, 2011) http://www.topdentistsonline.com/Emergency-Dentist/
- WebMD. "Handling Dental Emergencies." WebMD.com. Reviewed, March 15, 2009 (Oct. 22, 2011) http://www.webmd.com/oral-health/guide/handling-dental-emergencies
- WebMD. "How to Save a Knocked-Out Tooth." Reviewed, April 27, 2011. (Oct. 22, 2011) http://www.webmd.com/oral-health/how-to-protect-your-familys-teeth/baby-teeth-care