I got a call this week from a patient who had just returned from her honeymoon. She and her new husband were riding Citi Bikes in the West Village when her front wheel caught in the cobblestones. She was thrown from the bike and broke two of her front teeth.
We were able to see her immediately, which is important in a dental emergency, and repaired the damage after checking for hidden injuries.
What counts as a dental emergency?
Please call your dentist immediately if a tooth is knocked out, pushed out of position, or fractured due to an accident or while eating. Severe tooth pain, swelling, or bleeding that does not stop also deserve urgent attention.
Even if a chipped tooth does not hurt, contact your dentist after an injury. A fracture can extend into the inner part of the tooth, damaging nerves and blood vessels and causing problems later if not treated. Nearby teeth can also be injured without showing obvious damage. An examination will help you and your dentist decide what needs treatment now and what should be monitored.
If a permanent tooth is knocked out
Dentists call a tooth that comes completely out of its socket an avulsed tooth. This is a true time-sensitive emergency. Get dental care as soon as possible.
Handle the tooth by the crown, the part normally visible above the gum, and avoid touching the root. If the tooth is dirty, you can rinse it very briefly and carefully in tepid water. Do not scrub it, don’t use soap, don’t try to dry it, and don’t wrap it in tissue, which can adhere to the tooth.
If possible, gently place the permanent tooth back into its socket and hold it in place by biting softly on clean gauze. Do not try to force it into place. If you cannot put it back in the socket, place it in a small container of milk or saliva while you travel to the dentist. Do not store the tooth in plain water or leave it to dry out.
These recommendations apply to permanent teeth only. Never reinsert an avulsed baby tooth, but still call a dentist right away for guidance.
The sooner you can get treatment for a damaged tooth, the better the chances of saving it Even if some time has passed, don’t give up! Seek care as soon as possible.
Before: Two fractured front teeth after a bike fall.
After: Same-day repair of both front teeth.
Clinical photos and dental work by Dr. Madalyn Davidson.
If a tooth is chipped or broken
Gently rinse your mouth with warm water. Save any tooth fragments in milk and bring them with you since a fragment can sometimes be reattached. Apply ice or a cold cloth to your cheek or lip to help reduce swelling, and call your dentist right away.
Treatment depends on how deep the break is. Some teeth can be repaired with tooth-colored material, others may need a crown or treatment for an injured nerve.
When to go to the emergency room
A bike fall or accident that damages a tooth can also cause other injuries requiring emergency attention. Call 911 or go to the emergency room if you experience difficulty breathing, severe facial or jaw injuries, uncontrolled bleeding, loss of consciousness, vomiting, or double vision. Severe swelling of the mouth or throat also needs emergency medical attention.
For an isolated tooth injury, call your family dentist or an emergency dentist immediately. If you also need medical care, tell the medical team about the tooth injury so dental treatment can be coordinated.
A repaired smile still needs follow-up
This patient’s clinical result was encouraging, but dental trauma does not always end with the repair. Keep the follow-up visits your dentist recommends, even when everything looks and feels normal.
Fortunately, our patient already knew an emergency dentist. If you or a loved one experience a dental emergency, call our Chelsea office right away for same-day emergency care. We will ask you about the injury, when it occurred, and whether any teeth are broken, loose, displaced, or missing. We’ll explain what to do next and how to get the care you need.
Be well,
Dr. Madalyn Davidson