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Dental emergencies can have many causes, including accidents, sports-related injuries, tooth decay and infection. You may have a dental emergency if you have any of the following:
NOTE: If you have trouble breathing or your mouth continuously fills with blood, call 9-1-1 or go to your nearest hospital emergency department. Also seek an immediate medical assessment if you suffer a head trauma.
The following highlights some common dental emergencies. If you experience an injury to your mouth, face or neck it is important to ensure you receive any necessary medical attention first. Contact your dentist for any additional questions related to your individual circumstances and dental treatment needs.
A knocked-out permanent tooth may be saved but time is of the essence. If you knock out your permanent tooth, follow these steps
Please note: Do not try and reinsert a baby tooth. Contact your dentist to discuss the options.
Contact your dentist as soon as possible if an injury has caused your tooth to move. A displaced tooth can interfere with your bite and cause discomfort. If addressed early your dentist may be able to move the tooth back into position.
In most cases a small chip in the tooth does not constitute an emergency, particularly if it’s not causing pain. Speak to your dentist about the injury and treatment options.
Extensive cracks or fractures to a tooth require immediate attention: such injuries usually involve enamel (outer layer of the tooth) as well as the underlying dentin and possibly the pulp (vital structure of the tooth). This may cause pain and could lead to further damage if left untreated.
If you experience trauma to your tooth:
Cuts, lacerations or other wounds can also occur to the lips, tongue, cheeks and other soft tissues of the mouth. If you experience a trauma to the tissue:
It is important to see your dentist if you have an infection in your teeth or gums. Pain will usually be the first sign of an infection but you may also notice redness in the gums or swelling in your mouth. In the case of swelling that affects your ability to swallow or breathe call 911 or visit the nearest hospital emergency.
In most cases, an issue such as a dislodged filling or a displaced crown does not require urgent care. However, call your dentist immediately to discuss your concern and to arrange an appointment for further care. Also ask if there is anything you can do in the interim.
Gum disease (also known as periodontal disease) is a condition that affects the soft tissues and bone that support and anchor the teeth. In its mildest form it can lead to inflamed or bleeding gums, while more advanced forms can result in bone loss, gum recession and eventually, tooth loss. Gum disease is largely preventable; early detection is important to stop the progression of disease.
Gingivitis: Gingivitis is a mild form of gum disease. It can cause inflamed and swollen gums that bleed when teeth are brushed or flossed.
Periodontitis: Periodontitis is an advanced form of gum disease. It results in deepening pockets between the gums and the tooth, followed by bone loss and loosening of teeth. Periodontitis is a major cause of tooth loss in adults.
Gum disease is caused by an accumulation of bacterial plaque at the point where your teeth and your gums meet. Plaque, a sticky film, forms on your teeth daily. Brushing and flossing help to remove plaque from your mouth. Plaque can build up and harden to form calculus (tartar). Without removing tartar (professional dental cleanings are required) plaque will continue to build up while the bacteria within the plaque can irritate the gums and progress to break down bone.
Other contributing factors include tobacco use, diet, and some medications. Certain systemic diseases such as diabetes can also make you more susceptible to gum disease.
Signs that you may have gum disease include:
| Amphetamines | Antihypertensives | Bronchodilators |
| Antianxiety drugs | Antiparkinsonians | Decongestants |
| Antidepressants (tricyclics) | Antipsychotics | Diuretics |
| Anticholinergics (atropine) | Antispasmodics | Hypnotics |
| Anticonvulsants | Appetite suppressants | Muscle relaxants |
| Antihistamines | Barbiturates | Opioid (narcotic) analgesics |
At one time or another we all suffer from bad breath (Halitosis). For many, bad breath is a temporary problem, however, if bad breath persists there may be an underlying cause. If you have persistent bad breath you should speak to your dentist or physician to rule out any disease and take steps to prevent a future recurrence.
Food. Foods heavy in garlic, onions, and spices are among the culprits contributing to bad breath. Bad breath can also be triggered by infrequent eating or food particles left in the mouth.
Poor dental hygiene. Infrequent or poor brushing and flossing techniques can leave food in the mouth to decompose. Your mouth is warm, moist and dark—the perfect place for bacteria to grow if not properly cared for. It is important to remember to brush twice daily and floss to remove food particles between teeth. Bad breath can also affect those that wear dentures; always ensure you clean your denture daily.
Gum (periodontal) disease. Persistent bad breath is often an indicator of gum disease. Gum disease is caused by an accumulation of bacterial plaque at the point where your teeth and your gums meet. If untreated this condition can continue to advance, eventually leading to tooth loss.
Dry mouth. If you suffer from reduced saliva flow in the mouth you are more susceptible to bad breath. Saliva helps clean food particles from the mouth. Without this added protection bacteria can grow, leading to bad breath and other dental conditions. Many medications can contribute to dry mouth.
Tobacco use. The use of tobacco products can cause bad breath and increase your risk of developing oral conditions, including gum disease and oral cancer. Speak to your dentist for tips to help you quit or visit Quit Now.
Other medical conditions. While rare, bad breath can also be associated with other medical conditions such as sinus or throat infections, diabetes and some liver and kidney diseases.
Clenching, or grinding of teeth, most often at night, is a common problem for many adults and children. According to the Canadian Sleep Society, approximately 8% of adults and close to 13% of children experience sleep bruxism.
Anxiety, stress, disrupted sleep, misaligned and/or missing teeth are among the causes. More often than not those that clench, grind or gnash their teeth are not even aware they are doing it.
In many cases sound is the first indicator, as a partner and/or parent (of a child) hears the grinding. Other signs may include:
When you clench and/or grind, your teeth exert a huge amount of pressure on your teeth. Prolonged bruxism can lead to cracked, chipped, broken or loose teeth, or damage to the temporomandibular joint of the jaws.
Through regular dental visits, your dentist will monitor your mouth including any irregular wear on the surfaces of your teeth. It’s important to let your dentist know if you’ve experienced any unusual or increased sensitivity or pain in your head and neck area. This can help to diagnose bruxism early, and limit any damage to your mouth.
Oral cancer can occur anywhere in the mouth including the lips, tongue, gums, cheeks, the palate or throat. Many oral cancers can be successfully treated if detected early—an examination by a dentist is an important step in the early detection of oral cancers.
The following summarizes the approach to oral cancer screening as outlined in the Guidelines for the Early Detection of Oral Cancer in British Columbia 2008, published by the BC College of Oral Health Professionals (BCCOHP).
Dental exams: During your exam, your dentist will:
Based on completion of the above guidelines, your dentist may recommend the use of an optional screening tool. These screening tools do not replace the exam and are not required for all patients.
At times an optional screening tool, such as Velscope or Toluidine Blue Staining, may be used for more detailed examination of certain areas of your mouth or for patients with a history of oral cancer. These are not a required part of your dental exam, but may be used by your dentist following a review of your health history and lifestyle factors, or if they need to examine a particular area of your mouth more closely. Only a dentist can diagnose tissue abnormalities based on the use of the screening tools as part of their overall examination.
If your dentist notices something suspicious, they will monitor it for a short period of time and a biopsy may be required. Your dentist will inform you of your results. If further care is required this may be provided by your dentists or they may refer you to specialist.
There is no single cause of oral cancer. It results from a variety of factors and how individual patients react to those factors. Oral cancer occurs most often in people who use tobacco, and the combination of tobacco with alcohol greatly increases the risk.
Healthy behaviours and early detection are key factors to reducing cancer incidence and improving outcomes. Become familiar with your mouth and visit your dentist regularly for an exam. Call your dentist if you notice any of the following:
Since September 2017, the HPV vaccine has been made available to all Grade 6 students, regardless of gender. There is not a ‘catch-up’ program for boys older than Grade 6, however the program does cover the vaccine for high risk boys and young men up to age 26. This program change is due in part to the continued lobbying efforts of the British Columbia Dental Association. To learn more please visit Immunize BC.
Don’t ignore a mouth sore because it doesn’t hurt. Most pre-cancerous and cancerous lesions are completely painless. Minimize your risk for developing oral cancer: Avoid tobacco and excessive alcohol use, and wear lip balm that contains sunscreen.
Sun-damaged lips are vulnerable to skin cancer. Sunburns can occur in less than 15 minutes and it is the repeated sun exposure that can cause long lasting damage.
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Vancouver, BC V6J 5C6
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The BC Dental Association office is located on the homelands of the Coast Salish peoples, the Sḵwx̱wú7mesh (Squamish), Səl̓ílwətaʔ/Selilwitulh (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations. BCDA gratefully acknowledges that BC dentists live and work on the unceded, traditional and ancestral homelands of Indigenous Peoples and Nations across BC.
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