Keep Calm

Following recent guidance from NHS England and the Department of Health, dental practices have been advised to STOP AEROSOL SPRAYS and PRIORITISE URGENT TREATMENT.

As well as reducing risk to staff and patients, this will also prevent unnecessary travel in an attempt to reduce virus transmission.

NHS England is in the process of setting up Local Urgent Care Centres, but the details have not yet been released. 

If you have tried contacting us this week, you will have got through to a message on our answering machine, advising that we are now closed, and are only able to see dental emergencies.

Many of our patients however, have dental problems that maybe do not quite fit the criteria for a true dental emergency, but still require attention.

Please find below some advice on how you can manage dental issues at home until we can see you in the surgery.

 

 

 

 

 

 

 

Toothache

  • If the tooth is extremely sensitive to hot or cold, antibiotics will not help. The decay must be removed and filled.
  • If there is a hole in the tooth, or a tooth has cracked and is now sensitive/sharp, a temporary filling can be packed into the space. These are widely available from supermarkets¬† and pharmacies
  • Desensitising/sensitive toothpaste (like Sensodyne repair and protect) can help. Rub toothpaste directly on the affected area and do not rinse afterwards.
  • Anaesthetic gel such as Oragel can help ease the pain.Oragel

Sensodyne

Wisdom Teeth

  • Wisdom tooth pain is usually due to inflammation of the gum over the erupting tooth, which can be worsened by trauma from biting.
  • Most flare-ups can be managed with good home care and should settle in a few days to a week
  • Excellent cleaning is crucial, even if it is painful. The area must be kept clean to encourage healing.
  • Corsodyl mouthwash may be useful if you are not allergic to it. Do not use this for more than 1 week as it can cause staining.
  • Soft diet- as soft food will reduce trauma from biting
  • Warm salty mouthwashes
  • Painkillers such as paracetamol

Ulcers

  • Although painful, most ulcers will heal within 7-10 days. Any non healing ulcer which has been present for more than 3 weeks should be looked at by a dentist or doctor.
  • Warm salty mouthwashes will help to heal the ulcer.
  • Excellent cleaning is crucial to prevent further ulcer formation and to encourage healing.
  • Painkillers and soft diet are helpful.
  • Rubbing Dentures. Denture adhesive like Fixodent can help to secure a loose denture, and provide some cushioning. Any sharp edges can be removed using an emery board. If your denture is causing trauma, you can remove the denture when possible.

 

Pain or Bleeding After Extraction

  • Continue to take regular painkillers for several days after extraction, it is normal for the pain to be at its worst at day 3-4.
  • Some pink spit/oozing is normal after an extraction, but if the socket is bleeding freely, bite hard on gauze or a clean handkerchief for 20 minutes. If bleeding has not stopped, call your dentist.
  • If you smoke or rinse too soon after an extraction, you risk getting a dry socket. This can be very painful, and regular painkillers can be ineffective. Antibiotics will not solve this, and a dressing will be needed, which can be done by your dentist.
  • Bleeding from gums is not a dental emergency. Bleeding gums are usually due to gum disease, and will not stop until brushing improves. Brush 2x a day with fluoride toothpaste for 2 minutes, concentrating especially on the areas that are bleeding. Use floss or tepe brushes to clean between your teeth every day.

Painkillers

  • Anti-inflammatories (like ibuprofen) can help reduce sensitivity from teeth. Combining paracetamol and ibuprofen has also been shown to be effective.
  • There is currently no strong evidence that drugs like ibuprofen can make COVID-19 worse.
  • So until we have more information, take paracetamol to treat symptoms of coronavirus, unless your doctor has told you paracetamol is not suitable for you.
  • Painkillers should always be taken in accordance with instructions on the packet. Taking too many medications, or not taking them correctly, will not improve your symptoms, and can cause severe stomach and liver injury which can be life threatening.

Urgent dental treatment

  • Facial swelling extending to eye or neck.
  • Bleeding following an extraction that does not stop after 20 mins solid pressure with a gauze/clean handkerchief. A small amount of oozing is normal, just like if you had grazed your knee.
  • Bleeding due to trauma.
  • Tooth fallen out due to trauma.
  • Significant toothache preventing sleep, eating, associated with significant swelling, or fever that cannot be managed with painkillers.

Straight to A&E

  • Facial swelling affecting vision or breathing, preventing mouth opening more than 2 fingers width.
  • Trauma causing loss of consciousness, double vision or vomiting.

 

If you have any queries, or would like to speak to someone about a dental problem, please e-mail on [email protected]

Stay safe and health everyone. We look forward to seeing all our patients again once this pandemic is over.

 

Dr Sanaa Kader. 26/03/2020

Credit to Becky Davies for this information.