Advice On Dental Emergencies during COVID 19

In our short guide, we will give you some tips on how to look after your dental health while you are "self-isolating" and reasons why this is really important for your general health Please note: Our practice is currently temporarily closed ( April 2020 ) but will continue to provide a telephone Dental Emergency Service and On-Line Dental Consultations. This is in accordance with guidelines from the Department of Health and the British Dental Association to protect the safety and wellbeing of everyone. If you think you have symptoms of Coronavirus please ensure you let us know when you call. Please call 111 NHS helpline only if our Practice's online and telephone emergency cover does not improve your condition.

GUM DISEASE

Keeping your teeth and gums healthy is always important for your health in general but at a time like this, it can be vital.

"Gum disease" has been linked to a variety of other health problems, including:

heart disease and heart attacks

· diabetes and its control

l· stroke

· rheumatoid arthritis

· Stress

· At time's of increased stress, neglected dental hygiene and general health, we can become much more vulnerable to the effects of the bacteria responsible for causing gum inflammation ....and Covid -19.

For those who have suffered with cardio-vascular issues, the long term effects of poorly controlled gum health may also put you in a HIGHLY vulnerable group with regards to your reaction to COVID -19.

For Diabetics, bleeding and inflamed/infected gums can have a negative effect on diabetics who may find their blood sugar becomes less well controlled. This may have a serious impact on your susceptibility and ability to fight the effects bacterial or viral infections like COVID -19.

You can reduce your susceptibility to a degree by being mindful of your stress levels and using a whatever technique suits you to manage this. But also by simply LOOKING AFTER YOURSELF and by following our top tips you will give yourself a better chance of staying well.

Painful or bleeding gums

Painful or bleeding gums isn't a dental emergency and is usually caused by gum disease. It can be stopped by improving your overall oral health. Make sure you clean in between your teeth with floss or interdental brushes and follow up with a thorough toothbrush clean twice a day with a fluoride toothpaste.

How to manage pain from gums while self-isolating?

If there is bacteria or food debris trapped between the gum and the tooth, this can cause pain.

This can also happen around a partially errupted wisdom tooth.

Clean the area

· Thoroughly clean the area with floss or a te-pe interdental brush . You could put corsodyl gel onto the brush to help clean the area. Rinse thoroughly

· Rinsing thoroughly with Corsodyl mouthwash can help (but Corsodyl will stain your teeth so we don't recommend this for long term use).

Tooth sensitivity

If you have an extremely sensitive tooth and are in discomfort, again as with toothache, we would recommend that you avoid any foods which are either very hot or cold, like ice cream or hot drinks, as well as any foods which are acidic or sugary. These can aggravate sensitive teeth.

Continue to floss and brush your teeth as thoroughly as you can and rub sensitive toothpaste, such as Sensodyne or Colgate Prorelief, directly onto the affected area. You can use normal toothpaste if you don't have a sensitive one.

Painful Tooth

The most common dental problem people typically face is toothache. If you're experiencing dental pain, we recommend you follow this advice:

• Avoid extremes of temperature, such as hot drinks or very cold foods like ice cream
• Avoid sugary or acidic foods, especially sweets or fizzy drinks, even diet ones, as these can aggravate the pain
• Take over-the-counter painkillers such as paracetamol
• Use an over-the-counter anaesthetic gel, for example, Orajel, which you can buy in a pharmacy, to help relieve the pain
• Continue to brush and floss your teeth as thoroughly as possible, and rub toothpaste directly onto the sore tooth or area
• Massage the gum around the tooth to help ease pain
• Use cloves or cotton wool to place clove oil over the painful tooth or area of the mouth. You can buy cloves in supermarkets
• Keep your head elevated at night. Lying down can increase blood pressure in the tooth and cause pain
• Keep the area cold by using a cool pack or frozen vegetables wrapped in a towel. Apply this to your cheek. Don't apply ice directly to the tooth as this can increase pain and damage the tissues.

If your toothache is causing you excruciating pain, a loss of sleep and the above steps haven't helped, please call our emergency out of hours no at 07973 568 038 or 111 NHS helpline.

Wisdom tooth pain

Wisdom tooth pain is another common dental problem which you can usually help relieve at home. We recommend you:

• Rinse your mouth with warm saltwater as often as you can
• Buy some mouthwash suitable for gum problems, such as Corsodyl or Peroxyl, from your local pharmacy if you can
• Take over-the-counter painkillers such as paracetamol to help ease the pain
• Continue to clean your wisdom teeth thoroughly, even if it's painful to do so
• Keep the area cold by using a cool pack or frozen vegetables wrapped in a towel

If your wisdom tooth causes any swelling, difficulty opening your mouth or difficulty swallowing, please call our emergency out of hours number at 07973 568 038 who can provide you with further advice.

Pain/bleeding after a tooth extraction

If you've recently had a dental extraction, it's normal to experience some pain, especially in the three or four days. It's vital to:

• Keep the area clean to speed up the healing process
• Follow the instructions given to you by your dentist or hospital following the extraction
• Use over-the-counter painkillers and Difflam mouthwash to ease pain
• Rinse your mouth with warm salty water once it's safe to do so (follow the advice given to you post-extraction)
• Make sure you don't smoke for at least 48 hours following an extraction

It's also normal to experience some blood in your spit or oozing from the site of the extraction. If the socket is bleeding freely, bite down hard on a clean hankie or a gauze if you have one for 20 minutes. If the bleeding hasn't stopped, call our practice as soon as possible.

Sharp pain when biting

If you're experiencing a sharp pain when biting down, avoid hard foods such as nuts or sweets. You should also avoid foods which require a lot of chewing such as baguettes or tough meats. Try to use the other side of your mouth for chewing where you can.

Take over-the-counter painkillers such as paracetamol to help relieve the pain if you need to.

Sharp pain when biting down could be caused by tooth decay, a loose filling or a crack in your tooth. It might also mean there's damage to the pulp tissue inside your tooth, which could require treatment, such as a root canal.

If you experience sharp pain when biting, you should book an appointment with your dentist when they reopen.

Orthodontic pain or problems

Most orthodontic problems, such as wires digging in your gum, or pain from your braces rubbing, can be dealt at home. Please contact the practice for further advice.

If wires from your braces are digging in, it might be possible for you or a family member to use tweezers to replace the wire in the tube/band or use a nail clipper or scissors to shorten the long end.

• For thin wires: It may be that a thin wire is the correct size but may have rotated around the teeth so that it's short on one side and long on the other. Using tweezers, a pencil with a rubber on the end or a teaspoon, it may be possible to push the wire back round to prevent the long end digging in.
• For thick wires: If the wire is very thick and stiff it may not be possible to cut the wire with home instruments. If this is the case, it may be necessary to cover the wire to prevent it from digging in. The best thing to use is orthodontic wax, which you can buy online, or we can send to you if necessary. Failing that, using a wax covering from hard cheese such as a Babybel, using Blu-Tack or even chewing gum may help.

Facial swelling

You should contact your dentist if you have any kind of facial swelling. If the swelling is minor, your dentist may be able to prescribe you antibiotics over the phone. You can also:

• Use a cold compress or frozen vegetables wrapped in a towel to bring down the swelling
• Rinse your mouth with warm saltwater repeatedly until the swelling comes down

If the above doesn't bring down the swelling or it extends up to the eye, along your mouth, or down your neck, contact your dentist urgently.

If the swelling reaches the eye area and affects your vision or your breathing or prevents you from swallowing go to the nearest A &E as soon as possible.

Mouth ulcers

Mouth ulcers can usually be treated at home and should heal after 10 days. If you have a mouth ulcer and want to relieve pain, you should:

• Clean the area with warm saltwater as much as possible
• Take over-the-counter painkillers such as paracetamol to relieve pain
• Use mouthwash, Corosdyl and Difflam are good examples, which you can buy from your local pharmacy, to help reduce the ulcer
• Use mouth ulcer relief gel such as Bonjela or Iglu, which you can buy from the supermarket or pharmacies
• Use cloves or cotton wool to apply clove oil to the ulcer, which can help with temporary pain relief

If the ulcer hasn't healed after two weeks, it could be a sign of something more serious. Contact the practice immediately.

For further help and advice

If you have pain which isn't referenced in this article and is affecting your ability to sleep or concentrate, please get in touch with your local dentist. If you don't have a dentist, or your practice is closed due to COVID-19 please call the practice or our out of hours emergency number at 07973 568 038 If you can manage your pain at home, we'd still encourage you to visit our practice to get checked out once it reopens for routine dental care.

The health, wellbeing and safety of our patients, their families and our people remain our top priority at Barkingside Dental Care. We'd like to thank our patients for their understanding during the COVID-19 situation.

Once it is safe for our practices to re-open, we encourage you to get in touch and book an appointment.