Welcome to the emergency dentistry section of our website. Here you will find a lot of information and advice on what to do in a dental emergency. For most people, toothache can arise at any time and it is important to be prepared when it occurs in order to minimize unnecessary stress and anxiety.
Emergency dentistry has evolved in the past few years with the advent of more modern techniques such as rotary root canal treatment and reliable dental bonding. The days of having tooth extractions whenever dental pain started are over and patients now have more options for saving their teeth.
Occasional and temporary toothache or tooth sensitivity is usually caused by bacteria damaging the enamel and dentine of the tooth. In such a circumstance the tooth can become very sensitive to cold or sweet things. This is called reversible pulpitis and it can be treated with a white filling or an inlay or an onlay. Delaying treatment at this point will lead to the decay extending further into the tooth as times goes on and will result in irreversible pulpitis in future.
Constant toothache is usually caused by bacteria infiltrating deeper into the tooth and into the pulp of the tooth and irreversibly damaging the nerve tissues there and causing inflammation of the pulp. This can cause constant throbbing pain or a dull pain that can remain even despite the patient taking many different painkillers. This is called irreversible pulpitis and the treatment for this condition is either root canal treatment or tooth extraction. Unfortunately antibiotics and painkillers are unlikely to be much help at this point and the tooth will need urgent dentist treatment. Root canal treatment is a very technique sensitive procedure and needs to be carried out very carefully by an experienced dentist using rubber dam, apex locators, multiple cleaning agents and rotary instruments. Our clinic is equipped with this equipment to ensure the success of your root canal treatment.
If a posterior molar tooth fractures as a result of hard stimuli such as a hard piece of bread or meat, then the patient can suffer from cracked tooth syndrome. This can be very painful for patients to bite on a tooth and it will require the cracked cusp to be removed by the dentist. Once the cracked cusp is removed, depending on the severity of the fracture the tooth may need a dental crown. Crowns act like a cap and prevent the tooth from fracturing further. There are many different types of dental crowns such as all Zirconium crowns, all Ceramic crowns, metal ceramic crowns and gold crowns. We will discuss the various types of crowns available with you and allow you to choose a crown that fits your circumstances.
If an anterior incisor tooth fractures, perhaps as a result of dental trauma caused by an accident or an assault, then the incisor tooth can be built up again. This can be done with composite bonding or a porcelain veneer. Composite bonding does not look as good as porcelain veneers and stains more easily but it does not involve any tooth shaving and that is a big advantage as it prevents further damage to a tooth that has been recently traumatized.
Our emergency dentists also treat patients who suffer from teeth that have been pushed in or pushed out or even completely knocked out during an accident or an assault. In these situations, urgency is needed to prevent further permanent damage to the tooth. If you have been involved in a situation where severe damage has occurred to your teeth, you must call the emergency dentist immediately and arrange an urgent appointment with our dentists for your tooth to be looked at and treated urgently. When booking the appointment, please let the operator know if you have been involved in an accident so that your treatment can be expedited.
If a tooth fractures severely or decays to a point where it can no longer be saved and has to be removed or is simply missing, then we offer the options of having a same day denture or a dental bridge or a dental implant to replace that tooth. If your tooth has suffered severe damage, please call our team for that tooth to be assessed and all the treatment options discussed with you. We would never assume that one solution will fit all cases and will discuss with you all the options for replacing a tooth or multiple teeth.
Toothache can also be occasionally be caused by gum disease also known as Periodontitis. Gum disease is a silent disease that causes bone loss, gum recession, bleeding, tooth mobility, tooth abscess and sometimes with the patient being unaware of the problem until the disease is in advanced stages. Our emergency dentist will diagnose any undetected gum disease and treat the acute problem on the first visit. The dentist will then refer you to our gum specialists for expert continuous care of your gums in order to prevent further recurrence of gum disease.
Patients who have restorations such as dental veneers, Lumineers, crowns, bridges and dentures may be unaware that from time to time these restorations may fracture, become loose, debond or fail. This can occur at an awkward time and be a source of embarrassment for the patient. If any restoration fractures or becomes loose please call our practice and we will do what we can to repair or replace the restoration at the emergency visit. Some restorations such as dentures and veneers can be repaired but others such as dental crowns may need remaking depending on severity of the problem. If a restoration becomes loose as long as it still fits the tooth well, it can usually be recemented at the emergency visit.
It is worth knowing that root canal treatment can fail and a dental abscess can arise if the failed root canal is left to get worst. Occasionally if a failed root canal is left for a long time, it can get even worst and a dental cyst can arise. Patients are sometimes surprised when they get dental pain from a tooth that has been root filled. Root canal success is in the region of 70-80% but it is not 100%. If toothache arises from a previously root filled tooth then our emergency dentist will give you the options of either to redo the root canal treatment or have the tooth removed. This can be a difficult decision as most people don’t wish to lose their teeth but sometimes if there is not much left of the tooth or a large cyst has developed around the tooth, tooth extraction maybe the better long term solution. Dental implants with a success rate of over 95% and therefore offer a far better success rate than redoing root canal treatment and may offer a better solution for a failed tooth.
Patients undergoing orthodontic treatment with braces or Invsialign may suffer from a broken wire or lost Invisalign attachments. A broken orthodontic wire can rip into the soft tissues of the cheek and the tongue and cause extensive damage, bleeding and pain. In these cases its best to go to see the orthodontist who is carrying out your brace treatment but if their office is closed for the night or the weekend, you can call our emergency dentist on-call and arrange a same day emergency appointment. We will cover up the offending sharp brace wire and refer you back to your orthodontist for continuation of your orthodontic care.
Many people in their late teens and early twenties suffer from wisdom tooth pain which can arise at times of stress or when the body has been weakened by a cold or flu. Wisdom tooth extractions are usually complex due to the proximity of these teeth to important nerves and sinus’s. If you do suffer from a troublesome wisdom tooth, rest assured that our oral surgeons are available seven days a week to remove even the most difficult wisdom tooth under IV sedation or local anaesthetic.
Many patients suffer from dental phobia and are anxious of dentistry mainly due to difficult past dental experiences. For these patients putting off dental treatment leads to more dental disease spreading and becoming worst over time. We offer Intra venous sedation 365 days a year for all nervous patients to reduce their anxiety and make their dental treatment a more pleasant one. IV sedation is also called conscious sedation has become very popular and is very safe and can be used for any dental treatment. For safety reasons, patients who wish to have IV sedation must ensure that they have an escort to escort them home after IV sedation.
All of our patients are provided with a written treatment plan and a consent form outlining the costs, risks and alternative treatment before any emergency treatment commences. When you are seen for an emergency visit, you have the option to come back to see us for the rest of your dental treatment or go back to see your own dentist for the continuation of your dental treatment. If you decide to go back to your dentist, we can email your own dentist, your X-rays and notes should you wish so that he/she becomes aware of the emergency treatment that you have had and can continue your dental care.
Toothache and dental emergencies have a tendency to occur at any time but especially at night time or on holidays and weekends. Our emergency dentists are available 24 hours a day and 365 days a year even on weekends, Christmas day, new year’s day and bank holidays and they can be contacted by calling the dental emergency line on 0208 547 9997 at any time.