Are There Any Good Home Solutions for Sudden Dental Problems?

Posted by dentist3 in Dental Articles | 0 comments

Sudden toothache seen here
Sudden toothache seen here

Dental problems can happen when you can’t contact your dentist. What can you do in the moment?

Common problems are: a dental crown falling off, fillings break, a denture tooth falls off, pain, bleeding gum tissue, swelling or any combination of these events. 

Many dental crowns that fall off can be temporarily replaced using a denture adhesive as cement. Entire multiunit fixed bridges can fall off and may be simply repositioned without cement until you can see your dentist.

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For pain the best over the counter medication is ibuprofen, up to 800 mg to start, then 2 tabs every 4 hours but do not exceed the recommended dose. If the ibuprofen doesn’t work you may add 1000 mg of paracetamol (Panadol) 20 to 30 minutes after taking the ibuprofen. Paracetamol comes in 500mg and also 650 mg tablets.

PCM 500mg Capsules
PCM 500mg Capsules

These medications are good for a day or two after which the ibuprofen can cause stomach bleeding as does aspirin. After several days Paracetamol (PCM) can cause liver damage. 

If you are taking PCM, don’t drink alcohol. Alcohol also adversely affects the liver and will potentiate the harmful effects of PCM. Ibuprofen can also interfere with the effectiveness of many blood pressure medications.

So once again take ibuprofen only if PCM is inadequate and for only 24 hours. If you have a narcotic medication remaining from a previous episode you can take it as directed on the label. 

Again be careful if you are taking other medications that are depressants.
Common depressant drugs include Valium, Benadryl, and Xanax. It is a good idea to check with your medical doctor or pharmacist. 

In fact if you can’t contact your dentist, your medical dr will usually prescribe something appropriate for pain.

If you have swelling and pain you most likely have a dental infection. You can take an antibiotic that you have in the house. If possible consult with your dentist or if he is not available then consult with your family doctor. 

If neither your dr. or your dentist is available and you have some remaining penicillin then take one tablet every 4 to 6 hours or 1 tablet 4 times per day. Note the directions prescribed on the bottle. Taking 1 or 2 doses daily won’t help. 

After a few weeks the problem will come back. What other antibiotics are useful for dental infections? In order of effectiveness:

Clindamycin, Ciprofoxin, Tetracycline and Erythromycin (Zithromax).


Antibiotics do not cure dental infections. They will help until a dentist can remove the cause.

Be mindful that antibiotics can occasionally have serious side effects.


For example the Penicillin family of drugs can cause life threatening allergic reactions. If you take Penicillin and subsequently develop hives (allergic rashes) and difficulty breathing, call 999 or go to a hospital emergency room immediately.

Pharmacy

Antibiotics, especially if taken for many days, can cause persistent diarrhea and ulcerative colitis. In some cases a section of the colon will require resection to treat the ulceration. Clindamycin is the most common drug causing this problem. 

Stop the antibiotic if diarrhea occurs and call your doctor immediately. Solutions seen in the pharmacy can be of some help. Liquids containing eugenol can give some temporary relief if placed on a decayed tooth. Of course what you do depends on the type of pain you are having. 

If you are having pain that is constant and severe, you need immediate attention. Go to the Emergency of your local hospital.

What if you simply have sensitivity to cold affecting one tooth? If the sensitivity disappears seconds after the cold stimulus is removed then you probably have a problem called root sensitivity. This is caused by gum recession secondary to brushing too firmly with a hard brush.

Sensodyne Anti sensitivity toothpaste
Sensodyne Anti sensitivity toothpaste

A good temporary solution is the use of Sensodyne toothpaste. Used over a period of days, a chemical in the toothpaste renders the root less sensitive to cold. 

Obviously you should also avoid cold foods for a while. Generalized soreness or pain in the mouth with ulcerations is usually secondary to a viral infection. 

The most common virus involved is the herpes simplex virus. This virus causes cold sores. Denavir is a prescription medication that will make the ulcer resolve more quickly. Abreve is an over the counter medication which also speeds up the healing process. You may buy over the counter solutions or pastes containing Benzocaine for symptomatic relief. 

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Generalized bleeding from the gum tissue can be treated temporarily with very gentle cleaning and rinsing with a Chlorhexidiene mouth rinse or with Listerine. If you have severe bleeding from a local area such as between two teeth and the bleeding doesn’t stop within five minutes, what do you do?

Take a small piece of gauze, cotton or even a teabag and place direct pressure on the area. Tea contains tannic acid which is a mild hemostatic agent. The pressure should be maintained for at least 15 minutes. Do not rinse and spit.

If you rinse and spit after the bleeding stops you will dislodge the clot chat formed and the bleeding will recur. Avoid hot foods and beverages for at least 48 hours and don’t chew on the affected area. 

If you are taking a drug like warfarin and the bleeding recurs several times then consider going to the Emergency of the local hospital for help.

Restorative Dentistry. Should I have dental crowns done on my Teeth?

A crown can replace a large amount of tooth structure.
A crown can replace a large amount of tooth structure.

Teeth need to be restored when part of the tooth structure has been lost due to decay or fracture. The tooth may be restored in different ways depending on the amount of lost tooth structure, as well as the esthetic and biomechanical requirements. 

A filling is appropriate if a small amount of tooth structure is lost. When most of the tooth structure is lost then a cap, or crown as it is called in the profession, is required due to the mechanical requirements. 

In other words large fillings fall out or fracture because too little natural tooth structure remains to support and retain the filling material. 

Dental crowns are caps placed on top of damaged teeth. Crowns are used to protect, cover and restore the shape of your teeth when fillings don’t solve the problem. Dental crowns can be made out of metals, porcelain, resin and ceramics. They typically don’t require special care over time other than regular good oral hygiene.
Dental crowns are caps placed on top of damaged teeth. Crowns are used to protect, cover and restore the shape of your teeth when fillings don’t solve the problem. Dental crowns can be made out of metals, porcelain, resin and ceramics. They typically don’t require special care over time other than regular good oral hygiene.

A crown can replace a large amount of tooth structure. The crown is retained by preparing the remaining tooth with nearly parallel walls of tooth structure so that friction is created when the crown or cap is cemented to the tooth. 

The cement acts as a seal to prevent the ingress of bacteria around the periphery. The cement also adds to the retention of the crown. Crowns will sometimes fall off because there was too little tooth structure remaining to provide adequate frictional resistance to retain the crown. 

Fillings will fracture for the same reasons, too little tooth structure remaining or too large a filling. There are several materials used to fabricate fillings. The common filling materials are: composite resins, glass ionomers, resin ionomers, ceramics (all of the previous four are white fillings), silver amalgam and gold. 

Gold is being used less frequently because of its higher cost and unacceptable color in our culture. Silver amalgam is being used less frequently because of the esthetic requirements of some patients and because of concerns regarding the systemic toxicity of mercury in amalgam. 

The Malaysian Ministry of Health has reviewed the available evidence on this issue and has stated that silver amalgam restorations are not a health hazard. 

silver amalgam restorations are not a health hazard. 
silver amalgam restorations are not a health hazard. 

Therefore removing silver amalgam fillings and replacing them with white fillings is not required for health reasons. You may find more information on this issue and other dental care issues at www.ada.org which is the website of the American Dental Association. 

Many patients and dentists now prefer white fillings because of the more natural appearance. In some situations the white filling is more resistant to fracture. Caps or crowns are made from: porcelain (a ceramic material) fused to metal, porcelain alone, composite resins and Zirconia. 

The type of material used is determined by the esthetic and biomechanical requirements of each situation. The dentist will help you to make the appropriate choice. Missing teeth can be replaced in several different ways. 

One or more teeth may be replaced by a fixed prosthesis or bridge supported by teeth. A removable denture may be used to replace several teeth and is supported by attaching clasps to the remaining teeth. 

A complete denture can be used to replace teeth when all of the natural teeth have been lost. The complete denture is held in by adhesion to the underlying gum tissue. The saliva between the gum tissue and the acrylic denture base creates some retention in the upper arch but less retention is present in the lower arch. 

Dental implants may be used to support a single crown, many crowns or a full or partial denture. 

The porcelain veneer or laminate is a unique restoration used to enhance dental esthetics. The veneer is usually made by the dental technician but can be made by the dentist. Minimal surface preparation of the tooth is followed by bonding of the veneer (as thin as an egg shell) to the facial surface of one or more front teeth. 

Veneers are used to correct unsightly color and shape problems. Advantages of the veneer compared to a dental crown are: perfect transmission of light resulting in an excellent esthetic result, minor tooth preparation, and no impingement on the gum issue. The disadvantages are: fragility and useful only for teeth in good condition except for color or shape issues. 

All of the restorations described in the previous paragraphs are provided by the general or restorative dentist. Sometimes a patient with complex restorative needs will be referred to a Prosthodontist who has special training to help satisfy those needs.

Cost is determined by the materials used and the number of teeth being restored. For example a composite filling may cost RM 300. A ceramic inlay may cost RM 800. The cost of a dental crown may be RM 1300. The charge for fixed bridges is typically RM 1000 per unit. 

For example it may be necessary to use 4 natural teeth to support a fixed bridge used to replace 4 missing front teeth. In this case 4 caps and 4 pontics (replaced missing teeth are called pontics), total 8 units and may cost RM 1000 per unit for a total of RM 8000. 

Partial Flexible Dentures
Partial Flexible Dentures

A removable partial denture or full denture may cost RM1500. An implant supported restoration, that is the abutment post and cap supported by the implant, may cost RM 8500 per unit. Porcelain veneers or laminates cost about RM1000 per unit. 

Typical problems occurring after placement of multiple restorations are: discomfort in a tooth, irritation of the surrounding gum tissue, discomfort when biting and unacceptable esthetics. 

For these reasons it is a good idea to have large restorations cemented temporarily. 

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By doing this temporary cementation one can have problems corrected more casily. For example, endodontic treatment can be done without making a hole in the new bridge. A painful gum problem can be corrected easily by removing the bridge and reshaping part of the bridge that may have been impinging on the gum tissue. 

Esthetic problems can be corrected by returning the bridge to the dental laboratory to change the color of the porcelain. Once the bridge is permanently cemented it cannot be removed without destroying it. After several weeks of symptom free wear the bridge must be permanently cemented to prevent bacteria from causing new decay. 

Most general dentists spend most of their clinical time doing restorative dentistry. 

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