The current mandate in Texas requires dental practices to cease any non-essential dental procedures until April 22, 2020. Dentists are allowed and urged to provide emergency care to patients “in pain and/or suffering from infection/abscess”. This urgent dental care will prevent unnecessary trips to the emergency room or urgent care medical facilities. In our previous blog, we explained how we at Prosper Family Dentistry are continuing to provide care for our patients. Here we will explain just who needs that urgent dental care.
Life Threatening Dental Problems
While they are rare, there are certain dental infections that are truly life threatening. We typically divide dental infections into two categories: 1) endodontic, which means that the source of the infection is inside the tooth, and 2) periodontal, which means the source of the infection is around the tooth. Determining which category the infection falls into is an important part of the diagnosis and treatment of the infection.
For your purposes, though, you do not need to discern the source of the infection as much as you need to recognize the result of the infection. Both endodontic and periodontal dental infections carry the risk of spreading. The initial spread for both types is into the surrounding jawbone. They are not limited to the jawbone, though. Without intervention, it is possible for these infections to spread into the tissues surrounding the airway, bloodstream or brain. That’s where the serious danger lies.
Swelling > Pain
While pain is an important indicator of a dental problem, it is not the most important symptom in a true dental emergency. Because the biggest danger lies in a spreading infection, we are far more concerned with swelling than with pain. The reason we stress the importance of this is that it is possible to have a dangerous dental infection with swelling and with NO PAIN. When people assume that pain is the only thing that matters, they could miss the signs of the infection spreading.
Pain is often the result of an increase in pressure. The reason a toothache hurts so severely is that the nerve and blood vessel tissue within the tooth experience inflammation but have no place to swell, since they are confined within the hard tooth structure. The inflammation leads to an increase in pressure because it brings additional blood flow and cells into the tiny space within the tooth.
Once an infection spreads into the jawbone and the soft tissue surrounding it, the tissue allows swelling rather than confining the infection to a small space. Often the infection will “drain” by breaking through the gum tissue in a small fistula (often called a gumboil) that releases pus. These situations actually cause relatively little pain because there is no buildup of pressure.
When in doubt, it is best to assume that swelling = spreading.
How to Handle a Dental Emergency
The first step is to call our office immediately at 972-347-1145. If it is after hours, follow the instructions on the voicemail to reach our on-call dentists. (Either Dr. Jill or Dr. Cara will call you back. We are not out-sourcing at this time.) Please take photos showing the area of concern and any visible swelling, and be ready to text these images to the on-call dentist.
During this consultation, we will determine the need for an in-person visit and schedule it as needed. If prescription antibiotics are necessary, we will call those in as quickly as possible. For any treatment required to stop the progression of an urgent dental problem, we will schedule your time to be in the office in accordance with strict social distancing standards and the highest level of infection control protocols.
Your overall health is our ultimate priority. When a dental emergency puts your health at a higher risk than the current COVID-19 pandemic, we are here for you.
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