Dental emergency in Ambernath East

The single most time-critical thing in dentistry. Aim to be with us inside the hour.

• Pick it up by the crown, the part you chew with. Never touch the root.
• Do not scrub it, do not use soap, and do not wrap it in tissue.
• If it is dirty, rinse it briefly in milk or in the patient's own saliva.
• If you can, push it gently back into the socket the right way round and bite on a clean cloth to hold it.
• If you cannot, keep it in a cup of milk. Milk, not water: water destroys the surface cells that let it reattach.

Never try to reseat a child's baby tooth. Pushing it back can damage the permanent tooth forming above it. Bring the child in, bring the tooth, and leave it out.

The aim is to get through the next few hours without making it worse.

• Take whatever painkiller you would normally take for pain, at the dose on the packet.
• Rinse gently with warm salty water.
• Sleep with your head propped higher than usual. Lying flat increases the pressure and the throbbing with it.
• Avoid very hot, very cold and very sweet things on that side.

Never hold an aspirin against the gum. It burns the tissue and adds a chemical ulcer to the problem you already have.

Swelling means an infection has left the tooth and is now in the surrounding tissue. This is the one to act on today.

• Message or call now rather than waiting to see if it settles overnight.
• Keep your head raised, including while sleeping.
• Do not apply heat to the outside of the face. It encourages the infection to spread.
• Do not try to burst it.

If the swelling starts to close your eye, reaches your neck, or you begin to have trouble swallowing or breathing, stop and go to a hospital.

Some oozing for a few hours is normal. Bleeding that genuinely will not stop is not.

• Roll clean gauze or a clean cotton handkerchief into a firm pad, place it over the socket and bite down hard.
• Hold it for a full 20 minutes without lifting it to check. Checking is what restarts it.
• Do not rinse, spit, smoke or use a straw for the rest of the day.
• Stay upright and avoid anything strenuous.

If it is still soaking through after two full 20 minute attempts, call us, and go to a hospital if you cannot reach us.

Whether it needs treating tonight depends on how deep the break goes, which is not something you can judge from the outside.

• Keep any fragment in milk and bring it with you.
• Rinse your mouth with warm water.
• Cover a sharp edge with sugar-free chewing gum so it stops cutting your tongue.
• Chew on the other side until you are seen.

A pink or red dot in the middle of the broken surface means the nerve is exposed. That one needs to be seen the same day.

Usually uncomfortable rather than urgent, but the tooth underneath is now unprotected.

• Keep the crown. It can often be recemented, which is a much shorter appointment than remaking it.
• Rinse it and keep it somewhere safe rather than in a pocket.
• Avoid chewing on that side.
• Sensitivity to cold on the bare tooth is expected and is not, on its own, a reason to panic.

Never glue it back with household adhesive. It is not safe in the mouth and it usually means the crown cannot be reused.