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Current Scottish Government guidelines are to excercise social distancing and to only allow telephone advice to be given by your dentist. Your dentist may advise painkillers and/or antibiotics to help manage your problem. In urgent situations you may be asked to attend a health board site for treatment.

This is not how dentists would normally provide care for you, however due to the situation and the strict need for social distancing, it is a compromise we must all accept meantime. This guide contains some useful hints and tips to help manage common dental problems. (We do not recommend any specific brands and brands other than those pictured in this guide are available)

Maintain Good Habits

It is important to brush your teeth 2 times daily for 2 minutes with a toothpaste that contains fluoride. During lockdown it easy to snack more often but it is best to avoid sugary snacks between meals, as this can increase the chances of tooth decay. Useful tips can be found by visiting: www.child-smile.org.uk. This was developed with children in mind but the information can be used for all of the family.

Problems

Toothache

If there is decay in a tooth and it is extremely sensitive to hot or cold, then antibiotics are unlikely to help.

Good cleaning with a fluoride toothpaste and reducing sugar intake will help stop the decay from getting worse.

Once services return to normal your dentist can remove the decay and place a filling.

Wisdom Teeth

Wisdom tooth pain is usually due to inflammation of the gum around the tooth. This can be made worse by biting from the top tooth.

Most flare-ups can be managed with simple measures and should improve within a few days to a week:

  • Take painkillers
  • Mouthwash with chlorhexidine or warm salty water
  • A soft diet (to reduce trauma from biting) – Brush the area gently with a small-headed toothbrush (even if it is painful) as good oral hygiene will help it heal faster

Contact your dentist if you have any of the following, as you may need a course of antibiotics:

  • Swelling in your face or cheek – Difficulty swallowing
  • Difficulty opening your mouth

Pain After Extraction

Pain after an extraction is common for several days, but can usually be well controlled with pain killers.

If you smoke or rinse too soon after an extraction then there is a risk of dry socket. This is when the blood clot in the extraction socket comes away. This can be very painful and antibiotics do not help with this.

If this occurs you can gently rinse using warm salty mouthwashes to help soothe the area and continue taking pain killers until the pain settles, which can be up to 2 weeks.

Bleeding after tooth extraction

Slight bleeding can occur for a day or so following tooth extraction. This often seems worse than it really is, as the blood mixes with saliva. This will appear pink when you spit out.

If there is continued bleeding then:

  • Gently rinse with warm water to remove excess blood
  • Place a rolled-up piece of cotton or gauze over the socket and bite firmly to maintain continuous pressure for 20 mins before checking if the bleeding has stopped
  • Repeat this once if necessary
  • If bleeding does not stop then contact your dentist

Ulcers

Ulcers can be very painful but most will heal within a week or so. If you have an ulcer that has been present for 3 weeks or more then contact your dentist so that this can be checked.

Self Help

  • Mouthwash with warm salty water or chlorhexidine (chlorhexidine is not suitable for children under 7 years)
  • Take pain killers
  • Use pain-killing mouthwash or spray, which can be purchased from supermarket or pharmacies (eg Difflam spray)
  • Soft diet to prevent further trauma

Rubbing Denture

If there are sharp edges this can be smoothed with sand paper or a nail file. Denture fixative can be used to help secure a denture to avoid rubbing. Leave the denture out as much as possible until the ulcer heals.

Trauma

If you hurt your face or head then:

  • Rinse the area gently with warm water or a mild antiseptic
  • Remove any foreign objects from the mouth – Apply ice packs
  • Apply pressure with a finger to stop bleeding

You should contact your dentist or go to A&E if:

  • Loss of consciousness or blurred/double vision or vomiting
  • Significant facial trauma
  • There is significant bleeding that will not stop after 15 – 30 mins
  • If you think you have inhaled a broken tooth

If you have any doubts then contact your dentist.

If a tooth has been knocked out

Only do the below if it is one of the front 6 teeth (top or bottom)

  • Hold the tooth by the biting edge and avoid touching the root
  • If the root is dirty then rinse it for a few seconds under cold water – If possible put the tooth back in the gum socket it came from and gently bite on a tissue to hold it in place
  • If this is not possible then store the tooth in a container with milk

If a baby tooth has been knocked out or moved out of place without affecting the bite – Then a soft diet and painkillers is all that is needed.

If an adult tooth is fractured:

  • If it is small then you can use some sensitive toothpaste and or use a temporary filling kit to fill bigger cracks.
  • If there is a large crack and there is considerable pain then you may need to be seen for treatment. Please note that it is likely that only an extraction will be offered for premolar and molar teeth at this time.

Crown/cap out

Clean the crown/cap and tooth. If the crown appears mostly hollow then it may be possible to re-cement it:

  • Check the crown/cap fits without cement and make sure the bite feels normal
  • Use a dental cement or a denture fixative that you can buy from a pharmacy or supermarket
  • Do not use super glue
  • Practice placing the crown/cap a few times before using the cement/fixative.
  • Place the crown/cap and press firmly with your fingers and then bite firmly to make sure it is fully seated
  • Remove the extra cement/fixative with floss or a toothpick This is unlikely to work for veneers

Orthodontic problems

On Youtube search for “British Orthodontic Society” and you can find a number of video tutorials on how to deal with common problems with braces.

Bleeding gums

Brush 2 time daily with fluoride toothpaste for 2 minutes. Concentrate on areas that you get bleeding from. Chlorhexidine mouthwash can help in the short term but prolonged use can stain your teeth.

If the gums are very painful and this does not improve then you may need to contact your dentist.