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The crown is the largest, most visible part of the tooth.  In most cases, the crown is the part of the tooth that sustains trauma. The pediatric dentist can readily assess the severity of the fracture using dental X-rays, but any change in tooth color (for example, pinkish or yellowish tinges inside the tooth) is an emergency warning sign.  Minor crown fractures often warrant the application of dental composite, whereas more severe crown fractures sometimes require pulp treatments county .

If you notice that you have an abscess around your tooth, it is important to contact our Toronto dentist or the closest emergency dentist to you immediately. Seek emergency dental treatment if your temperature spikes along with pain in your mouth. It is possible you have an infection you urgently need your dentist to examine and treat. These are serious problems that can lead to systemic illness or even death.

If a tooth has been knocked-out of the child’s mouth completely, it is important to contact the pediatric dentist immediately.  In general, pediatric dentists do not attempt to reimplant avulsed primary (baby) teeth, because the reimplantation procedure itself can cause damage to the tooth bud, and thereby damage the emerging permanent tooth.

Brackets and ties that poke: When teeth move, the wires connecting them can start to poke at your cheeks. Use a pencil eraser, cotton swab or tweezers to try and reposition that stubborn wire. If that doesn’t work, use a sterilized nail clipper to cut the end off if possible. You can always use a bit of wax to relieve irritation.

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Immediate management includes a chair side repair of the fractured veneer with composite material. Bonding composite to the exposed metal will involve achieving macro mechanical retention by making grooves and notches or abrading the surface. Bonding material back onto exposed porcelain involves abrading, hydrofluoric acid etching and silanating then followed by a conventional bonding procedure. Composite patch will remain a temporary solution as the longevity of composite restorations is not predictable as well as the colour of composite is not as stable as porcelain for aesthetical reasons.[2]

Some define a dental emergency in terms of the individual's willingness to attend for emergency dental treatment at any time at short notice, stating that persons who are fussy about when they are available for treatment are not true emergency cases.[1]: 702

Management includes cleaning all the residues and cement, to carefully inspect for any underlying caries or fractures. Details that need to be assessed include contact, margins and gingivae points occlusion needs to be checked in both ICP and in lateral and protrusive excursions, before the crown can be re-cemented. Stronger cement should be used than the original such as resin cements, especially in cases of heavy occlusal forces.

If the child has received trauma to the head, proceed immediately to the Emergency Room.  Even if consciousness has not been lost, it is important for pediatric doctors to rule out delayed concussion and internal bleeding.

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Most orthodontic problems are not considered serious enough to warrant an emergency phone call. Sure, they may still be painful or cause irritation. In these cases, though, you should take over the counter medications and apply compresses for comfort until normal business hours. Check out these common orthodontic problems and how you can relieve pain in the home setting:

Toothache is common in children of all ages and rarely occurs without cause.   If pain persists, contact the pediatric dentist.  Some common causes of toothache include: tooth fractures, tooth decay, tooth trauma, and wisdom teeth eruption (adolescence).

The factors that are taken into consideration in making this decision include the strength of the temporary crown to be placed and occlusal forces. Thus, a thorough occlusal examination is of paramount importance, strength of the cement, a strong alternative of cement should be considered. The occlusion assessment should also include the functional and static occlusion as well as the possible presence of Para functional habits, such as clenching or bruxism.

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If you are still unclear about what to do when this type of situation arises, call your dentist and speak to a member of the team about your options. Unless you are registered with 24-hour clinic, but it’s common practice to offer contact details and helpful information via an answering machine, in case patients need assistance out of office hours, as is the case with a lot of dental emergencies it’s unlikely that there will be anyone at the surgery to assist you in person if it is not during regular operating hours.

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It’s important that you are clear with whoever you speak to about your problem, so that they know exactly what your condition is and how urgently you need an appointment – this helps them assess the situation and prepare for your arrival if you need to make your way to the surgery at short notice. It should be obvious that attempting any kind of dental treatment on yourself at this time is a very bad idea, although you may be surprised how many people would rather try an extraction by themselves than try and arrange an appointment in the early hours of the morning. This sort of behaviour will only cause you more pain and possibly exacerbate the problem further.

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After an accident, you may be in the position to save a tooth that is endangered by the trauma. Always ask yourself if you are in any more danger of losing the tooth than you were before the incident. Then, consider whether seeing a dentist now can make a difference. You might not know the answers to these questions, but asking them can help you look at the situation logically. If the tooth will likely be lost, see the dentist within 30 minutes of the trauma to avoid losing a tooth.

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