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Emergency
Visit During Normal Business Hours
Dental Emergencies Not During Normal Business Hours
Teeth Injuries |
Chipped Teeth |
Toothache
Maxillary Frenum Tear – Torn Gum between 2 Top Front Teeth
Cut or Bitten Tongue,
Lip or Cheek
The Specialty
Consultation Visit
Emergency
Visit During Normal Business Hours
For a true dental emergency, we will use our best efforts to treat
your child in a timely manner. Emergencies are assessed over the
phone to determine if the patient needs to be seen immediately or
can wait until later that day or the next business day. If seen, it
will be decided what the next step and the best course of treatment
will be for your child. Please contact us if you have any dental
concerns.
Dental
Emergencies Not During Normal Business Hours
If your child falls and hurts their mouth you must try to assess the
situation. If they have lost consciousness they must immediately go
to the emergency room or you must call 911.
Pediatric Dentists will only treat oral injuries so check their
teeth, mouth and lips. Any other facial injuries should be seen by
the emergency room, their pediatrician, or plastic surgeon if
stitches and cosmetic results are a concern. You will be asked about
their medical history and vaccination status.
In the event of a dental emergency see the list below. We make every
effort to always have someone on call. For patients of record,
please contact the office at 410-771-8200 and listen to the message
on the answering machine for instructions on how to contact the
dentist on call.
Teeth
Injuries:
Avulsion – Knocking Out an Entire Tooth
If a permanent tooth is knocked out completely – FIND THE TOOTH! Be
sure to hold it by the crown -- not the root. You may lightly rinse
the tooth but DO NOT clean, scrub or handle the root. Inspect the
tooth for fractures. If it is in good shape, try to reinsert it into
the socket. Have the child keep the tooth in place by biting on a
piece of gauze or a clean washcloth. If you cannot reinsert the
tooth, transport the tooth in any kind of milk or the child’s
saliva. The child must see a dentist IMMEDIATELY! Time is a critical
factor in saving this tooth.
If a baby tooth is broken through the nerve call our office. If it
is knocked out completely, stop the bleeding with pressure and call
our office on the next business day.
Any other chips and bumps to the teeth may or may not need to wait
until the next business day. Use your best judgment and call our
office if you have any concerns.
Chipped
Teeth:
All Teeth can be chipped – both baby teeth and permanent teeth. They
can be chipped into the first layer of tooth structure – the enamel,
the second layer – the dentin, or the third layer – the pulp or the
nerve. The depth will determine the seriousness of the trauma.
Examine the tooth to see how large the chip or fracture is. See if
the tooth is loose. Look for bleeding from the tooth – not bleeding
from the gum. If you see red blood coming from the center of the
tooth then the pulp or the nerve has been exposed. In that
situation, call the office. In all other situations, you may see a
white or yellow area. Use your best judgment to decide whether or
not you should call the office.
**Remember – most teeth are chipped from accidents! Car seats
and mouth guards are the best protection that we have to help avoid
these types of traumas.
Is your child a serious athlete? Ask us about our custom mouth
guards!
Toothache:
Rinse the mouth vigorously with warm water and use a toothbrush and
dental floss to dislodge impacted food or debris around the affected
tooth. DO NOT place aspirin on the gum or on the aching tooth. If
necessary, you may give you child Acetaminophen (Tylenol) or
Ibuprofen (Motrin or Advil) to help with their pain. If facial
swelling develops apply a cold compresses and call our office. If
severe swelling suddenly occurs causing the child’s face or eye to
shut or the face feels warm to the touch go immediately to the
emergency room.
Maxillary Frenum Tear – Torn Gum between 2 Top Front Teeth
Directly under your child’s upper lip and inserting between their
two front teeth is a piece of gum tissue known as the frenum. Often
times when children fall, they tear this attachment. This does not
usually require stitches but can be very bloody and messy. Sometimes
the attachment is so tight that the fall tears the attachment and
causes a frenectomy – a procedure that many need to have performed
later in life. Treatment is usually palliative in nature. Stop the
bleeding with pressure using either gauze or a clean washcloth. Give
your child Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) if
needed. Apply Ice to the upper lip if swelling occurs. A soft diet
may also help.
Cut or Bitten Tongue,
Lip or Cheek:
If your child bites their tongue lip or cheek and there is bleeding
apply firm but gentle pressure with gauze or a clean washcloth. Give
your child Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) if
needed. If bleeding does not stop after 20 minutes or it cannot be
controlled by simple pressure, take the child to hospital emergency
room.
The Specialty
Consultation Visit
 While
we often treat patients as primary care providers, you may have been
referred to us, as Pediatric Dental Specialists, by your family
practitioner or general dentist. Often times this referral is for us
to perform treatment or to give an opinion on some problem or
question to which the referring doctor is either not specially
trained or is not fully comfortable doing.
When you are referred to us, this first visit is known as a
Specialty Consultation. At this visit, no treatment other than a
review of medical and dental history, an oral examination and,
perhaps, X-rays will be taken if required. You will be given an
appointment for treatment, a treatment plan for your child and many
forms with detailed explanations of the treatment your child needs.
This visit is extremely important and we need to meet your child and
evaluate them.
While we understand that this is an extra visit, we feel that it is
in the best interest of your child. At this visit, we can review all
treatment needs with you and schedule the next appointment(s) at the
appropriate time of day. For example, your child may need to be the
first patient of the day or perhaps be on an empty stomach in order
to the complete the appropriate treatment.
At this consultation appointment, we will also give you all the
information that you will need pertaining to office policies and
finances.
While we understand that you are busy and that you want to get your
child’s treatment started as soon as possible, this Specialty
Consultation is essential for many reasons:
We need to determine what kind of treatment is needed. The work for
which your child was referred to us is NOT always the treatment that
we recommend after we review the history, clinical examination and
evaluate the X-rays. In many situations, the referring dentist was
unable to obtain X-rays because they did not have the training or
the small equipment needed to take the X-rays on your child. We use
this visit to attempt to get these X-rays and other diagnostic
methods.
We need to meet your child so that we can decide which method of
treatment is best suited for them. There is no “cook book recipe”
for treating children. We must evaluate your child’s behavior and
ability to follow directions. Based on their medical history, work
needed, and ability to cooperate, we need to develop a treatment
plan that is based on their particular needs. They are all
individuals with individual needs and we cannot treat them until we
meet them and assess them specifically.
There are many options that we can use to treat children at
different ages and with different treatment needs. Some of our
patients will simply hop up into the dental chair and open their
mouths.
Others are a little nervous and may need the use of Nitrous Oxide
Analgesia, commonly known as “laughing gas” or “happy air” to help
them relax. Nitrous Oxide does not put your child to sleep and we
will explain to you and your child how it works and what to expect.
We will also recommend that your child not eat or drink for 3 hours
prior to their next appointment if using Nitrous Oxide.
In other situations, we may recommend the use of conscious sedation
using oral medicines which we administer in our office. Conscious
sedation patients must have an excellent medical history in order to
be candidates for this type of procedure. They must be cold and
cough free and we must evaluate them prior to administering the oral
sedative the morning of the procedure. They must also not eat or
drink prior to this appointment.
In other more extreme situations, we will take some children
including those patients with special needs, to the hospital or
surgery center operating room and perform all dental treatment under
general anesthesia as an outpatient. In these cases, we will have an
anesthesiologist administer the general anesthesia and while the
patient is asleep, we complete all dental procedures including
X-rays, cleaning, fillings, sealants, extractions, crowns, pulpal
procedures, space maintainers, impressions and any other necessary
dental procedures. Once our treatment is complete, the patient will
be transported to the recovery area for observation and will be
released upon permission of the anesthesia department or post
anesthesia care unit.
As you can see, there is much that we need to do to make sure that
our treatment meets your child’s needs.
We hope that you understand why it is so important that we have this
initial consultation visit. We want your child’s treatment to be
tailored to their needs. We find that this makes for the best
success and experience that we can give.
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