In these moments of confinement, in order to know if it is really an emergency or not, to ask a series of questions when the patient calls by phone, such as the following: is it an emergency? does it have pain or discomfort when chewing? when has it happened? where has it happened? does it bother with the cold or heat ? Do you have to take medication? Do you have any fragments or fallen teeth? Among others.
In addition, we recommend requesting that they send a photography of the area or tooth for which they refer the urgency or pain, so that you can know exactly what it is and take the appropriate measures if you have to perform any treatment in the dental office.
It is of great importance, now more than ever, that all measures universal and specific in order to actively collaborate in the infection control. Therefore, it is important that the following indications are followed:
- Upon arrival at the consultation that the patient and his companion disinfect their hands with alcohol
- Rinsing the patient with 0.2% povidone iodine solution or 1% hydrogen peroxide prior to dental procedures greatly reduces viral load.
- Use rubber dam whenever possible. Its use has been proven to reduce the viral load present in aerosols generated by dental procedures by up to 70%.
WHAT TO DO WITH A CORONARY FRACTURE?
First of all, the complete medical history: general data of the patient: allergy to medications, history of trauma (how, when and where) and if he has had loss of consciousness, amnesia, nausea, dizziness, etc.
In the exploration both soft and hard tissues must be considered. In the soft tissues Explain the face, lips and gums. It is important to clean the area and remove if there is any fragment, so it is recommended to place topical anesthesia previously. In the hard tissues The alveolar process should be examined, assessing the displacements, note if there is mobility, examine the tooth, assess the coronary fracture, if there is pulp exposure, and examine the adjacent and antagonists.
Faced with a coronary fracture of a permanent tooth The objectives to take into account in these teeth are the following:
- Maintain pulp vitality
- Integrity of the periodontal ligament
- Alveolar development
- Soft tissues
- Aesthetic aspects of the patient
In order to correctly diagnose the tooth, it must be done periapical radiographs, always with positioned, in three projections (central, distoradial and mesioradial). If there are soft tissue injuries, also do X-rays. In addition, the size of the pulp chamber, the integrity of the lamina dura, and the state of root development of the tooth should be assessed.
The treatment will always be, if possible, the maintenance of pulp vitality. So if you are close or there is even exposure of the dental pulp must be to protect this first, before doing any dental reconstruction treatment. In an emergency, the pulp will be hermetically sealed and, if possible in the same visit, the tooth will be restored. If you have the fragment of the fractured tooth and it is intact, it can “stick” and in this way return the tooth to its original anatomy.
It is of crucial importance to do controls and monitoring of trauma, as well as to see if the evolution of the tooth is favorable or not. There are also some cares To follow after the emergency visit, these are: semi-solid diet for 1 or 2 weeks, prevent the accumulation of plaque and food debris, so you should brush with a soft brush after each meal, and rinse with an antiseptic mouthwash. (as 0.12% chlorhexidine) for 2 weeks.
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