Managing your at home

Tips to help manage dental problems until you are able to see a dentist

01 02 Accessing care

-Following guidance from NHS England and the department of health, dental practices have been advised to "stop aerosol sprays" and "prioritise urgent treatment" where possible. - By temporarily closing the practice we are preventing unnecessary travel reducing virus transmission. - This information aims to advise people in pain who still need to access care and support people managing symptoms at home. Emergency Care

-If you need to access emergency care call us on 01932 571200 during weekday working hours. We will then triage you.

-Outside of weekday working hours if you have a dental emergency please CALL 111

-There are centres available with appropriate protective equipment which will allow staff to treat you safely; we can triage you to them if required

03 04 What counts as a dental emergency?

Straight to A&E Urgent Dental Treatment Non-Urgent Facial swelling affecting Facial swelling extending to (may need to wait) the eye or neck. vision or breathing, Loose or lost crowns, Bleeding following an bridges or veneers preventing mouth extraction: bleeding that does Broken, rubbing or loose opening more than 2 not stop after 20 mins of dentures pressure with a gauze. fingers Bleeding gums Bleeding due to trauma Trauma causing loss of Broken, loose or lost fillings Tooth broken or fallen out Chipped teeth with no pain consciousness, double and causing pain Loose orthodontic wires vision or vomitting Toothache preventing sleep,

Uncontrollable dental eating, associated with haemorrhage significant swelling or fever that cannot be managed with painkillers

05 Painkillers Anti-inflammatories (like ) can help reduce pain from teeth. Combining and ibuprofen has also been shown to be effective.

Painkillers should always be taken in accordance with instructions on the packet. Taking too many tablets, or taking medications incorrectly will not improve your symptoms, and can cause serious stomach and liver injury which can be life threatening.

14.04.20 NHS England advises that: The lowest effective dose of ibuprofen should be used for the shortest duration necessary to control symptoms.

Toothache 06

If the tooth is extremely sensitive to hot or cold, antibiotics will not help. The decay must be removed and filled. These home measures may help make symptoms manageable until care can be accessed. Good cleaning with fluoride toothpaste and reducing sugar intake will help stop decay from worsening.

If there is a hole in the tooth, or a tooth has cracked and is now sensitive/sharp, a temporary filling can be packed into the space. These are available from supermarkets, pharmacies and online.

Desensitising/sensitive toothpaste can help.

Rub the toothpaste directly onto the affected area and do not rinse afterwards. Anaesthetic gel can also help to ease the pain 07 Wisdom teeth pain is usually due to inflammation of the gum over the erupting tooth, which can be worsened by trauma from biting.

Most flare ups can be managed with good home care and should settle in a few days to a week: 1.Excellent cleaning (even if it is painful to brush, the area must be kept clean to encourage healing) 2.Corsodyl mouthwash (avoid using for more that 1 week as it may cause staining) OR Corsodyl Gel helps relieve specific sore spots. 3.Soft diet (soft foods will reduce trauma from biting) 4.Painkillers (as aforementioned) 5.Warm salty mouthwash

If you have difficulty swallowing, swelling in your face or cheek or difficulty opening your mouth, call us. You may need antibiotics if the infection is spreading 08 Ulcers Although painful, most ulcers will heal naturally within 7-10 days. Any non-healing ulcers/oral lesions present for more than 3 weeks should be assessed by a dentist or doctor. Call us on 01932 571200, we will ask you to send pictures.

What you can do at home: Warm salty mouthwashes Excellent cleaning is key, even if it is painful to brush. The mouth must be kept clean to encourage healing and prevent more ulcers from forming. If it does hurt, try a soft bristle brush or baby toothbrush Difflam (Benzydamine) spray or mouthwash as per packet instructions Soft diet, this will reduce trauma when biting down Painkillers If caused by a rubbing denture use some denture adhesives Mouthwash

09 Pain after an extraction

Continue to take regular painkillers for several days after the extraction, it is normal for the pain to worsen around day 3-4. Pink spit/oozing is normal after an extraction, but if the socket is bleeding freely, bite hard on gauze or a clean hankie for 20 minutes. If the bleeding has not stopped call us.

We must be careful when prescribing antibiotics and cannot prescribe after an extraction unless an infection is present. If you smoke or rinse too soon after an extraction then you risk dry socket. Dry socket is very painful and regular painkillers are unlikely to be effective.

We recommend that you call us in this instance, you may need a dressing to cover the exposed bone.

Bleeding gums 10

Bleeding from the gums is NOT a dental emergency

Bleeding gums are usually due to gum disease and will not stop until brushing improves. Brush twice a day with a fluoride toothpaste for 2 minutes. Concentrate on the areas which are bleeding.

At first, the bleeding is uncomfortable but this will improve as your oral hygiene improves.

Use floss or inter dental brushes to clean between your teeth everyday. You may need a few different sizes, this is normal.

11 Lost Crown Clean and check the crown, if the crown is mostly hollow then you can attempt to re-cement it at home if you feel confident to do so. If you cannot get the crown to fit, wait to see your dentist.

1.Remove any debris from the crown, you can use something like the tip of a paperclip to scrape the old cement away. Clean your tooth thoroughly. All debris MUST be removed from both the tooth and the crown for it to seat properly. 2.Check the crown fits without cement. Check it feels okay to bite on, if it feels too tall it is not fitted correctly, double check for debris. NEVER force a crown or post onto your tooth, this can cause fracture. 3.Crowns can be replaced using a dental cement from a pharmacy. Do NOT USE superglue or denture glue. 4.Follow instructons on crown re-cement kits