Abscess

An abscess is when there is a swollen and possibly painful area that is filled with pus. An abscess is one way that your body forms a barrier and tries to contain an infection. It is difficult to predict the time frame for the existence of an abscess. It may be one or two days after the beginning of the infection, or an abscess can be present for months or even years if not treated.

The two types of abscesses in the mouth are a gum abscess (periodontal) or a tooth related abscess (periapical). A periodontal abscess can happen when there is an infection in the space between your gum and your tooth. In severe gum disease, bacteria can build up under the gum and in the bone. A periapical abscess can be seen with an X-ray on the tip of the root of the tooth as the infection spreads in the bone surrounding the tooth.

An abscess does not go away on it’s own, though in some cases it can be present for months or years without treatment and may not cause any pain. However, it is vital that the infection is removed as soon as possible as it can not only damage the surrounding bone and teeth but can also affect your general health and cause serious health problems. If you notice a small bump or ‘pimple’ on your gums or notice a bad taste in your mouth, you may be suffering from a dental infection.

If you see small pimple like swelling on your gum or notice a bad taste, rinse your mouth with warm salt water regularly whilst you make an appointment to come in and see us. Even if the salt water is relieving the symptoms, it is still important to see a dentist as soon as possible so that the cause of the infection can be removed.

Bleeding/pus around a tooth

If there is any exudate oozing from the gums around your tooth, it is a sign that there is an infection at this tooth. The blood and/or pus may be coming from the tooth itself if you have deep decay on it, or it may be coming from the gums surrounding the tooth if you have gum disease. If you see blood or pus around your teeth, please come in and see us as soon as you can. In the meantime, gently massaging the area and using a warm salt water rinse (dissolve some salt in warm water and gargle with it) may help to control the signs and symptoms.

Bleeding after an extraction

A small amount of bleeding is completely normal and to be extracted after an extraction. If there is some bleeding following your extraction, just swallow the blood with your saliva. If there is a steady flow of blood from your extraction socket, then apply pressure to this area by biting firmly on a piece of gauze or a clean handkerchief for 15-20 minutes. If the bleeding persists despite the firm pressure, call us immediately and come in as soon as you can. If you can’t get in touch with us, please go to your local emergency department so that they can look at the extraction socket and confirm that it is healing up sufficiently.

Broken tooth

Even if there is no immediate pain or sensitivity at a broken tooth, it should still be assessed by a dentist as soon as possible. Leaving it un-repaired may lead to the tooth becoming sensitive or painful. Further, if not treated and repaired, a broken tooth may break further and may become irreparable.

Whilst you wait for your dental appointment to get the broken tooth assessed and repaired, clean out any debris in the area with warm salty water. If the break was caused by trauma, a cold pack on the outside of the cheek can reduce swelling and discomfort. If there is a piece of the tooth that has broken off, bring it in when you come for your appointment as it may be possible to bond the broken pieces back to the tooth. Keep the broken piece of tooth moist until you come in if possible.

Broken/lost filling

If you have a filling that has been broken, has come loose or has fallen out, please call and come and see us as soon as possible. It is important to get the tooth assessed and repaired as soon as possible even if there is no pain or swelling in the area. If it is left for too long, there is a possibility that more of the tooth may be lost and the tooth may then become difficult or impossible to repair. Further, an unfilled tooth is a food trap. As debris collects in the hole in the tooth, there may be further tooth decay forming and the hole may get deeper until it reaches the nerve and can no longer be repaired as a simple filling.

Chipped/cracked tooth

Depending on the depth of the crack or chip on your tooth, you may feel nothing at all or you may feel some sharp and erratic pain on chewing or after release of biting pressure. If you find your tooth is extremely painful when chewing on grainy foods such as wholegrain bread, then a crack maybe the culprit. You may also notice that there is pain or discomfort on a particular tooth when there are temperature changes in your mouth or when your teeth are exposed to sweet foods.

If the crack extends below the gum, you may also get a pocket of gum disease down the cracked surface. If the crack is very superficial and is causing no pain but you are not happy with the appearance, we can do a bonded restoration or hide the crack in other ways. If the crack is deeper and causing discomfort we may need to treat the tooth straight away. Please contact us if you think you are suffering from a cracked tooth so that the friendly team at Be Pain Free Dentistry can advice you on the ideal treatment for your tooth.

Denture repair

If your denture is no longer comfortable in your mouth, bring it in to us and we may be able to repair or adjust it to make it more comfortable for you. If your denture is too tight or too lose, or if its broken or has missing teeth, then it may be in need of some adjustment or repair.

Some small repairs can be done in the chair while you wait, but bigger repairs will need to be sent to a laboratory. We will send it through straight away and will do our best to get your teeth back to you as fast as we possibly can.

If your dentures are a few years old, or if there has been recent changes to your mouth or teeth either from worn teeth or changes in your gums or jaw bone, you may find that your dentures are uncomfortable and may feel loose. When you come for your regular check ups, we encourage you to bring your dentures with you so that we can help identify any early problems. In some cases a reline or a completely new denture may be required to maximise your comfort.

Extraction

There are many reasons why we may need to extract your tooth. This could include teeth that are damaged or decayed beyond repair, advanced gum (periodontal) disease or a cracked tooth that is painful and can’t be settled down. Teeth may also need to be removed to prevent complications such as an infection, or to improve your appearance.

If we do determine that a tooth needs to be taken out, we will discuss the situation with you in detail and it will ultimately be your decision. We will take an X-ray of the tooth during the treatment planning stage. This is done so that we can confirm the need for an extraction and also determine the safest and easiest way to remove this particular tooth.

Once you are ready for the extraction, all the nerves supplying this area will be anaesthetised and the tooth will be coaxed out of its socket.

Orthodontic wire discomfort

If your orthodontic wire is causing irritation to your cheeks, gums, or tongue, please come and see us as soon as possible. Do not attempt to remove it yourself as you may cause further damage. If the wire is embedded in your cheek or gums see us immediately or go to your local emergency department. If it is sharp but not embedded your gums, cheek or tongue, then try to cover the end with a small cotton ball or some soft wax until you can be seen by the friendly team at Be Pain Free Dentistry.

Loose tooth following trauma
  • If the tooth is still in place then there is usually no need for treatment, however, it is still advisable to get your friendly dentist to have a look at it and take some x-rays to make sure there are no problems hiding underneath that may lead to a nasty surprise in the future. You may notice that there is some bleeding around that tooth or that it may be loose. In some cases, we may need to put a splint in that area to stabilise the tooth if required.
  • If the tooth has been knocked completely out of the socket please make an emergency appointment to come in to see us. Pick up the tooth by the white part that is usually visible in the mouth (not the root that is usually under your gum). If the tooth is dirty, wash it for 10 seconds in cold water and either reposition in the socket and hold it in position with a handkerchief. Take care to make sure the tooth is repositioned exactly as it was previously in your mouth. If you choose not to reposition it yourself, then store the tooth in some milk or in your own saliva until you can come in to see us. DO NOT STORE THE TOOTH IN WATER! The sooner the tooth can be replanted into the socket, the higher its chance of survival so please make an urgent appointment so that we can maximise the chance of the tooth surviving.
  • If the tooth has moved in your mouth after it’s had a knock to it, you need to see us as soon as possible. Do not attempt to move the tooth yourself. We may need to reposition the tooth under anaesthesia in some cases. We would also often place a splint in that area to stabilise the tooth.
Lost crown/veneer

It is not unusual for a crown or veneer to fall off, especially if its been bonded onto your tooth for a long time. If a crown does fall off, do NOT try to put it back on your tooth by yourself. If you just put it on the tooth without it being bonded on by a dentist, then it can be swallowed or breathed in. Contact us and we will try to book you in as soon as we can so that we can try to cement the crown back on for you.

If the crown has fallen off because there is tooth decay under it, then we can’t simply bond it back on. Instead we will need to take an x-ray to assess the extent of the decay, and then remove the decay and stabilise the tooth before we can replace the crown.

Tooth ache

If you have a toothache, you should try to see a dentist as soon as you can. Sometimes, what is felt as an ‘ache’ is just tooth sensitivity, but more often a tooth ache is an indicator of something more sinister such as tooth decay or an infection. Whilst you are waiting for your dental appointment, rinse well and try to remove any food that may be trapped in that area (use floss or an interdental brush if required).

If there is a swelling, a cold pack on the outside of the cheek may help. Take appropriate pain relief as required (please do not place the tablets directly on the gums or teeth as this may cause damage to the teeth, gums or cheek. Instead, ingest the tablets as recommended on the packaging and ensure you do not exceed the maximum dose).

Swelling

If you are experiencing any facial swelling (with or without pain) call us immediate and discuss the situation with us. If you can’t contact a dentist, it may be ideal to contact your local emergency department.

Swellings usually develop after some form of injury or trauma to your face. It could be from a sporting injury, a cut, a bite or sting or a dental abscess. In some situations, there may be no known cause of the facial swelling. There will be a localised area of redness, swelling, heat and sometimes pain. There may be associated symptoms such as a fever or throbbing pain.

If the cause of the swelling is an infected tooth, then the tooth will need to be removed in order to allow the swelling to resolve. Swelling is a serious situation and may lead to a compromised airway (especially if the cause is a lower back tooth). If there is no breathing or swallowing difficulty associated with your facial swelling, please call us and come in as soon as possible as we need to identify the cause of the problem and remove it as soon as we can so that your body can proceed to heal and repair itself.

If you have any breathing or swallowing difficulties associated with your facial swelling, please go straight to your local emergency department.