Sometimes we emergency doctors are called upon to temporarily be dentists. Teeth get knocked out in injuries, and we have to tend to the tooth as well as the other, more doctory injuries. It makes us a little uncomfortable- there is a whole profession dedicated to mouth care, and we are by comparison rank amateurs. Then there is the non-emergency that always makes us groan in frustration, the dental infection.
Dental infections in the Emergency Department make us groan because their very nature is not an emergency. Dental infections happen in slow motion. They start with cavities, which take months to grow. They are highly preventable- doesn’t everyone brush their teeth? And when pain starts, the pain can be taken care of with ibuprofen and tylenol until the next dentist visit- no need to clog the Emergency Department!
So here are the details to take care of dental infections. Step one- don’t have one. Make sure your kid brushes his teeth twice daily. And with kids from age 3 to 10, don’t always take their word for it. Parents need to observe that their child brushes all surfaces carefully, twice daily. I’ve seen plenty of parents who say their kids brush their teeth, but one look in the mouth tells me that maybe what the kid is doing is a quick one-two on a few teeth and done! Older kids should learn to floss too.
Kids need to have lower sugar diets, for their teeth as well as their waistline. No sodas, candy, packaged sweets in the house at all! That high sugar content destroys teeth as well as general health. Finally, all kids over age 3 should have check-ups with the dentist twice per year. Dentists can spot and treat cavities before they become big problems.
Once a cavity gets big enough though, bacteria get into the deeper tooth and gum tissue. Then the gums swell with infection, and it hurts! Then the tooth really needs a dentist. The dentist can prescribe an antibiotic to clean up the infection and plan about repairing the damage. In the mean time, pain medicine like ibuprofen or tylenol can make your child’s life a lot easier. Occasionally, stronger medicines can be prescribed for bedtime pain. But of course, to take care of the above, you have to have a dentist! If you don’t have one for your three-year old, get one now.
Preventing dental infections is easy, if you do a little work in prevention. Teach your kids to brush their teeth and floss, and be sure with your own eyes that they do it at least twice per day. Again, do not even bring temptation into the house- don’t buy sodas and sugary snacks. Finally, have a dentist. That way, you don’t have to have some dumb emergency doctor pretend that he is one.