What To Do In A Dental Emergency

Emergency Ambulance
Do you know where to go if you have a dental emergency in Singapore?

Why Choose B & F Dental Clinic in the event of a dental emergency?
- Conveniently located in Bukit Timah, Singapore.
- 5 min walk from Sixth Avenue MRT (DT7)

- Fully equipped for all basic procedures with 3D Digital X-ray available.
- Dentists have experience working in government hospital A & E departments with management of common dental emergencies.

- We are able to provide you with a medical report on request for your insurance claim needs.
Easily contactable by phone (6909 7664) or WhatsApp (9383 6121).

Most dental conditions are not life-threatening.

Remain calm as panicking will not help you.

However, some dental conditions do require urgent care, such as:
1. Uncontrolled Bleeding
2. Severe Dental Pain / Toothache
3. Facial Swelling due to existing infection or internal bleeding
4. Traumatic Injuries - dislodged or loosened teeth, broken teeth or jaws, deep lacerations or cuts to the gums.

Traumatic injuries can occur from face-down falls (e.g. fainting), or impact to the face / jaw such as in the event of a car accident, sports, falling objects or assault.


1. Uncontrolled Bleeding From Face / Jaws or Gums

Blood and Bleeding

How and Why
Uncontrolled bleeding can occur from deep cuts to the face and jaw or tongue / gum tissue.
Uncontrolled or delayed bleeding can also occur after extractions or gum treatment, especially if you have bleeding tendencies.

Useful Information You Can Prepare For Your Dentist
1. When did the bleeding start?
2. Was anything done to cause it? (E.g. dental extractions.)
3. Are you on any blood thinner medications such as Aspirin / Warfarin / Apixaban / Clopidogrel or similar?
4. Are you taking any supplements that can increase bleeding risk such as grapefruit juice, gingko or garlic extract?
5. Do you have any known liver conditions? The liver produces a lot of clotting factors.
6. Are you on any form of kidney dialysis?

First-Aid for Uncontrolled Dental / Facial Bleeding
First thing to do: Identify the source of the bleeding if possible.
Avoid rinsing and spitting repeatedly! That can cause more bleeding.
Try to put pressure on the bleeding area by firmly biting or pressing cotton gauze / cotton pads on it for at least 30 - 60 minutes.
Do NOT keep changing the cotton gauze even if it turns red as it will leach / draw more blood out from the injury site. A blood clot needs time to form undisturbed.

Secondly, assess the amount of bleeding.
A minor bleed from an extraction site can seem like a lot of blood when mixed with saliva.
If a lot of thick red blood is pooling in the mouth and forming large jelly-like lumps that we call liver clots, that could indicate a bleeding tendency or underlying blood condition.
Please consult your dentist immediately.
They may need to refer you to a medical doctor for further hematological investigation.

What Will the Dentist Do?
The dentist will assess the source of bleeding and if controllable, stitches or haemostatic agents may be placed painlessly under anaesthetic to stop the bleeding.

See your dentist immediately if the bleeding cannot be controlled.

2. Severe Toothache / Dental Pain

Dental Toothache Emergency Pain
Ow, it hurts!

How and Why
Dental Pain / Toothache can occur for many reasons such as:
1. Infection of the gums or abscess formation.
2. Infection and inflammation of the tooth / nerve tissues.
3. Deep decay.
4. Cracked or split tooth.
5. Combination of the above.

Be aware that the pain from a toothache can temporarily disappear after a few days because the living nerve tissues may die from the infection and they become unable to continue informing you that there is a problem.

This does not mean that the problem has healed itself!

Such infections usually worsen after and the tooth may become very painful to bite on as the nerve fibers at the base of the tooth root detect the infection from the tooth after that). The earlier they are treated, the better the chance of long-term success.

Useful Information You Can Prepare For Your Dentist
1. When did the toothache start and what happened?
2. Is it a dull ache or a sharp pain? Does the pain happen on its own at night? Does it give pain on biting?
3. Did the tooth ever have any pain or dental treatment in the past?
4. Have you taken any painkillers / medications and did they help?
5. Did you do anything that could have resulted in the pain such as biting on a piece of bone in your food?
6. Is the tooth shaky?

First Aid for Dental Pain / Toothache
If you have no allergies, you can try a moderately strong Over-The-Counter painkiller such as Ibuprofen to help control the discomfort.

What Will The Dentist Do?
The dentist will need to do a examination first and possibly take x-rays.
They may need to do various tests on your teeth to identify the source of the pain.
If required, local anaesthetic may be given to numb the tooth for pain control.
Painkillers may be given to help with additional pain relief.

In certain cases, if the tooth is badly infected, anaesthetic may not work and the tooth may still be acutely painful.
The dentist may apply some medication to the infected tooth and arrange a follow-up appointment after that to continue treatment once the discomfort has subsided.

If the tooth can be restored, root canal treatment may be an option to keep the tooth in place.
If the tooth cannot be restored, extraction and replacement can be an option.
Medication is often only a short-term way to mask the problem as it does not eliminate the source of the problem.

3. Severe Facial Swelling

Face Swelling
Facial swelling is cute in chipmunks but not in humans!

How and Why
Facial swelling can occur if the you have had wisdom tooth surgery and there is bleeding into the tissue spaces. It can also occur if the you have a badly infected tooth and there is a collection of pus in the tissues at the area - this is called cellulitis. Facial swelling can be dangerous if it causes swelling to the point that the person has difficulty breathing. This is a condition called (Ludwig's Angina).

Useful Information You Can Prepare For Your Dentist
1. When did it start?
2. Was there any treatment done for the teeth or jaws recently?
3. Have you taken any medication or painkillers for the facial swelling?
4. Have you had any fever?

What Will The Dentist Do?
The dentist will assess the extent of the problem by examination and X-ray if required.
If the source of the facial swelling appears to be a wisdom tooth or rotten / infected tooth, the dentist may be able to remove the source of infection ASAP so that you can heal.
Abscesses or collections of pus can sometimes be drained from the mouth.
Less serious cases can usually be first assessed or handled by your general dentist.
For severe cases such as if you have difficulty breathing, you may choose to head directly to the hospital A & Es as listed below.

4. Traumatic Dento-Facial Injuries

Punch
What do you do if you get punched?

How and Why
Traumatic injuries to the teeth and jaws can happen for a variety of reasons. Situations our dentists have personally encountered include:
1. Children falling at the swimming pool area and chipping their front teeth.
2. Children falling at the playground and having a tooth fall out.
3. Joggers falling forward on the treadmill and hitting their front teeth on the machine.
4. Minor car accidents involving the patient's lower jaw hitting the steering wheel resulting in a combined jawbone and teeth fracture.
5. Bamboo pole hitting a patient's front tooth as they were doing housework at home.
6. Motorcycle / motorbike accidents involving deep facial lacerations due to the rider being flung off the bike, requiring fine stitches to the tongue, face and cheek.

Useful Information You Can Prepare For Your Dentist
1. When (Date and Time) and how did the trauma happen?
2. Was there any mud, soil or dirt involved in the injury?
3. Did you bring the tooth or tooth fragment if available?
Re-implantation of a dislodged tooth or re-bonding of a tooth fragment may be possible if done quickly (within 1 hour).
4. Was it a baby tooth?
Baby teeth are not re-implanted as doing so may cause injury to the permanent tooth underneath.
5. Did you manage to handle the tooth correctly to keep the root cells alive?
Do a gentle rinse in water if needed to remove debris. Do not scrub the tooth! Put it immediately in a biologically-friendly solution such as cold fresh milk or chilled saline solution (eye-wash sterile saline is acceptable). The tooth must be kept moist and re-implanted within 1h of being lost for the best chance of success, or the reimplantation may fail. Root canal treatment may need to be done on the tooth to prevent infection.
6. Any head injury? Was there any point of time that you lost consciousness or blacked out?
In such cases, the dentist may refer you to the hospital A & E to check for head injuries or internal bleeding.

What Will The Dentist Do?
Re-implanting avulsed (dislodged) teeth is an extremely time-critical process.
Teeth that have been properly stored may possibly be re-implanted with immediate root canal treatment if deemed appropriate.
It is better to see the nearest dentist ASAP for first aid if if there is a dislodged (avulsed) whole tooth that maybe be re-implanted as a delay of more than 1h will drastically reduce the chances of success.
Teeth that have been displaced from their original position can be pushed back into place within the first 8 - 12 hours. This may no longer be possible after 24 - 48 hours.
The dentist may take X-rays and / or photos to document your injury. These may be used as supporting documents if you have to submit insurance claims.
If there is any severe bleeding, the dentist may stop the bleeding for you first with compression or stitches.
Dirty wounds such as with mud / sand will need to be thoroughly cleaned / debrided with disinfectants such as Chlorhexidine and Hydrogen Peroxide to reduce the chance of subsequent infection.
Shaky / loose teeth or jaw bone may be fixed with a splint to reduce movement for proper healing.
Teeth that have suffered hard impact may undergo internal tissue death over the next few days or weeks and may require root canal treatment in the near future once there are obvious signs of infection.
Medications such as analgesics or antibiotics may be prescribed.

Follow-Up
The dentist may give you review appointments at regular intervals to monitor your recovery by following up with the required tests to see if further treatment is required.
You may be referred to a medical doctor to undergo a tetanus booster jab if there is a risk of wound infection.
In serious cases, you may be referred to an institution like the government hospital.
For assault cases, it is advisable to file your own police report.

Medical Report
This may be required for insurance claims. We are able to do a medical report for you on special request. A fee is chargeable for this service.

What do I do if I have a Dental Emergency?

During office hours, please contact us at 69097664 or 93836121 immediately.
After office hours, you may approach the following government hospitals with emergency dental services as listed below.

What do I do if I have a bad toothache outside of regular clinic hours?

If the toothache is less severe, you can consider taking an over-the-counter painkiller such as Ibuprofen while waiting for the dental clinic to open. Do not take medications if you have suspected allergies.
Never put oral painkillers such as Aspirin against the gums beside the painful aching tooth as these are often acidic and can cause minor chemical burns to the gum tissue.
Topical application is also unlikely to help relieve dental pain, if at all.

What do I do if I have a suspected jaw fracture and / or serious bleeding outside of regular clinic hours?

Jaw fractures can occur if you have suffered a heavy impact to the face or have suffered a face-down fall. Signs of jaw fracture include: Inability to close the teeth together as per normal, jaw stiffness, numbness, bruising.
In such cases, it may be good to seek assistance in a government hospital's A & E Department as listed below. However, do be prepared for a long waiting time if the hospital is crowded and your case is deemed to not be of critical urgency.

Suggested Emergency Dental Services at Night in Singapore

Not all hospitals have night duty dental services available in-house.
In that event, you may be re-routed to another hospital.

Singapore General Hospital
Department of Emergency Medicine
1 Hospital Drive, 169608
Google Maps: https://goo.gl/maps/jMdPFZfKnyyJVg9n9
+65 6321 4311 Accident and Emergency 24h Hotline
+65 6222 3322 General Enquiries Line

24h Emergency Dental Services are available at the SGH Department of Emergency Medicine, located at Block 1, Level 2.
https://www.ndcs.com.sg/patient-care/emergency-dental-services

National University Hospital
Department of Emergency Medicine
5 Lower Kent Ridge Rd, Singapore 119074
+65 6772 5000 Emergency Department 24h
+65 6772 2555 Children's Emergency 24h
https://www.nuh.com.sg/patients-visitors/Facilities-Amenities/Facilities/Pages/default.aspx?facilitiesType=Emergency

After registering, a nurse will normally attend to you for triage, assign you a priority level according to the severity of your condition, and advise you on where to wait for consultation. Patients with serious illness and injuries will be attended to first.
An initial assessment will be done by a Medical Officer. A Dental Officer will be called in as needed for further assessment and/or to perform an emergency procedure.

Emergency procedures may include:
- Giving a local anaesthetic injection and/or prescribing painkillers for temporary pain relief.
- Putting in a medicated temporary dressing to soothe the tooth
- Extracting the tooth if it is a simple extraction.
- Young children may be sedated for difficult procedures.

An emergency consultation fee applies. Please take note that hospitals will normally not do non-critical treatment in the Department of Emergency Medicine such as:
- Scaling
- Fillings
- Difficult Extractions
- Root Canal Treatment
- Removal of wisdom teeth
- Dentures
- Crowns, bridges, or implants
- Orthodontic treatment
The Emergency Department may refer you to the respective Dental Centres in the daytime or back to your private dentist for such procedures.

About B & F Dental Clinic

B & F Dental provides a full range of dental services in Singapore. We understand the importance of timely treatment for dental emergencies and we are committed to helping you get out of pain as soon as possible. 

Conveniently located in a central part of Singapore near Bukit Timah - Downtown Line Sixth Avenue Station (DT7), we are equipped for and dedicated to providing the best professional care and service to our valued patients.

Contact us for any inquiries at 6909 7664 / WhatsApp 9383 6121. For less urgent matters you may email us at info@bnfdental.com.