COVID-19 EMERGENCY ADVICE

GENERAL ADVICE

ORTHODONTICS ADVICE

NHS England and the Department of Health have recently instructed all dental practices to establish a remote urgent care service during the coronavirus outbreak. We will provide telephone triage for our patients with urgent needs during usual working hours and wherever possible treating with advice, analgesics and/or antibiotics.

Below is some advice  to help you manage your pain at home.

 

Non-urgent dental care

These issues can be dealt with when we re-open.

  • Bleeding gums

  • Broken/rubbing/loose dentures

  • Loose/lost fillings, crowns, bridges, veneers

  • Chipped teeth with no pain

  • Loose orthodontic wires.

 

 

Urgent dental treatment

 

Swelling

  • Take regular painkillers if required

  • Use hot, salty water mouthwash if it's draining

  • Obvious facial swelling – antibiotics may be prescribed by the dentist for severe infection and swelling

  • If you have continuing or recurrent symptoms please call us

Head to A&E if facial swelling is affecting your breathing eating or vision.

Pain after an extraction

  • Take regular painkillers – it is normal for pain to be at its worse on days three and four

  • Rinse gently with salty-water after every meal

  • Avoid alcohol and smoking

  • Eat soft foods

  • Do not disturb the clot covering your extraction site

  • Maintain good oral hygiene

  • If pain is worse after a week, call us

  • If pain is severe and uncontrollable and preventing from sleeping please call us

Bleeding gums

  • Maintain good oral hygiene

  • Brush twice a day – this can initially exacerbate bleeding but keep going

  • Use interdental brushes or floss to clean between the teeth

  • Rinse with chlorhexidine-based mouthwash

  • Do not smoke

 

 

Trauma

  • If you have any kind of dental trauma, whether mild or severe, please call us so that we can triage you

  • Head to A&E if trauma is causing loss of consciousness/double vision or vomiting

 

 

Toothache

  • Take regular painkillers if required

  • Rinse with cold water, this can alleviate the pain

  • Maintain good oral hygiene with a fluoride toothpaste and reduce intake of sugary food to ensure decay does not worsen

  • If pain is severe and uncontrollable, preventing sleeping or eating, please call us

 

 

Tooth sensitivity

  • Rub sensitive toothpaste directly on affected area and don’t rinse afterwards, leave on overnight

  • Orajel may help ease the pain

  • Avoid stimuli (cold/acidic foods or drink).

 

 

Wisdom tooth pain

 

  • Keep the area clean with a small headed toothbrush or single tufted toothbrush

  • Rinse two to three times a day with warm salt water or chlorhexidine mouthwash

  • Take Paracetemol/Ibuprofen if required

  • Obvious facial swelling - please call us

  • Regular pain killers if required

  • Call back in 48-72 hours if your symptoms have not resolved

  • If you feel unwell, have limited mouth opening (less than two fingers) and difficulty swallowing, call us

Ulcers

  • Traumatic ulcers are usually sore but resolve in a week or two

  • Brush twice a day, salt water/chlorhexidine mouthwash at different times to brushing

  • Local pain relief using mouthwashes or topical gels – Paracetemol/Ibuprofen, benydamine hydrochloride mouthwash or topical anaesthetic gels

  • Maintain good oral hygiene

  • If due to rubbing dentures, try Fixodent to secure loose dentures. Any sharp or rough edges can be adjusted at home using an emery board. Leave dentures out if too sore to wear

  • Avoid precipitating factors eg spicy food

  • Avoid smoking.

Any non-healing and non-painful ulcer present for two weeks or more requires an assessment – please call us.

 

 

Teething

  • Teething begins around six months and children can experience pain in the mouth during teething, which may effect their sleeping, and eating

  • Ensure the child is adequately hydrated

  • Liquid Paracetemol/Ibuprofen (sugar free), lidocaine topical gel can help relieve symptoms of pain relief and pyrexia

  • Pureed food, cool liquids and teething aids can be helpful –  avoid pureed sweet foods eg fruit purees as can lead to decay.

 

 

Grinding pain

  • Clenching/grinding of teeth is common in periods of stress or due to some medications (as listed above)

  • Eat a soft diet for two weeks

  • Limit opening of mouth when yawning or eating – place hand under chin

  • Avoid recurrent chewing habits eg chewing gum/nail biting

  • Ibuprofen gel – rub onto skin

  • Warm/cold compress over affected area

  • Massaging sore areas of face eg temples

If you experience loss of vision with temporal pain - please call us.

 

 

Lost filling/crowns

 

  • Take painkillers if required

  • Purchase temporary cement/filling kit from chemist or online

  • Eat a soft diet

  • Avoid hot/cold foods

  • Maintain good oral hygiene and a low sugar diet

  • Use a soft toothbrush and sensitive toothpaste

  • If you have inhaled fragment then please call us

Most orthodontic appliances can be left in situ for some months without detriment to the treatment if the you continue with the usual after care instructions;

  • Exemplary oral hygiene – brushing 3 times a day with your standard toothbrush, followed by interproximal brush use.  As an adjunct, use of a fluoride mouthrinse eg. Fluoriguard (225ppm), once a day.

  • Low sugar diet - Where possible avoid all snacking on sugars and drinks with ADDED SUGAR. Fizzy drinks should be avoided in particular.

  • Avoid hard, sticky and hard food that could break your brace wire or fracture brackets (debond) off a tooth.

Wires digging in

  • If a thin wire, it may be possible for you or a family member to use  tweezers to replace wire in the tube/band or tweezers and a nail  clipper/scissors to shorten the long end

  • It may be that a thin wire is the correct size but may have rotated round the teeth so that it is short on one side and long on the other. Using tweezers a pencil with a rubber on the end or a teaspoon, it may be possible to push the wire back round to prevent the long end digging in.

  • If the wire is very thick and stiff  it may not be possible to cut the wire with home instruments. If this is the case it may be necessary to cover the wire to prevent it being sharp. Relief wax/silicone may be sent to you or you can buy it online (Orthodontic Wax) Failing that using a wax covering from hard cheese (baby-bell, cheddar), Blue tack or even chewing gum may help

Broken bonded retainers

 

  • Push wire back down towards the tooth as much as possible. (Fingers or tweezers)

  • Cover with best medium available (Ortho wax, Cheese wax, Blu tack, chewing gum)

  • Cut the exposed unbonded wire using tweezers and nail clippers/scissors

  • Gently pull the wire to remove the whole retainer

Gold Chains

  • If the gold chain was recently placed and is now dangling down, it may be possible to cut it short. Gold is quite a soft metal and it may be possible to cut the chain using some nail scissors or nail clippers. Always hold the loose end with tweezers or similar item. If possible leave at least 5 links through the gum so it can used later by your orthodontic team

  • If you have a none dissolvable coloured stitch discuss with your dentist about the feasibility of removing it at home using nail scissors to prevent a minor infection in the gum.

Invisalign

  • If your current aligner is in good order keep wearing it as much as possible

  • If your current aligner is broken or ill fitting, step back to your previous  aligner

  • If neither option is open to you, ring us for advice

  • It may be possible to have a new aligner at the correct stage made for you and sent out to you - please call us

Elastic Bands

  • At this time if you run low or out of elastics please call us

  • If band is very loose your dentist may be able to talk you through removal

  • Please adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.

 

Separators

  • These should be removed at the earliest opportunity - Attempt removal with  end of safety pin, small paper clip or wooden tooth pick

 

Please feel free to contact us at any time with any questions you might using the contact form below or call us on our usual telephone number at the top of the page or below.

FIND US

Unit 5, City Business Centre

Lower Road, London SE16 2XB

Email: info@cbcdental.co.uk

Tel: 020 451 88554

Opening Hours:

Mon - Weds - 09:00 - 20:00

Thursday - 09:00 - 18:00

Friday - 08:00 - 16:00

Saturday - 09:00 - 16:00

CONTACT

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