Dental Emergency Kit
Dentist In A Box the only dental emergency kit to use for providing emergency dental care.
Imagine a dental emergency kit which is compact, easy to use, designed by an experienced dentist, containing clear, concise instructions and materials for dealing with common dental problems until you can see a dentist.
Dental problems can make you miserable.
Dental problems such as broken fillings, broken or loosened teeth are usually unexpected. Traumatic injury involving teeth is remarkably common however community organisations are surprisingly under-equipped to cope effectively with this. Any delay in appropriate action jeopardises the injured tooth from being saved! Emergency dental care is often required as dental injury is difficult to satisfactorily manage without instructions and materials. Painkillers taken for relief may cause also cause problems. Blutack and chewing gum don't work so how long can you survive on pain-killers?
Manage dental problems, anywhere, anytime.
No mixing, medical or dental knowledge needed! Easy to follow, user-friendly instructions and suitable materials are included in all Dentist In A Box™ kits.
For your protection an expiry date is printed on the outside of each kit.
A kick in the teeth?
John Banky, Dental Surgeon, Melbourne, Australia
Dental injury is a distressing event, often causing psychological as well as physical problems, since
it normally involves the highly visible front teeth. And it is particularly common among athletes, with
sports-related dental injuries said to account for nearly 40% of all dental injuries (1).
However, even this statistic probably underestimates the true prevalence of sport-related dental
injury, which is often not reported (2), tends to occur outside surgery hours (3) and often occurs
with other, more serious injuries, such as concussion, cuts to the scalp and face and fracture of the
jaw or other facial bones (4-9).
The risk of dental injury is particularly high with collision and contact sports. Sports involving high
speeds and high impact ( alpine skiing, boxing and martial arts) tend to result in more facial bone
fractures, while those with low speeds and low impact (basketball, rugby and soccer) are more likely
to be associated with dental injuries (10).
As the number of contact sport participants increase, traumatic accidents resulting in dental injuries
also rise (11). And the bad news is that dental injury can still happen to athletes who are behaving
responsibly by wearing the recommended mouthguards (12, 13).
Equally worrying is the fact that, although dental injury has been recognised as an occupational
hazard for sportsmen and women for many years, its management ‘on the field’ remains poor (14),
due to the lack of appropriate training offered to teachers, first-aid providers and other sport
management personnel, and the inadequacy of existing first-aid kits.
Managing dental injury
As dental injury is usually part of a multi-injury presentation it is often not noticed or ignored at the
time of presentation. But this type of injury is not minor and requires prompt treatment if it is not to
lead to further problems.
It is important that anyone with injured teeth should be seen by a dentist as soon as possible. While
locating dental assistance much can be done at the scene of the accident to provide immediate care
reducing the risk of long-term complications.
Athletes with any injury to the head, face or mouth should not return to the field until the full extent of
the damage has been determined. The head, face and mouth have a plentiful blood supply resulting
in copious bleeding after injury. – Concerns about exposure to blood-borne infections now prohibit
athletes from remaining on the sports field with an uncontrolled bleeding wound or blood-stained
clothing.
Although injuries to lips and cheeks tend to bleed profusely, they also heal quickly due to the
excellent blood supply to the face. Such injuries however, are often linked with chipped, fractured or
loosened teeth, which also need treatment as suggested below:
Chipped and fractured teeth
• Cover the exposed area of tooth, which may be very sensitive to temperature change or the
movement of air across the tooth surface;
● Take care to find and collect any chipped off tooth fragments otherwise a chest X-ray may be
needed to exclude the possibility of fragments being lodged in the lungs or windpipe;
• Fragments can be reattached temporarily but securely, using the splinting material provided in
Dentist in a Box, to cover the exposed area of tooth. If this is not possible, be sure to keep them
to pass on to the dentist;
• Chipped back teeth can be managed using the no-mix temporary filling material provided in
Dentist in a Box.
If you cannot re-insert the tooth immediately into its socket transport the patient at once to a dentist
with the tooth completely submerged in isotonic saline (from Dentist in a Box).
For best results, care should be provided within 20 minutes of injury.
(The dislodged permanent tooth should be re-inserted into the socket from where it came within 20
minutes of injury, this can be done by anyone provided gloves are worn to prevent blood-borne
infection).
Research has shown that immediate care after injury offers best chance (up to 97%) of tooth
survival. The chances of success are reduced to 84% five minutes after injury, 8-66% 5-20 minutes
post-injury and 3-21% after more than 20 minutes. Clearly minimal delay between injury and the
provision of primary care is essential for the best long-term results .
Immediate care after dental injury doesn’t just improve the chances of tooth survival reducing postinjury complications and thus the overall costs of dental treatment.
Loosened teeth
These are teeth that move excessively but are still in their correct position in the mouth. Appropriate
action is to:
• Hold the affected tooth in place;
• Splint the mobile tooth to a sound neighbouring tooth. Stiff aluminium foil is available but difficult
to use. The splinting material supplied in Dentist in a Box is easier to use. (See table 2 below,
for details about this and other dental emergency kits);
• Seek dental assistance.
Long-term problems
The lifetime maintenance cost for dental injury was estimated by a National US Youth Task Force in
1992 at US$10,000-15,000 per injured tooth, including initial treatment, further treatment of
complications, provision or replacement of crowns and review visits until the tooth was lost.
Often the full extent of damage to the teeth and surrounding area after injury is not immediately
apparent. Restorative care for dental traumatic injury may be lengthy, complicated, costly and
extensive(17), and often undertaken in several stages. Treatment is not always successful. The
affected teeth may be lost despite treatment due to persistent infection associated with the injured
tooth/teeth caused by any of the reasons below.
Signs and symptoms suggesting a need for further investigation and possible treatment include any
of the following:
• swollen face;
• swollen gum around the teeth;
• extreme sensitivity of the teeth to temperature;
• a pimple on the gum, giving rise to occasional discharge. (The pimple may disappear then reappear again after a time);
• change (dulling/darkening) of tooth colour;.
• pain on chewing and/or biting;
• Painful or restricted movement of the jaw.
Such symptoms may be caused by:
• cracked/split tooth crown;
• cracked/split tooth root;
• damage to the nerve of the tooth;
• temporomandibular joint injury;
• fractured jaw or cheek.
If the cause of the infection cannot be eliminated the bony support around the tooth root in the jaw is
eroded, loosening the affected tooth, and possibly surrounding teeth. When this occurs tooth loss is
inevitable. If the tooth root has split the tooth may not be retained. These problems may not be
apparent initially but could be detected by subsequent radiographs as part of regular periodic review
for up to five years as recommended by International Association of Dental Traumatology.
Reducing the risks
Missing front teeth are a highly visible deformity, which may in some cases be the only legacy of a
sporting career. Schools and sporting organisations acknowledge the devastating impact of dental
injury and make efforts to reduce the risk by encouraging the use of mouthguards.
However, for these to be effective, they must be worn regularly. And the problem is that there are a
number different types of devices to choose from claiming to provide adequate protection to teeth,
with variable degrees of comfort and quality of fit, which has led to widespread confusion among
players (12,18-23).
Since younger players tend to take their lead on such matters from elite and other more
experienced athletes, the fact that some of these don’t wear mouthguards has a predictably
discouraging effect (2).
So what makes for an acceptable mouthguard? The following factors are key:
• It should be comfortable, well-fitting and not prone to dislodging on impact;
• It should provide adequate thickness of material (4mm) over vulnerable areas to reduce impact
forces(24);
• When biting lightly the on the guard, large areas of its biting surface should be in contact with
the teeth in the opposing jaw, so minimising the risk of jaw fracture;
• Only a custom-fitted mouthguard can accommodate each individual’s unique arrangement and
number of teeth while ensuring adequate thickness of material to protect vulnerable areas.
Mouthguard use and care
• Don’t share your mouthguard. This is a close-fitting appliance designed to be worn only by its
owner; • Don’t store the mouthguard in places where it may be subject to excessive heat build-up (eg your
car) which may lead to distortion;
• During use, remove the mouthguard after each quarter/half of play, and rinse it and your mouth
with water before re-inserting. At the end of play, rinse your mouth with water, wash the
mouthguard with soap and cold or warm (never hot) water, then rinse with cold water;
• Store the mouthguard in its container when not in use. This should have ventilation holes that
allow the guard to dry and encourage air circulation, preventing unpleasant odours;
• Before use, check the dry mouthguard in good light for any visible tears, particularly where the
material is thin or worn. Identify any rough areas that may indicate splits or cracks by running
your finger along the non-fitting surface of the guard that comes into contact with the opposing
teeth. This surface must also be checked for damage following any heavy blow to the mouth or
jaw.
Remember that no mouthguard will last forever. With use, the biting surface of any mouthguard may
flatten, wear or become dangerously thin over the biting edges of the front teeth, allowing the player
to bite through the mouthguard during use.
Damaged or worn mouthguards provide no protection other than a (false) sense of security, so be
sure to get yours checked by a dentist before each season of play and at any other time if you have
cause for concern.
It’s easier and cheaper to replace a mouthguard than to replace a lost tooth
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