Dental Care at Home and in the Clinic during the covid-19 or Coronavirus crisis.
- During the Covid-19 crisis only severe emergencies will be seen in the clinic as per guidelines issued by An Taoiseach (28th March 2020).
- This guide lets you know:
- If you should contact us for an emergency appointment
- How you can deal with Non-Urgent dental concerns until you can be seen at the clinic.
What Happens if you call us with dental concerns in the Covid-19 Crisis
- You will initially be triaged over the phone by a qualified Dental nurse and where appropriate dental advice will be given.
- If your concern requires more advanced knowledge you will receive a call from the on-call dentist giving you the appropriate advice.
- If your concern requires emergency care you will either be seen by the dentist or referred to hospital.
Dental Emergencies Requiring Treatment
(Adapted from the American Dental Association Guidelines)
- Uncontrolled Bleeding: This is if you cannot stop bleeding after 20 minutes of placing solid pressure with a sterile swab (gauze/cloth).
- Trauma causing fracture of teeth, facial bones or uncontrolled bleeding.
- Swelling: Infection can cause severe facial swelling. If this extends to the floor of the mouth, the neck oO below the eye it requires urgent care. If swelling limits you opening your mouth (less than 2 fingers) that is also a major emergency.
The following are severe but may not require a physical visit:
- Severe Dental Pain: This could be due to a fractured tooth or trauma, due to decay or another reason for the nerve of a tooth or gum to cause pain.
- Toothache not manageable with pain killers.
- Swelling: Localised at a tooth or of the gum.
CONTACT US URGENTLY IF YOU HAVE ANY OF THE ABOVE on 01 454 7464
Non-Urgent Dental ConcernsLoose or lost Crowns, bridges, veneers or dentures
- Loose or lost implant restorations
- Loose or lost tooth or implant
- Fractured or chipped teeth, restorations, crowns or dentures NOT causing you pain.
- Bleeding gums
- Ulcers and blisters
- Sensitivity or mild pain of teeth
We will see you when we re-open but contact us if you need advice on 01 454 7464
- Using Over the counter medications will allow you manage most dental pain. The following is for ADULTS ONLY
- We suggest the following medication:
- Initially take 200mg Ibuprofen tablets every six hours (this can be doubled if required and taking 400mg as an initial dose may help ).
- If further relief is needed take 500mg Paracetamol every 6 hours (this can be doubled if required).
- MOST IMPORTATNTLY:
1) Check with the pharmacist if there is an interaction with other medications you are taking.
2) DO NOT EXCEED THE MAXIMUM DAILY DOSES ALLOWED and do not take if allergic.
Loose or lost crowns and bridges
- The biggest danger here is you could swallow or inhale a restoration. In general if a restoration comes out we recommend you leave it out until you can see a dentist.
- If you can get temporary cement from a pharmacy you can replace a crown or bridge unitil you get to a dentist. Ensure you try the crown/bridge in many times without cement to ensure it is fitting correctly. Also check your bite is correct. If the bite is wrong or you cannot repeatedly put it back in the correct position DO NOT try to cement yourself.
- Mix the provisional cement, replace the crown/bridge and wipe off excess. Bite firmly for 5 minutes.
- A big issue with a lost crown or bridge is the teeth will change position after a few days and it will not be possible to replace the old crown or bridge. If possible just placing the crown/bridge into the correct position for a couple of hours a day will maintain this space for you. Take it out for meals or sleeping.
- Do not try to replace lost veneers as they are not stable
Loose or lost dentures or implant restorations.
- A loose denture or implant bridge is not an emergency.
- Attend your dentist when it is safe to do so and they will discuss your options.
- With a loose implant bridge it is possible if left indefinitely to damage the implants so attend as soon as allowed in the Covid-19 crisis.
Loose or lost tooth or implant
- If you have a tooth that is loose or an implant that is very mobile again this is not an emergency but can be very annoying. Try and avoid any trauma with eating or cleaning but do maintain cleaning.
- If the tooth or implant comes out place some clean rolled up cloth (hanky) on the area and bite firmly for 15 minutes. If there is continued bleeding contact the dentist urgently.
Fractured or chipped teeth, restorations or crowns
- If they are causing you no pain or discomfort just keep clean until you see a dentist.
- If they are causing pain from sensitivity try and avoid things that stimulate the pain and try and cover the area with a sensitivity toothpaste. Covering with Vaseline can also help.
- A dentist would never normally advise a patient to adjust a tooth but if you cannot see a dentist and the tooth is causing you trouble as it is sharp you could try and smooth it slightly with an emery stone.
- Finally if a fractured sharp tooth or restoration is painfully lacerating your gums then contact the dentist who may need to see you.
- This is not normally an emergency.
- Bleeding gums are usually caused by gingivitis which resolves with good cleaning. Periodontitis which is more severe rarely causes pain and can be treated after the Covid-19 crisis.
- Maintain good cleaning and you should see this reduce. Use corsodyl mouthwash for three days in addition if required. Cleaning should include normal brushing and very importantly using floss or brushes between the teeth.
Ulcers and Blisters
- These are common and usually not anything suspicious. Taking pain killers and maintaining cleaning is usually all that is required.
- If after 7 days they have not improved or are causing serious pain a dentist will need to see you.
- Management should involve normal cleaning and hot salty mouthwashes.
- If still a concern try a barrier like Bonjela Complete (we do not advise the use of bonjela which is too aggressive) to minimise soreness. You dry the area and apply with the applicator provided.
- Sensitivity has different levels of concern and is usually mild however for some patients it is severe and very limiting.
- It is not a dental emergency and you will be seen after the Covid-19 Crisis.
- Initially use sensitivity toothpastes and you can smear a little of this on the tooth when going to bed. You can also cover the area with Vaseline.
- Avoid foods and temperatures that stimulate the sensitivity.
Pain around wisdom teeth
- This can usually be managed, for a period at least, at home.
- It is essential to clean the area directly with a brush which will be sore. Using corsodyl Gel on the toothbrush will also help, use for 3 days at a time.
- Take painkillers as previously outlined.
- Use hot salty mouthwashes a few times a day.
- If pain continues or there is swelling, especially if getting worse, call the dentist urgently.
If you read the guide and are uncomfortable or confused please call the clinic on 01 454 7464