During working hours
Please call 0208 958 7108
EMERGENCY NHS APPOINTMENTS: Please note we only have a small number of allocated emergency appointments for existing and registered NHS patients available during the week. These are strictly for
- Severe toothache and painful swellings, both getting no relief from using painkillers and keeping you up at night.
- Severe trauma (with pain) to the face, resulting in broken teeth
Please contact the practice and we will aim to see you within 24 hours.
URGENT NHS APPOINTMENTS
Urgent appointments will be booked within a couple of days/weeks and usually with your normal dentist. These include
- Broken filling with little sensitivity
- Loose or lost crown
- Broken dentures
- Bleeding gums
Outside of working hours
Private emergency care: Please leave a Whatsapp on or leave a voicemail on the practice number which is 0208 952 7108. Our dentists can re-open the surgery on weekends for severe dental emergencies so always call if you need help.
NHS emergency care: Please call NHS Direct on 111 for self care advice or details of where you may access out-of-hours dental services in your area.
Most emergency appointments will be on a private basis only and incur a charge. We deal with all dental insurance companies so please mention if you have cover at the time of booking.
What counts as a dental emergency?
Please call us on 0208 952 7108 if you are experiencing any of the following:
- Fractured teeth
- Wisdom teeth
- Facial swelling extending to eye or neck.
- Bleeding following an extraction that does not stop after 20 mins solid pressure with gauze/clean hankie. A small amount of oozing is normal, just like if you had a grazed knee.
- Bleeding due to trauma.
- Trauma resulting in a tooth being knocked out of the socket, or a large fracture resulting from trauma and causing severe pain.
- Significant toothache preventing sleep or eating, associated with significant swelling, or fever that cannot be managed with painkillers
- Loose or lost crowns, bridges or veneers.
- Broken, rubbing or loose dentures.
- Bleeding gums.
- Broken, lose or lost fillings.
- Chipped teeth with no pain.
- Loose orthodontic wires.
Please go straight to A&E if you are experiencing any of the following:
- Facial swelling affecting vision or breathing preventing mouth opening more than 2 fingers width.
- Trauma causing loss of consciousness, double vision or vomiting.
For pain relief we advise paracetamol in the first instance unless this is not a suitable option for you. Anti-inflammatories like Ibuprofen, unless this is not a suitable option for you, can help reduce sensitivity from teeth. Combining paracetamol and ibuprofen has also been shown to be effective. There is no strong evidence that drugs like ibuprofen can make Coronavirus worse. If you have no coronavirus symptoms carry on taking ibuprofen as normal. Until we have further information, you should take paracetamol to treat symptoms of coronavirus unless your doctor has told you paracetamol is not suitable for you.
All painkillers should be taken in accordance with instructions on the packet. Taking too many tablets WILL NOT IMPROVE YOUR SYMPTOMS and can cause serious stomach and liver injury which can be life threatening.
If the tooth is extremely sensitive to hot or cold, this may be a sign of decay and antibiotics will not help. These at-home measures may help assist with pain management until you can see a dentist:
- Good cleaning with fluoride toothpaste and reducing sugar intake will help stop decay from getting any worse.
- If there is a hole in the tooth, or the tooth has cracked and is now sensitive, a temporary filling material can be packed into the space to help make symptoms more manageable. These are widely available both online and from supermarkets or pharmacies.
Toothpaste aimed at reducing tooth sensitivity, such as Sensodyne Repair and Protect, may also help reduce pain. Rub the toothpaste directly on to the affected area and do not rinse. Anaesthetic gel such as Orajel can also help ease the pain.
If the pain is severe, rinsing with cold water can sometimes ease the pain whilst you are waiting to be assessed by a dentist.
Although painful, most mouth ulcers will heal within 7-10 days. A dentist or doctor should assess non-healing ulcers/oral lesions present for more than 3 weeks. Please call your practice for guidance if required; otherwise follow the home measures described below:
Warm salty mouth washes
Excellent cleaning (even if it is painful to brush, the area must be kept clean to encourage healing and prevent more ulcers forming. However, be gentle and do use a soft/baby toothbrush)
Difflam (Benzydamine) Spray or mouthwash as needed.
Soft diet (soft food will reduce trauma form biting)
Painkillers (paracetamol or ibuprofen following packets instructions)
Rubbing Dentures (Denture adhesives like Poligrip or Fixodent may help secure a loose denture. Any sharp edges can be removed using an emery board. Remove dentures when possible if causing trauma)
Corsodyl mouthwash (avoid use for more than 1 week as may cause staining)
Continue to take regular painkillers for several days after an extraction. It is not uncommon for the pain to be at its worst on days 3-4.
We cannot provide antibiotics for pain after extractions unless infection is present. We also cannot prescribe antibiotics without assessing you over the telephone first.
Some pink spit/oozing is normal after a tooth extraction. If the socket is bleeding freely, bite hard on gauze or a clean hankie for 20 minutes. If bleeding still doesn’t stop, please call your dentist.
If you smoke or rinse too soon after an extraction you risk a dry socket. This can be very painful and regular painkillers are unlikely to be effective. You should call you dentist for an emergency appointment. Antibiotics will not solve this and a dressing may be required to cover the exposed bone.
Bleeding from gums is NOT a dental emergency. Bleeding gums are usually due to gum disease and will not stop until your brushing technique improves. Brush twice daily with fluoride toothpaste for 2 minutes, paying particular attention to the areas that are bleeding. Remember to also use floss or interdental brushes to clean between your teeth every day.
If your gums are extremely painful and look infected (bright red with a grey/green appearance) you should still try your best to brush them even though they will bleed. Take painkillers as required and use mouthwashes such as chlorhexidine or peroxyl which can be purchased from your pharmacist.
- Clean and check the crown. If the crown is mostly hollow, you can attempt to re-cement it at home if you feel confident to do so.
- Remove any debris from the crown; you can use something like the tip of a paperclip to scrape the old cement away. Clean your tooth thoroughly; all debris should be removed from the crown and the tooth for the crown to seat properly.
- Check the crown fits without cement. Check carefully that the bite feels correct, if the tooth feels too tall or proud, it is not fitted correctly, double check for debris. Never try to force a crown or post onto your tooth, this can cause the root to fracture. If you cannot get the crown to fit, keep the tooth as clean as possible and wait to see your dentist.
- Crowns should be re-fixed back onto the tooth using a dental cement from a pharmacy like Recapit. DO NOT USE SUPERGLUE or FIXADENT to fit your crown.
- Once you have practiced placing the crown, dry the tooth and crown, mix the cement as instructed on the packet and fill the crown. Place the crown directly onto the tooth and bite firmly to press it into place.
- Remove any excess cement with a toothpick and floss between your teeth to make sure they do not stick together.
- If a tooth has been chipped and is sensitive and/or sharp then applying a sensitive toothpaste or using an emergency repair kit is advised.
- If a baby tooth has been knocked out, do not attempt to put it back in. Clean the area, bite on a clean hankie or towel for 20 minutes if it is bleeding, give the child age appropriate pain relief medicine and keep to a soft diet until the area has healed.
- If an adult tooth has been knocked out
- handle the tooth by its crown (the white part), avoid touching the root
- if the tooth is dirty, wash it briefly (10 seconds) under cold running water
- try to re-implant the tooth in its socket and then bite gently on a handkerchief to hold it in position
- if this is not feasible, store the tooth for transportation to the designated urgent dental care centre in milk (not water). Alternatively transport the tooth in the mouth, keeping it between molars and the inside of the cheek.
- You need to telephone for an emergency dental appointment.
The British Orthodontic Society advise that most orthodontic appliances can be left for some months without detriment if you continue with the usual after care instructions;
- Exemplary oral hygiene – brushing 3 times a day with their standard toothbrush, followed by interproximal brush use. You can also use a fluoride mouth rinse e.g. Fluoriguard (225ppm), once a day.
- Low sugar diet – where possible avoid snacking on foods and drinks with ADDED SUGAR. Fizzy drinks should be avoided in particular.
- Avoid sticky and hard foodstuffs that could break the brace wire or fracture brackets off a tooth.
Patients may in the coming weeks experience pain, problems and loose wires. At present, the best advice is to avoid all but the most essential mouth procedures to limit spread of the disease to the wider population.
If you suspect that you may have swallowed or inhaled a piece of your brace, you must call for advice.
A small piece of brace will normally pass through even if you have swallowed it.
For advice on managing common orthodontic/brace problems and solutions visit the British Orthodontic Society website (www.bos.org.uk)
An orthodontic patient where possible should contact their orthodontic practice or suitably qualified health care professional first to ensure that they are carrying out procedures safely and for any further advice if their condition deteriorates to resolve the problem.