I have a molar with an amalgam filling and root canal, and the tooth cracked in half on New Year's Day. The list of local dentists covered by my dental insurance is slim, and the soonest I could get in is this coming Tuesday. Problem is, the tooth has cracked off below the gumline at one point, and I've got swelling and tenderness. I'm regularly rinsing with salt water, and alternating between acetominophen and ibuprofen to supress the pain, which is still at a pretty high level. How do I make it to my appointment as comfortably and safely as possible?
Pain management/infection control for broken tooth while waiting on dental appointment?
This is a tough one, because with a vertical fracture you will be tearing into the gum and periodontal ligament anytime you bite down. Obviously you need to be on a soft diet, and rinsing will help to drain any infection that's starting.
I would explain your situation to the dentist's emergency service, and see if you can get a referral perhaps to an oral surgeon. Sometimes if the fracture isn't too far under the gumline the tooth can be saved; unfortunately especially for teeth that have had root canals, the fracture is usually such that the tooth needs to be extracted.
Steve Bornfeld, DDS
Reply:Go to your local drug store and buy a temporary filling kit. You can use this to patch your tooth together until you see the dentist. Also get some Abesol for tooth pain or clove oil (pure) and apply it to your gums. This will numb the area and make life a little bareable until you see the dentist. If you are afraid of infection, just remember to gargle with something like Listerine a couple times a day, to keep the germ content down in your mouth . Good Luck
Reply:You should have stressed the need for an appointment immediately. It may be in your best interest to call the dentist this weekend; he will at least be able to phone in some antibiotics and a pain medication. Even if the tooth has a root canal, once fractured it can become infected involving swelling and pain. Stick to the ibuprofen 600mg every 4-6 hours to help ease the pain. Advil or Motrin always works better for dental pain. Call your dentist tomorrow morning, he will be able to take care of you before your appointment next week. Sometimes the people who work as receptionist, don't know the first thing about dentistry, it amazes me at the incompetence. It's not just the patients who suffer for this.
Reply:You are doing pretty much all you can do. We often suggest that, when in pain, our patients can take up to 800mg of Ibuprofen every 6-8 hours, but only for 24-48 hours. Tuesday is actually pretty good, but you might ask them to put you on their cancellation list for Monday. You can try either heat or cold on the outside of your face, which ever feels better, although warm moist heat usually works the best. Try elevating your head while sleeping. Pain usually worsens when you're lying flat. I have seen some suggest Orajel or something like it. I honestly don't know if it works or not but it may be worth a try. Hang in there.
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