In summary. When faced with acute dental pain or trauma, the first rule is to distinguish what can be managed at home while waiting from what requires a same-day evaluation. An abscess cannot be resolved with antibiotics alone and should never be heated; a fractured tooth fragment is preserved in milk or saline solution; a permanent tooth ejected from the socket (avulsion) has a prognosis that depends on the minutes. For emergencies, Studio Buniato reserves dedicated daily availability: telephone 011 4373857 and WhatsApp Patient Care.
I have severe dental pain now: what should I do immediately?
The useful immediate measure is to control the pain with an analgesic already tolerated in the past and contact the practice for an evaluation, avoiding maneuvers that could worsen the situation. Acute pain is a signal, not a diagnosis: the same intensity can arise from a deep cavity, an abscess, a fracture or an erupting wisdom tooth, and each of these has a different management. For acute pain, the literature documents that the combination of ibuprofen and paracetamol, in people who have no contraindications, offers better pain control than the two drugs taken individually. This concerns the symptom, not the cause: no analgesic replaces the removal of the origin of the problem. Avoiding heat sources on the cheek, not placing the aspirin directly on the gum and calling the office to correctly locate the emergency are the three steps that guide the rest.
I have an abscess: is the antibiotic enough? Can I put the heat on?
No to both questions: the antibiotic alone does not resolve an abscess of dental origin and local heat is contraindicated. An abscess is a collection of pus that arises from an infection starting from the tooth or the supporting tissues; as long as the cause remains - an infected canal, a periodontal pocket, a compromised tooth - the infection tends to recur. The Cochrane systematic review on the topic concludes that, in adults with symptomatic apical periodontitis or acute apical abscess, there is no evidence that systemic antibiotics alone offer a benefit when dental treatment can be performed: it is drainage of the collection and treatment of the tooth (root canal therapy or, where indicated, extraction) to resolve the picture. Antibiotics remain a targeted tool, decided by the clinician, in cases with signs of systemic spread or general impairment, not a shortcut to postpone treatment.
On the home front, the most frequent mistake is to apply heat - hot water bottle, compresses - in the hope of alleviating: heat favors the progression of the infection towards the surrounding tissues. If local relief is needed while waiting, cold is preferable, externally and for short intervals. Swelling that extends to the neck or floor of the mouth, difficulty swallowing or opening the mouth, and fever are signs that require immediate contact, without waiting until the next day.
I broke a tooth and I have the fragment: how do I keep it?
Keep the fragment wet, immersed in milk or saline solution, and bring it with you to the visit: in some cases the fragment can be re-adhered. The international guidelines on dental trauma (IADT) indicate that, when intact, the coronal fragment can be reglued to the tooth, and that it must be kept hydrated to avoid dehydrating the tissues. Therefore, avoid letting it air dry or wrapping it in a handkerchief. In the meantime it is useful to gently rinse your mouth with water, check for bleeding and protect any sharp edges with your tongue or gauze. A fracture can affect only the enamel or reach deep into the pulp: the difference is not always visible to the patient, and this is why even an apparently minor chip deserves a check, preferably a quick one.
My tooth was completely knocked out due to a blow: can it be put back?
Yes, a completely ejected permanent tooth (avulsion) can often be reimplanted, and the prognosis depends crucially on how long the tooth remains out of the socket and how it is preserved. The IADT guidelines on the avulsion of permanent teeth indicate to reimplant the tooth as soon as possible: when conditions permit, immediate reimplantation on site, immediately after the trauma, offers the best conditions for the periodontal ligament. If immediate replantation is not possible, the most important factor is to prevent the root from drying out: the time that the tooth spends dry in the air is the main enemy of the ligament cells, and beyond approximately sixty minutes of remaining dry their survival is markedly reduced.
Correct maneuvers are precise. Pick up the tooth by touching only the crown, never the root. If it is dirty, rinse it briefly with saline solution or milk, without rubbing. If you feel like it and the tooth is permanent, try to gently put it back in place and keep it in place by biting on a clean tissue. If this is not possible, immerse it in a suitable preservation medium: the systematic review on preservation mediums and the IADT guidelines indicate milk and saline solution among the practical and easily available options; in the absence of alternatives, saliva (keeping the tooth in the vestibule of the mouth, if there is no risk of ingestion) is preferable to air or water. Tap water should be avoided as a preservation medium because it damages the ligament cells. Then immediately contact the office or the emergency room: here the minutes really count. Reimplantation is not performed in children's milk teeth, but the evaluation is still urgent.
I have pain and swelling behind the last molar: what is pericoronaritis?
Pericoronaritis is the inflammation of the gingival tissues that partially cover an erupting tooth, typically the lower wisdom tooth, and must be evaluated clinically because home relief is only temporary. The flap of gum above the tooth retains residues and bacteria, resulting in pain, local swelling, sometimes difficulty opening the mouth or bad breath. While waiting for the visit, rinsing with warm, slightly salted water and delicate hygiene of the area can help, but these are containment measures. The definitive management depends on the situation of the tooth: professional cleaning of the area, and based on the position and recurrence of the episodes the shared decision on whether to remove the tooth. When fever or swelling that spreads, contact should be brought forward.
I have pain after surgery: when is it normal and when should I call?
A certain degree of pain and swelling in the first days after an extraction or operation is expected and generally gradually eases following the instructions received; instead, it must cause the study to call pain that increases after improving. The typical course is maximum discomfort at the beginning, controllable with prescribed analgesics, followed by gradual improvement. These are signs that deserve contact: intense pain that reappears a few days later (possible alveolitis after an extraction), swelling that grows instead of reducing, fever, bleeding that does not stop with gauze held under pressure, or an alteration in sensitivity that persists. In these cases it is not useful to increase the drugs on one's own initiative: it is more sensible to describe the picture under study, which will indicate the correct step.
How does Studio Buniato in Turin manage emergencies?
The practice reserves availability dedicated to emergencies every day, so that acute pain or trauma can be quickly assessed and placed on the correct path. The first contact serves to understand the nature of the problem and its real urgency: some situations - avulsion of a permanent tooth, swelling that extends, difficulty swallowing - do not allow waiting; others are managed with a close appointment. The channels are the telephone 011 4373857 e WhatsApp Patient Care, useful for describing the symptom and, where necessary, sending an image that helps orient the priority. The evaluation in the studio makes use of theimaging when indicated, to distinguish what is treated conservatively from what requires a different approach, and not to postpone a decision that the times make important.
Frequently asked questions
Can I take an antibiotic I have at home if I suspect an abscess?
It is not recommended to take antibiotics on your own. The available evidence indicates that, when dental treatment is possible, antibiotics alone do not resolve the abscess: the cause must be removed. The choice of whether and which antibiotic to use, typically as support in selected cases, is up to the clinician after the evaluation. Contact the studio to define the route.
How long do I have to replace an knocked out tooth?
The less time that passes, the better the prognosis. Replanting in place immediately after trauma offers the best conditions; if this is not possible, store the tooth in milk or saline solution and reach the office or emergency room without waiting. After about an hour of the tooth remaining in the air, the ligament cells survive with difficulty, which is why minutes count.
How do I store a detached tooth or fragment?
In milk or saline solution. They are means indicated by the guidelines on dental trauma because they keep the tissues hydrated. Avoid tap water, which damages cells, and do not leave the tooth or fragment out in the open. The fragment must be brought with you to the visit.
Can I put heat on my cheek if I have an abscess?
No. Local heat can favor the spread of the infection. If you are looking for relief while waiting, external cold for short intervals is preferable. Swelling extending to the neck, difficulty swallowing or opening the mouth, and fever require immediate contact.
Is pain after an extraction normal?
A nuisance in the first few days, which gradually improves, is within the expected course. Instead, you should call if the pain increases after getting better, if the swelling increases, if a fever appears or if the bleeding does not stop with pressure gauze.
How do I contact the firm for an emergency?
Telephone 011 4373857 and WhatsApp Patient Care. Every day, availability is reserved for emergencies: the first contact serves to understand the nature of the problem and its real priority.
Sources
- Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, O'Connell A, Flores MT, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2020;36(4):331-342. doi:10.1111/edt.12573. PubMed.
- Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O'Connell AC, Day PF, Tsilingaridis G, Abbott PV, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dental Traumatology. 2020;36(4):314-330. doi:10.1111/edt.12578. PubMed.
- Adnan S, Lone MM, Khan FR, Hussain SM, Nagi SE. Which is the most recommended medium for the storage and transport of avulsed teeth? A systematic review. Dental Traumatology. 2018;34(2):59-70. doi:10.1111/edt.12382. PubMed.
- Cope AL, Francis N, Wood F, Chestnutt IG. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane Database of Systematic Reviews. 2018;(9):CD010136. doi:10.1002/14651858.CD010136.pub3. PubMed.
- Moore PA, Hersh EV. Combining ibuprofen and acetaminophen for acute pain management after third-molar extractions: translating clinical research to dental practice. Journal of the American Dental Association. 2013;144(8):898-908. doi:10.14219/jada.archive.2013.0207. PubMed.
For an evaluation of your specific case, the first specialist visit includes the complete diagnostic analysis.
