Tooth Trauma (Part I of IV)

Whenever a tooth is injured in a fall, there are certain steps that one must take. First and foremost, a head injury must be ruled out. When one has fallen or received a blow to the mouth, it is not uncommon to also incur trauma to the head. Especially when a tooth has been chipped and there is blood in the mouth, the focus of attention can be on the oral cavity. If there are any symptoms such as dizziness or loss of consciousness, a physician should be consulted. Once head injury has been ruled out, then the focus can be placed on the mouth. If a front tooth was chipped, look for a small red dot toward the center of the tooth.

Exposed nerve/ "red dot" after trauma

This should be checked after any blood has been rinsed away. The red dot is the tooth’s nerve. If it is exposed, there is a fairly high likelihood that it would need root canal treatment. A dentist should be consulted as soon as possible in that situation. The next thing to look at is to see if any teeth are loose or displaced. Again, if either of those conditions are present, a call to your dentist would be in order. Otherwise, it would be best to see your dentist at your earliest convenience so that he can x-ray the tooth to make sure that there are no fractures under the gums.

IV Sedation in Dentistry

It is not unusual to have some apprehension before a dental appointment. Most, if not all, of that normally goes away once the area to be treated has been numbed. However, some people have dental phobias, usually related to past, unpleasant experiences that make even a routine dental visit a stressful occasion. For most of these people, either nitrous oxide and/or oral sedation is adequate to quell the fears, but there are still a few who need deeper sedation. There are a number of wonderful medications that can be delivered intravenously. Since these are given IV, they can be titrated (adjusted) to the perfect level for each individual patient. We use Versed (midazolam) in our office. It is a very safe sedative that can fully relax a patient, but keep their protective reflexes and their ability to respond to commands intact.

Monitor vital signs

We monitor vital signs continuously to assure the highest level of safety. It is important that the patient does not have anything to eat or drink after midnight. They also must have a ride home after the procedure and should not drive or operate machinery for the next 24 hours. The addition of IV sedation to a dentist’s armamentarium can make a dental procedure extremely pleasant for even the most fearful patient.