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How to Look After your Oral Health during the COVID-19 Lock Down

You’ve been asked to remain indoors for all but essential travel for the past two weeks. You’ve exhausted all of the Netflix box sets that interest you. Maybe home-schooling the kids has driven you slightly mad. Boredom gets the better of you and you reach for the bag of chewie sweets that you’ve been resisting for the last week. The first one you eat finds it’s way to the back right tooth that’s been sensitive on and off for the last month and CRACK!! Suddenly, the chewie sweet has something hard in it that was not there before! You reach for the phone and call your dentist, only to discover that it is closed, and so is every other dentist that you try. Is there any way you can deal with this yourself at home?

This blog is to offer some suggestions of how you can help yourself with dental care in this unique time of country wide lock down. We will address what is an actual dental emergency, and what can wait until dentists re-open. We will offer tips and advice of not only how to deal with toothaches, lost fillings, lost crowns and broken teeth, but also how to prevent them from happening in the first place.

From the 23^rd of March, most dental practices in the UK were either completely closed or offering telephone only advice and prescriptions. A letter from the Chief Dental Officer in the Government asked us to cease all routine dentistry and face to face appointments. They asked us to provide telephone advice and prescriptions only. This lead most practices to take the difficult decision to close their doors and offer a telephone only service to their patients.

What Counts As A Dental Emergency?

The chart below outlines what is and what is not a dental emergency.

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Thankfully, there are ways of dealing with some more minor dental problems yourself at home.

Toothache

If a tooth pain is made worse by hot and cold and the tooth feels sensitive, antibiotics will not help. There are some home measures which may manage the pain until a dentist can be seen again.

If there is a hole in a tooth, or a tooth is cracked and is now sharp or sensitive, a temporary filling can be placed into the hole yourself. These are widely available from supermarkets, pharmacies and even from Amazon.

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If a tooth is sensitive, desensitising toothpaste, such as Sensodyne Repair and Protect or Colgate Prorelief can help. Rub this toothpaste directly on the sensitive area and do not rinse it off afterwards. Also anaesthetic gels such as Orojel can help to ease pain and sensitivity.

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If the pain is not managed by any of the above mentioned means, painkillers may be necessary. Anti-inflammatories like Ibuprofen are good and reducing dental pain. Combining Paracetamol and Ibuprofen has also been shown to be effective. People have been concerned about taking Ibuprofen with COVID-19 symptoms, however, there is currently no strong evidence to suggest Ibuprofen makes COVID-19 any worse. However, until we have more information, it is best to take Paracetamol to treat symptoms of coronavirus, unless your doctor has recommended otherwise.

Painkillers should always be taken in accordance with instructions on the packet. Taking too many tablets or taking medications incorrectly will not improve your symptoms, and may cause serious stomach and liver problems which could be life threatening.

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Wisdom Tooth Pain

One of the really common problems we see at an emergency appointment here at the clinic is wisdom tooth pain. It is usually due to inflammation of the soft tissue over a wisdom tooth that is not fully through. This can be made worse by biting on the inflamed gum.

Most cases of this wisdom tooth problem can be managed with good home care and should calm down within 2-7 days.

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It is extremely important to keep the area clean, even if it is painful to brush the area. Corsodyl or salty mouthwashes also help, however avoid using Corsodyl for any longer than a week as can cause staining of the teeth.

For more severe cases, painkillers may be necessary. Again, Ibuprofen or Paracetamol should be used as per instructions on the packet.

Most cases of wisdom tooth pain is not an infection, but just inflammation. Therefore most cases do not require antibiotics.

However, if you have difficulty swallowing, swelling in your face or difficulty opening your mouth, please call your dentist as you may need antibiotics if there is a spreading infection.

Mouth Ulcers

Mouth ulcers can be incredibly painful, even when small. The good news is that most will heal within 7-10 days. If an ulcer is present for more than 3 weeks without healing, this should be assessed by a dentist or a doctor.

There are many home methods that can help painful ulcers such as:

Warm, salty mouthrinses.
Excellent cleaning, even when painful.
Difflam spray or mouthwash.
Soft diet.
Painkillers
Corsodyl mouthwash. (no longer than 7 days to avoid staining)
Denture adhesives like Fixodent, if the ulcer is due to a rubbing denture.

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Lost Crowns

If you have lost a crown, it is possible to temporarily cement it back yourself until you are able to see a dentist. If you use the correct temporary cement, your dentist should be able to easily remove the crown, clean it and cement it back with a permanent adhesive when the time comes. Below are the steps in re-cementing you crown back temporarily.

Check the crown for suitability for recementing. If the crown looks mostly hollow on the inside, you are probably fine to try re-cementing it.
Clean the hollow inside of the crown from debris. You can use a toothpick or the end of a paperclip to do this.
Check that the crown fits without cement first. Check that the bite feels normal. If the bite feels too high, it is probably not fitted correctly. Remove the crown, and check for debris again. Never force a crown or post onto, or into your tooth. This can cause a root fracture. If you cannot get the crown to fit, keep the tooth as clean as possible, keep the crown safe and wait to see your dentist.
You should use an appropriate temporary dental cement from a pharmacy such as Recapit. Do not use superglue or Fixadent.
Once you have practiced placing your crown, dry the tooth and crown, mix the cement as instructed on the packet and fill the crown. Place the crown directly on the tooth and press into place. Then bite firmly into place.
Remove any extra cement with a toothpick and floss between your teeth to make sure they do not stick together.

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If you are unsure of any of the above, please do not hesitate to call your dentist as they should still be available for telephone advice and to provide prescriptions where appropriate. You may also be able to contact your dentist by email. We are happy to answer any questions and offer advice via email at info@ancellsfarmdentalclinic.com.

Dr Jay Tanna 07.04.20 Dentistry