100 Sparks Valley Road, Suite C, Hunt Valley, MD 21152
Phone: 410-771-8200 | FAX: 410-771-8201


Emergencies page art for Pediatric Dentist Dr. Shari Kohn

EMERGENCIES

Emergency Visit During Normal Business Hours

Dental Emergencies Not During Normal Business Hours

Teeth Injuries    |    Chipped Teeth    |    Toothache

Maxillary Frenum Tear – Torn Gum between 2 Top Front Teeth

Cut or Bitten Tongue, Lip or Cheek

The Specialty Consultation Visit

Emergency Visit During Normal Business Hours

For a true dental emergency, we will use our best efforts to treat your child in a timely manner. Emergencies are assessed over the phone to determine if the patient needs to be seen immediately or can wait until later that day or the next business day. If seen, it will be decided what the next step and the best course of treatment will be for your child. Please contact us if you have any dental concerns.

Dental Emergencies Not During Normal Business Hours

If your child falls and hurts their mouth you must try to assess the situation. If they have lost consciousness they must immediately go to the emergency room or you must call 911.

There are certain words that can provoke fear. Examples of these negative types of words are words like “pick,” ”needle,” ”shot,” ”hurt,” “drill,” “fluoride,” “X-ray,” “bright light, We try not to use these words in our practice at all. We listed some alternative words at the bottom. Parents, siblings and friends tend to inadvertently use these words and unintentionally cause their children to become nervous or frightened.

In the event of a dental emergency see the list below. We make every effort to always have someone on call. For patients of record, please contact the office at 410-771-8200 and listen to the message on the answering machine for instructions on how to contact the dentist on call.

Please note there is an after hour fee associated with appointments during non business hours.

Teeth Injuries:

Avulsion – Knocking Out an Entire Tooth
If a permanent tooth is knocked out completely – FIND THE TOOTH! Be sure to hold it by the crown -- not the root. You may lightly rinse the tooth but DO NOT clean, scrub or handle the root. Inspect the tooth for fractures. If it is in good shape, try to reinsert it into the socket. Have the child keep the tooth in place by biting on a piece of gauze or a clean washcloth. If you cannot reinsert the tooth, transport the tooth in any kind of milk or the child’s saliva. The child must see a dentist IMMEDIATELY! Time is a critical factor in saving this tooth.

If a baby tooth is broken through the nerve call our office. If it is knocked out completely, stop the bleeding with pressure and call our office on the next business day.

Any other chips and bumps to the teeth may or may not need to wait until the next business day. Use your best judgment and call our office if you have any concerns.

Chipped Teeth:

All Teeth can be chipped – both baby teeth and permanent teeth. They can be chipped into the first layer of tooth structure – the enamel, the second layer – the dentin, or the third layer – the pulp or the nerve. The depth will determine the seriousness of the trauma. Examine the tooth to see how large the chip or fracture is. See if the tooth is loose. Look for bleeding from the tooth – not bleeding from the gum. If you see red blood coming from the center of the tooth then the pulp or the nerve has been exposed. In that situation, call the office. In all other situations, you may see a white or yellow area. Use your best judgment to decide whether or not you should call the office.

**Remember – most teeth are chipped from accidents! Car seats and mouth guards are the best protection that we have to help avoid these types of traumas.

Is your child a serious athlete? Ask us about our custom mouth guards!

Toothache:

Rinse the mouth vigorously with warm water and use a toothbrush and dental floss to dislodge impacted food or debris around the affected tooth. DO NOT place aspirin on the gum or on the aching tooth. If necessary, you may give you child Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) to help with their pain. If facial swelling develops apply a cold compresses and call our office. If severe swelling suddenly occurs causing the child’s face or eye to shut or the face feels warm to the touch go immediately to the emergency room.

Maxillary Frenum Tear – Torn Gum between 2 Top Front Teeth

Directly under your child’s upper lip and inserting between their two front teeth is a piece of gum tissue known as the frenum. Often times when children fall, they tear this attachment. This does not usually require stitches but can be very bloody and messy. Sometimes the attachment is so tight that the fall tears the attachment and causes a frenectomy – a procedure that many need to have performed later in life. Treatment is usually palliative in nature. Stop the bleeding with pressure using either gauze or a clean washcloth. Give your child Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) if needed. Apply Ice to the upper lip if swelling occurs. A soft diet may also help.

Cut or Bitten Tongue, Lip or Cheek:

If your child bites their tongue lip or cheek and there is bleeding apply firm but gentle pressure with gauze or a clean washcloth. Give your child Acetaminophen (Tylenol) or Ibuprofen (Motrin or Advil) if needed. If bleeding does not stop after 20 minutes or it cannot be controlled by simple pressure, take the child to hospital emergency room.

The Specialty Consultation Visit

While we often treat patients as primary care providers, you may have been referred to us, as Pediatric Dental Specialists, by your family practitioner or general dentist. Often times this referral is for us to perform treatment or to give an opinion on some problem or question to which the referring doctor is either not specially trained or is not fully comfortable doing.

When you are referred to us, this first visit is known as a Specialty Consultation. At this visit, no treatment other than a review of medical and dental history, an oral examination and, perhaps, X-rays will be taken if required. You will be given an appointment for treatment, a treatment plan for your child and many forms with detailed explanations of the treatment your child needs.

This visit is extremely important and we need to meet your child and evaluate them.

While we understand that this is an extra visit, we feel that it is in the best interest of your child. At this visit, we can review all treatment needs with you and schedule the next appointment(s) at the appropriate time of day. For example, your child may need to be the first patient of the day or perhaps be on an empty stomach in order to the complete the appropriate treatment.

At this consultation appointment, we will also give you all the information that you will need pertaining to office policies and finances.

While we understand that you are busy and that you want to get your child’s treatment started as soon as possible, this Specialty Consultation is essential for many reasons:

We need to determine what kind of treatment is needed. The work for which your child was referred to us is NOT always the treatment that we recommend after we review the history, clinical examination and evaluate the X-rays. In many situations, the referring dentist was unable to obtain X-rays because they did not have the training or the small equipment needed to take the X-rays on your child. We use this visit to attempt to get these X-rays and other diagnostic methods.

We need to meet your child so that we can decide which method of treatment is best suited for them. There is no “cook book recipe” for treating children. We must evaluate your child’s behavior and ability to follow directions. Based on their medical history, work needed, and ability to cooperate, we need to develop a treatment plan that is based on their particular needs. They are all individuals with individual needs and we cannot treat them until we meet them and assess them specifically.

There are many options that we can use to treat children at different ages and with different treatment needs. Some of our patients will simply hop up into the dental chair and open their mouths.

Others are a little nervous and may need the use of Nitrous Oxide Analgesia, commonly known as “laughing gas” or “happy air” to help them relax. Nitrous Oxide does not put your child to sleep and we will explain to you and your child how it works and what to expect. We will also recommend that your child not eat or drink for 3 hours prior to their next appointment if using Nitrous Oxide.

In other situations, we may recommend the use of conscious sedation using oral medicines which we administer in our office. Conscious sedation patients must have an excellent medical history in order to be candidates for this type of procedure. They must be cold and cough free and we must evaluate them prior to administering the oral sedative the morning of the procedure. They must also not eat or drink prior to this appointment.

In other more extreme situations, we will take some children including those patients with special needs, to the hospital or surgery center operating room and perform all dental treatment under general anesthesia as an outpatient. In these cases, we will have an anesthesiologist administer the general anesthesia and while the patient is asleep, we complete all dental procedures including X-rays, cleaning, fillings, sealants, extractions, crowns, pulpal procedures, space maintainers, impressions and any other necessary dental procedures. Once our treatment is complete, the patient will be transported to the recovery area for observation and will be released upon permission of the anesthesia department or post anesthesia care unit.

As you can see, there is much that we need to do to make sure that our treatment meets your child’s needs.

We hope that you understand why it is so important that we have this initial consultation visit. We want your child’s treatment to be tailored to their needs. We find that this makes for the best success and experience that we can give.

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