Category Archives: Emergency Dentistry

root canal problems

I had a root canal treatment for an infected tooth. After I finished treatment, my dentist gave me a prescription for penicillin. A week later I was still in pain. He wrote me a prescription for Vicodin and said if it still hurt after another week he’d give me a different antibiotic. I don’t think I can wait that long. Plus, the Vicodin makes me feel weird. What do you recommend?


Dear Barry,

man grabbing the side of his jaw in pain

Your dentist is missing the boat here. First, the antibiotic prescription. While penicillin can work, it wouldn’t be my first choice after a root canal treatment. Instead, I’d try a stronger antibiotic such as clindamycin.

Second, the amount of time he’s waiting to get you on the correct antibiotic is way too long. You should have been feeling better after a couple of days and he wants you to wait over two weeks! No.

There’s a good likelihood you still have a dental infection because something was missed here. You don’t want the infection to spread any more than it already has.

Where to Go From Here

I think you need to see a root canal specialist and have this re-treated. When you call the office, let them know what is going on so they can get you on the right antibiotic.

To give you realistic expectations here, a root canal re-treatment is usually successful only in 50-75% of the time.

If it turns out, the re-treatment doesn’t work, you may need to extract the tooth in order to get rid of the infection. If that happens, you’ll want to discuss your tooth replacement options with your dentist. If you want the top of the line replacement, then getting a dental implant is the best bet. Your next best option is a dental bridge. However, it does require crowning the two adjacent teeth.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

When a Tooth is Knocked Out

I was at the playground and saw a boy who was hit in the mouth and lost a tooth as a result. His mother just tossed it because it was a baby tooth, but it got me to wondering. What would I do if it was an adult tooth?


Dear Melissa,

a hockey player with a knocked out tooth

Whenever a tooth is knocked out, it’s a dental emergency whether it’s a baby tooth or an adult tooth. Even though the baby tooth doesn’t need to be saved the dentist needs to check the pulp of their tooth to make sure no damage was done which will affect the adult tooth underneath.

With an adult tooth, it’s even more serious. You have about 30 minutes to try and save the tooth. Call your dentist right away and let them know what happened. They’ll be available and ready as soon as you get there.

If you don’t have a dentist, you can do an internet search for an emergency dentist. These are general dentists who will see non-established patients in cases like yours. Again, let them know you’re trying to save a tooth so they’ll be prepared. Time is of the essence.

You’ll only want to handle the tooth by the crown (the part which is visible when you smile). Try never to touch the root. Additionally, you’ll want to keep it moist. If you can, put it in a glass of milk. If that’s not available, you can just place it between your gums and your cheek.

If Your Tooth Can’t be Saved

There are times when a tooth can be saved. In that case, you’ll have options for your replacement. Ideally, you’d want a dental implant. That’s almost like having a natural tooth. However, if it’s a teenager or child you’re talking about an implant isn’t possible. Their jaw has to be finished growing.

After a dental implant, the next best option is a dental bridge. This suspends a false tooth between two crowns. There are other options as well if neither of those work for you such as a removable partial denture or a dental flipper. A flipper is only meant to be temporary though, while you are waiting for a better replacement.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.

Did the emergency dentist blow off a possible infection in my tooth?

I’m completely put off by the emergency dentist I just saw. I’m partially to blame for the situation I’m in because I’ve blown off getting a filling for about a year on one particular tooth. When I called, I told them about that tooth, but also explained to them that I thought the tooth next to that one also needed a filling. I was assuming they would schedule enough time for the dentist to take care of both. It was one of the last appointments of the day, and when I finally got in the chair, he basically took a few minutes to look in my mouth and proceeded to tell me I needed a filling – but only on the tooth next to the one I already had a cavity in. I questioned him on it and he changed his tune and said I did need two fillings, and that I’d have to come back to have them done. Seriously? I am in pain and now I have to wait even longer! What’s the point of seeing an emergency dentist? It feels like this guy just wanted to get out of there so he hurried me along. He looked at my teeth so fast that now I am wondering if he missed an infection or something more serious. — Jackie

Here’s the thing about cavities… they can be very painful depending on how deep they are in the tooth. It doesn’t always mean there is an infection or a need for a root canal (which is usually pretty obvious had you had a full-blown exam and x-rays).

Dentists perform “tests” to try and figure out what tooth/teeth are bothering you so they can offer the best diagnosis and treatment plan. Teeth often refer pain to neighboring ones and even a cracked tooth can cause a lot of pain. Sometimes things can be missed even if there are x-rays.

It is strange that your dentist missed the second cavity until you called him out on it. It’s understandable that you felt hurried along or maybe even misdiagnosed. Get the fillings done as soon as you can – and maybe find another dentist to do it. Dentists don’t always schedule time for the actual work to be done – especially if they haven’t done a thorough exam. It’s simply too difficult to know the exact course of treatment or how long it will take. If you try a different dentist, be sure to let them know your diagnosis and recommended treatment from the emergency dentist at the time you make the appointment. This should help the office in determining if the dentist can set aside the extra time to do the fillings in addition to the initial exam.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Is pain and tenderness around my implant an emergency?

I had an implant placed about three months ago and the healing process has been great – up until last night. Something felt different and now this morning there’s tenderness and pain that is radiating into my jaw. It hurts enough that I can’t really eat. Of course it’s the weekend, so I’m not sure if this is something I should be worried about having looked at immediately by an emergency dentist or wait until Monday. Any advice? — Gabrielle

It’s probably a good idea to see an emergency dentist. From what you’re describing, you likely have an infection at the implant site since the pain is getting worse and spreading to your jaw. Not being able to eat is also a concern and worthy of a visit to the dentist, too.

Oral infections can spread quickly if not taken care of. They can even become deadly if it attacks the heart or brain. Infection can also lead to complete implant failure and significant bone loss. If that happens and your implant needs replaced, bone grafting will need to be done before placing a new post. Early treatment with an antibiotic can stop this from happening.

If your regular dentist has an answering service, try calling there first.  If they don’t have an on-call line or they don’t respond in a timely manner, look up your nearest emergency dentist and get an appointment as soon as you can.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

I’m embarrassed to tell my dentist I had fillers injected

My tooth is in serious pain, but I’ve been holding off on going to the dentist because I recently had Juvederm injections in my laugh lines. I know a lot of people do it, but I’m kind of embarrassed to admit it to my dentist. I’m afraid if I don’t tell him the filler will move if I try and have my tooth fixed. So, I just keep waiting hoping I can make it at least two weeks (which is what my post op instructions stated). The longer I wait, the more it hurts and the the more of an emergency situation this becomes. Help! — Sara

You definitely don’t want to apply pressure to any areas where filler has been injected for at least a couple of weeks. But, if your tooth is continuing to get worse, you should be seen and you definitely don’t need to feel embarrassed to tell your dentist about the injections.

Call your dentist and get in as soon as possible so he can x-ray and examine the tooth. Once he knows you have the fillers, he’ll be extra careful about applying pressure and you’ll probably feel most uncomfortable trying to open your mouth – simply because the fillers cause tenderness and swelling. If it was just a regular check-up, you could easily put it off a few weeks, but this toothache could quickly become very serious and visiting the emergency dentist will not affect your fillers.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Will “DIY” tooth fix while on vacation come back to haunt me?

Wouldn’t you know that while I was on my dream beach vacation, the crown on my front tooth broke and split in half! Since I was out of the country and still had a few days until going home, I panicked. I had no idea how to go about finding a dentist and was afraid it would cost a fortune, so I did the easiest thing I could think of – I bought some super glue for a quick fix and got back to the beach. It totally worked, but now that I’m home and need to see my dentist, I’m afraid I’ve caused a big problem. Will my dentist be able to get it off to replace it? — Leon

Let’s face it… nobody wants to look in the mirror at a broken tooth – especially on vacation. But while DIY may be your specialty for home projects, it’s really best to leave any tooth “fixes” to the professionals.

It can be intimidating when you’re away from home to try and find an emergency dentist (even more so when you’re out of the country and you’re dealing with a possible language barrier, not to mention possible insurance hassles). But here’s the deal: an emergency dentist could have temporarily re-attached the crown properly so you could get by a few days until heading home. Try not to worry too much because your dentist will be able to get the crown off. Most bonding agents and cements he uses are stronger than any super glue you could buy. However, there’s no guarantee that it will come off in once piece, so you should be prepared in case you need to have it completely re-done. If you ever find yourself in this predicament again and you can’t get into your dentist right away, check at your local drug store for over-the-counter dental cement. It can be tricky to use and it will be temporary, but it’s a much better choice if you have to do a quick “DIY” fix.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

How long will bonding done by the emergency dentist last?

I slipped and fell on the ice last weekend. Unfortunately, my face broke my fall. I wound up with a black eye and a serious chunk of one of my front teeth missing. I went to the emergency dentist to have it checked out. He took x-rays and told me the tooth looked like it was ok structurally. Then, he patched it up and told me to follow up with my regular dental office to have it permanently fixed and checked on again later. I don’t want to waste time and money on another appointment if it isn’t necessary and it looks like he used the same stuff that’s usually used in fillings. Do I really need to go back or can I just let this one be? The patch job by the emergency dentist looks just fine to me.  — Don

Dear Don,
Glad to hear you’re mostly ok after the fall. As for the tooth, the emergency dentist probably did use the same composite material that’s normally used in fillings. If that’s the case, it could last years, perhaps even decades.

With that said, there’s probably more to this than simple bonding. First of all, the tooth was traumatized. Sometimes when a tooth is injured by blunt force, it doesn’t give off any symptoms right away. However, the blood flow to the tooth could have been cut off and that wouldn’t show up on x-rays. If this is the case, the tooth could be dead or dying, and it will eventually need a root canal. Unfortunately, the first sign this has happened is often pain or an abscess, though sometimes the person notices discoloration as well. Anytime you see an emergency dentist, he’ll refer you back to your regular office for a follow-up. In cases with trauma, having the dentist check out the tooth again later could save you a lot of pain and trouble.

As for your comment about having the tooth permanently fixed, could he have mentioned to you that the tooth needed a crown? If the chip was severe, the bonding won’t be adequate and the tooth will need all-around protection. Your best bet is to follow the advice of the emergency dentist and schedule a visit with your regular office to get it checked out. If you’re still wary, you can always call the office that did the work and clarify why he wanted you to follow up.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Is it an emergency when a child knocks out a tooth?

My kids love going to the play area at the mall. At times it can be a little crazy with kids running all over the place, but for the most part, we typically escape with a bump or a bruise here and there. Last week, a little boy had a pretty traumatic injury from what I could see. There was blood coming from his mouth, but I wasn’t exactly sure what happened at first. It turns out the kid knocked his tooth out and all the mom did was stop the bleeding (and the crying) and  let him go back out to play. If that would have been my kid, I would have immediately taken them to the dentist. It seems like an emergency to me so why didn’t she take him right away to get it checked out? Am I overreacting? — Mallory

It’s hard to say what happened. Knocking out a tooth isn’t always a dental emergency – especially when it comes to young children who still have their baby teeth. That’s not to say that he shouldn’t have it checked out in the near future to make sure there’s no other damage to his mouth or to the adult teeth that are yet to come in. It sounds like he recovered fairly quickly so it might not have been as bad as it looked. I’m sure his mom would have done something different if she felt it was warranted.

An older child knocking out an adult tooth is a different story. It would definitely be best to have the tooth implanted immediately if possible. You can save a tooth by placing it in a wet towel, glass of milk or even back in the child’s mouth until he or she can get to the dentist (which should be as soon as possible to achieve the best outcome).

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Can I wait till Monday or should I see an emergency dentist?

I recently started having a jaw ache that I was pretty sure was related to the implant I’ve had for about a year. Because I knew it didn’t feel right, I immediately went back to my implant doctor so he could evaluate it. Needless to say, he said he didn’t see anything wrong and that I had nothing to worry about. Since he is an implant specialist, I assumed I could trust his judgement. This weekend I woke up and fixed some breakfast. When I started to eat, it was quickly apparent something was very wrong because there was a bad taste in my mouth that I have never experienced before. I felt the tooth and it seems a little loose, so I looked at it in the mirror and there is pus oozing out all around the implant. I am absolutely freaked out! Of course it’s the weekend… should I call an emergency dentist or should I wait for my implant doctor to get back in the office on Monday? — Mary Ellen

Mary Ellen,
Oh my… this does sound like a serious situation. Even though you think your implant dentist doesn’t work on the weekends, you should try calling because he may be “on-call” for things like this or his voice mail might at least give an emergency number to call. Hopefully he will get back to you in a short amount of time, but if not, you should absolutely see an emergency dentist. From what you describe, it sounds like you have an infection – and it’s probably been getting worse all along. You need treatment immediately, not only to ensure the implant doesn’t completely fail, but also to make sure your overall health isn’t compromised. Depending on exactly what the emergency dentist determines in the examination, he will likely at the very least prescribe an antibiotic for the infection. If it’s loose, he could also splint it to hold it in place. He may not be able to offer a long-term solution, but at least he can help you keep the infection from spreading until you can get in to see your implant dentist.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.

Is it an emergency if I lost my healing cap?

Six months ago I had implant surgery and I’m currently waiting for it to heal completely so I can get the crown placed. Today, I noticed a large hole in my mouth – it completely freaked me out! I think the healing cap must have come off and I have no idea where it is. This is costing me so much and now I’m worried that I could get an infection or potentially damage the implant. Why do these things always happen on the weekend? I left a message on my dentist’s answering service, but I’m not sure if he will even call me back until Monday. Can it wait until then? — Ann

Dear Ann,
First, take a breath and try to relax. While healing caps don’t typically fall off, it can happen and there’s likely not any immediate concern.

After six months, the soft tissue around your dental implant should be well on the way to being healed so the chances of an infection are pretty slim. The main thing you want to watch until you can get it fixed is that you don’t injure the area – eating softer foods can help. If you notice food getting caught, try to pack it with cotton or gauze, or you can use a temporary denture adhesive that is found in the dental section of most grocery or drug stores to cover it.

Your dental implant should be fine looking at the long-term. Just be sure to make an appointment with your dentist as soon as possible before the tissue could collapse or try to heal over the top. If you wait too long, that could make it much more difficult to place the crown.

This post is sponsored by New Orleans cosmetic dentist Dr. Duane Delaune. Read more about why many consider Dr. Delaune to be the best dentist in New Orleans.