The dental emergency basic kit is useful for practitioners working where no dentist is readily available, particularly in rural and remote locations. The kit should have the material requirements for temporary relief of:
If a permanent (second) tooth is knocked out (e.g. in an accident or fight) but is intact, it can be saved by the following, immediate procedure. The tooth should not be out of the mouth for longer than 20 to 30 minutes from the time of injury.
Using a glove hold the tooth by its crown and replace it in its original position, preferably immediately (Fig. 12.1); if dirty, put it in milk before replacement or, better still, place it under the tongue and ‘wash’ it in saliva. Alternatively, it can be placed in contact lens saline or the solution in the ‘Dentist in a Box’ kit (www.dentistinabox.com.au). Note: Do not use water, and do not rub or wipe (it removes dentine) or touch the root.
Fix the tooth by moulding strong aluminium foil over it and the adjacent teeth. If none is available, substitute with a large wad of Blu Tack. Moulding foil can be difficult: an alternative is to suture with a figure-of-eight silk suture to encompass the tooth. It can also be secured to the two adjoining teeth with a strip of tape cut from a disc in the ‘Dentist in a Box’ kit.
Refer the patient to his or her dentist or dental hospital as soon as possible. Tell the patient to avoid exerting any direct biting force on the tooth.
Replacement of a knocked-out tooth
Note: If a blood clot is present, remove it after a nerve block. Teeth replaced within 20 to 30 minutes have a 90% chance of successful reimplantation.
LOOSE OR PARTIALLY DISLODGED TOOTH
Loosening is excessive movement of a permanent tooth with no displacement.
Splint the mobile tooth to a neighbouring tooth with the splinting material from the kit (see above). Alternatively, use chewing gum or Blu Tack. Refer the patient to a dentist.
Rinse the mouth with warm water. Cover the exposed area, which is usually painful, with dental tape. Recover and store the tooth fragment for use by the dentist. If possible, secure the broken fragment with splinting material from the kit. Refer the patient to a dentist.
A temporary measure is to stick a piece of chewed sugarless gum ...