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Medical and Dental Care Emergencies

The primary purpose of a patient visit to the dental office is to allow their doctor and/or dental auxiliary to perform a dental treatment that will aid in the improvement of their overall oral health. The primary goal of the doctor is to perform this treatment as effectively and as safely as possible. Patients give little thought to the possibility that some unforeseen medical emergency might arise in the period of time during which they are in the dental office.

Many of the things done by the doctor and staff prior to, and during, the dental treatment are done to minimize the risk of a medical emergency. For example, the medical history questionnaire, recording of blood pressure, and discussion of a patient's health history help to determine what potential risks might be present and enables the doctor to modify the planned dental treatment to minimize the potential risks. In many instances, the use of conscious sedation will be indicated as a means of decreasing stress associated with dental care. This is especially important in persons with cardiovascular diseases (such as high blood pressure or angina) who might be somewhat fearful of visiting the dentist. The use of effective drugs for pain control (such as local anesthetics) is yet another means of minimizing the risk of medical emergencies developing during treatment.

In the unlikely event that a medical emergency does occur while a patient is in the dental office, one should know that (it is highly likely) the doctor has received training in the management of medical emergencies that develop frequently.

Amongst the more commonly observed medical emergencies in dental offices are fainting, seizures, acute asthmatic attacks, allergy, and chest pain (angina).

Virtually all of these emergencies occur as a result of fear and anxiety. Therefore, it becomes very important for the patient to advise their doctor if they are apprehensive about their dental treatment. Steps usually can be taken which will prevent these situations from occurring.

Additionally, in many states it is mandatory for all dentists to be certified in basic life support (CPR) on a regular basis. In many dental offices, additional staff personnel are also trained in this very important technique.

Dental offices maintain an emergency supply of oxygen, as well as commonly used emergency equipment and drugs.

And finally, most dental offices are located in close proximity to their community's Emergency Medical Services (EMS) system (9-1-1). A telephone call activating this system will provide well-trained life-saving medical assistance within a few minutes.

By Stanley F. Malamed, DDS

General Dentistry Care: Frequently Asked Questions

Q. When would you consider tooth bleaching?

A. You would consider tooth bleaching if your teeth have yellowed with age or are stained from tobacco, tea, coffee or food.

Q. What are the practical expectations of tooth bleaching?

A. Every case is different, but generally there is a two-shade improvement as seen on a dentist's shade guide. The success rate relies on the types of stain involved, your compliance, and the material and method used.

Q. How long does tooth bleaching last?

A. Depending on your personal habits such as smoking and drinking coffee or tea, tooth whitening should last from one to five years.

Q. Do over-the-counter bleaching products work?

A. Some over-the-counter bleaching products do whiten teeth, but many of the products can damage teeth with extended use or misuse because they are too abrasive or use ill-fitting trays. Some materials contain titanium dioxide that actually put a temporary pigment coating on the teeth. Although small doses of titanium dioxide are considered safe, the net effect is to put a layer of "paint" on the teeth that is soon lost.

Q. What is orthodontics?

A. Orthodontics, also known as malocclusion or “bad bite”, is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities.

Q. What is an orthodontist?

A. An orthodontist is a dentist who has undergone specialized training to require the advanced qualifications and specialized skills required to give their patients quality treatment.

Q. What causes orthodontic problems?

A. Most orthodontic problems are inherited, but some are acquired.

Q. What is the importance of orthodontic treatment?

A. Orthodontic treatment is important because crooked and crowded teeth are hard to clean and maintain. This may lead to conditions tooth decay, but eventually cause gum disease and tooth loss. Malocclusion (bad bite) can also lead to pain associated with TMD.

Q. What does orthodontic treatment involve?

A. Orthodontic treatment usually involves wearing braces prescribed and designed by the orthodontist. You may feel some tenderness as the teeth start to move. By placing a constant, gentle force in a carefully controlled direction, braces can slowly move teeth through their supporting bone to a new desirable position.

Q. How long does orthodontic treatment take?

A. Generally, orthodontic treatment time with braces ranges from 1 to 3 years. Early treatment procedures may take only a few months. The actual time depends on the growth of the patient's mouth and face, the cooperation of the patient and the how severe the problem is.

Q. How much does orthodontic treatment cost?

A. The actual cost of treatment relies very much on the individual case and depends largely on the length and complexity of treatment.

Q. What toothpaste should your child use?

A. You should use a match-head sized amount of toothpaste. The use of toothpaste should not begin until 2 years of age.

Q. When should you start taking children to see a dentist?

A. It is recommended that children see a dentist by age one and definitely by 16 months of age.

Q. How often should a child see a dentist?

A. It is recommended that the child be seen every six months after the initial examination.

Q. Why is it important to care for primary or baby teeth?

A. It is important to care for primary teeth because they are much more susceptible to tooth decay than the permanent teeth. There are many other reasons.

Q. How are digitized X-rays beneficial?

A. Digitized X-rays reduce the exposure of radiation to the patient, and eliminate the film and darkroom processing within the dental office.