Dental Preparedness, by Pat

Thursday, Jan 14, 2010

You and your group are sitting around a roaring campfire enjoying the end of a long days hunting. You bite down on some trail mix and suddenly get a shooting pain in your mouth. You’ve just broken your first molar and are four hours from the nearest dentist. Now what? Believe it or not, this happens more often than we would like to believe. In a survival scenario, it may be days or weeks or never that you get to a dentist. So, what do you do? 

The most important thing to do is to prepare for a dental emergency, just like you have prepared for food, electricity, shelter and self-defense. Prevention is the key to avoiding these situations.   What does that mean? We have heard it since we were kids, “Brush twice a day, floss, and see your dentist twice a year.” Routine visits to the dentist can often times prevent those emergencies from happening. Often times those small cavities can be taken care of before they get out of control requiring crowns, root canals or extractions.

Brushing and flossing regularly make the difference. When under stress the body will tend to develop inflammation more easily, including gingivitis, an inflammation of the gum tissue. So, when prepping for the worst-case scenario, be sure you have multiple toothbrushes and plenty of floss. In a pinch, you can use your finger or a washcloth to wipe the teeth clean.  Even a twig can be used to stimulate the gums and clean the teeth.

So, what should you pack in your medical kit for dental emergencies? Here are some basics that need to be included:

  1. Dental floss- also good for tying things down in a pinch.
  2. Dental wax- can be melted down and used to make a candle if needed. Should be a soft type of wax.
  3. Some type of Temporary filling material such as Cavit
  4. Temporary dental cement such as Den-temp for re-cementing crowns.
  5. Cotton pellets for use with;
  6. Oil of cloves, which is a substitute for Eugenol
  7. A set of dental tweezers
  8. Tight fitting latex or vinyl gloves. The mouth carries more bacteria than any place in the body.

What causes a toothache and what should you do about it? A toothache is the result of injury to the nerve of the tooth. This can be the result of trauma or a deep cavity. If the nerve becomes infected, it can result in an abscess, which is an infection of the bone around the tooth that can be extremely painful. Often times an abscess can cause swelling around the tooth. The infection can spread to other parts of the head and neck resulting in difficulty swallowing and even in the ability to breath.  This type of infection, if left untreated, can eventually cause an infection of the blood, which can lead to death. Don’t mess around with it.

How do we treat this on our own? First, figure out which tooth is causing the problem. Be sure the area in the tooth  is cleaned out.  Take a cotton pellet and soak it in Oil of Cloves, and place it in the cavity. Be sure you don’t get it on the soft tissue because it can burn.  Other products you can use include Dent’s Toothache Drops, Orajel and Red Cross Toothache Medicine. When you have the cotton in place, cover it up with some Cavit or other temporary dental filling.

For pain, I highly recommend using 400mg of Ibuprofen taken with 800 mg of Tylenol at the same time, every 4-6 hours. If that doesn’t do the trick then a narcotic such as Codeine or Vicodin can be taken every 4-6 hours. Be sure to take these with food. If infection is present, an antibiotic should be taken for 5-7 days. Under no circumstances should you place aspirin on or next to the tooth. It can cause serious burns to the gum tissue.

What about treating gum inflammation, commonly known as gingivitis? This is usually the result of poor oral hygiene. Proper brushing and flossing can prevent it. If pain and bleeding are taking place, increasing your brushing and flossing can often help.  Be sure that you are getting enough Vitamin C in your diet, a deficiency can also have a negative impact on the gums. A side note on gum inflammation: Studies have shown that people with bleeding gums have a substantially higher incidence of heart attack and stroke.

So, you bite into a nice leg of venison and break off a filling, what now? If you have access to a dentist, get to them as soon as possible. If that is not possible, you can use a small amount of temporary filling material such as Cavit to fill the hole. Be sure to bite down on the material while it is soft so it will not interfere with your bite after it hardens. In a pinch you can use some soft dental wax to fill the cavity.

Crowns (caps), inlays and onlays can come out when you eat sticky foods such as caramels or taffy. If the tooth isn’t sensitive, save the restoration and take it to a dentist as soon as you can. If that is not possible, or the tooth is sensitive, it may be necessary to try and re-cement the crown temporarily. To do this, clean out any material on the inside of the restoration.  Mix a thin layer of temporary dental cement such as Den-temp and place it inside the restoration.  Carefully align the restoration with your tooth and gently bite it down all the way to place. Since the crown is only in temporarily, be very careful about chewing on it, so that you don’t jar it lose and swallow it. See a dentist as soon as possible.

What happens to a tooth if you fall or get hit in the mouth? Usually this can result in injury to the upper front teeth. The teeth can be knocked out of position, either forward or backward. They can be loose or hanging out of their sockets. Or they can be knocked out completely. If possible, see a dentist immediately. If this isn’t possible, the tooth can gently be repositioned to line up with the other teeth. Be aware that this process can be extremely painful.  Biting on a piece of gauze gently can help hold it in position.  Get to a dentist as soon as you can so that the tooth can be splinted to other teeth. 
           
A tooth that has been completely knocked out is known as an avulsion.  The first 30 minutes of a knocked out tooth are the most important. If treated correctly, the tooth can often be saved. If the tooth can be replaced in the socket within the first 30 minutes, there is a good chance that the body will accept it. After about 30 minutes the body will treat it as a foreign object and reject the tooth. 
           
Once the tooth has been found, pick it up by the crown, not the root and gently clean it off using sterile water or milk.  Use gauze to stop any bleeding from the socket in the mouth.  Gently place the tooth back in the socket and using steady pressure, push it back into place.  Have the person use gentle biting pressure on some gauze and get to a dentist ASAP to have the tooth stabilized. If for some reason the tooth can’t be immediately placed back in the mouth, place it in a container of Hank’s solution, designed specifically for this situation. If this is unavailable, use a container of sterile saline or milk and get the person to the dentist immediately.

As with any other type of prepping, preparation for dental emergencies is extremely important and needs to be well planned out. The nice thing about preparing for a dental emergency is that it is not very expensive to do. See your dentist regularly, brush and floss, and Keep Smiling.


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