Dental Trauma or Infection Clinical Pathway, Emergency Department – Discharge Instructions

Dental Trauma or Infection Clinical Pathway — Emergency Department

Discharge Instructions

Dental Injury

Your child was diagnosed with a dental (tooth or gum) injury. Teeth can break, fall out, or become loose. This can cause pain. In many cases, children get better without problems, especially when dealing with primary (baby) teeth. However, if your provider recommends following up with a dentist, it is very important to make an appointment.

Symptoms

  • Pain and sensitivity to hot or cold and pressure
  • Swelling to gums or mouth
  • Bleeding
  • Loose or chipped tooth

Treatment

  • If there is bleeding, apply pressure for about 10 mins on the area with a clean cloth or gauze. An older child can bite down on the gauze or cloth firmly.
  • Give your child pain medicine, such as acetaminophen (Tylenol) or ibuprofen (Motrin/Advil)
  • Give your child a soft food diet for the first several days
  • Maintain good oral and dental hygiene using a soft toothbrush or mouthwash as directed
  • Your provider may prescribe antibiotics or oral rinse depending on the injury

When to Call Your Dentist

  • If there is pain or sensitivity to the tooth that is unrelieved by pain medication
  • If the tooth becomes discolored
  • If the tooth is still loose after more than 2 days
  • If the tooth has been splinted in the Emergency Department, it is essential that you follow up with a dentist as recommended

When to Return to the Emergency Department

  • If your child has difficulty swallowing or breathing
  • If the bleeding does not stop after applying pressure for 10 mins
  • If your child develops new or worsening pain in the jaw with opening and closing the mouth
  • If your child develops a fever
  • If your child develops worsening redness, swelling, and/or drainage

Tooth Abscess

A tooth abscess is a collection of infected material (pus) resulting from a bacterial infection of the tooth. It is usually caused by tooth decay but can also result from a tooth being broken or chipped.

Symptoms

  • Gum redness
  • Gum swelling
  • Facial swelling
  • Pain
  • Fever

Treatment

  • Your child must follow up with a dentist in 3-4 days.
  • Your child may need to have the abscess drained by a dentist or an oral surgeon if it was not drained in the Emergency Department.
  • Antibiotics are given to treat the infection and should be taken as prescribed by your doctor.
  • Ibuprofen or acetaminophen may be given for pain.
  • If you are prescribed an oral rinse, use as directed.

Call your Doctor/Nurse Practitioner if Your Child

  • Complains of increased pain
  • Develops a fever and/or looks ill
  • Develops new or worsening facial swelling and/or redness
  • Develops difficulty opening his or her mouth
  • Has difficulty swallowing or is unable to drink