Author Topic: Dental Emergency Preps  (Read 29419 times)

Offline mamabear

  • Survivalist Mentor
  • *****
  • Posts: 846
  • Karma: 35
Re: Dental Emergency Preps
« Reply #60 on: October 11, 2009, 05:12:35 AM »
Drbob, I am the one that said I took antibiotics. I did not say I took a couple of days. I took two full rounds of ten days worth of dr prescribed antibiotics. Both times three days aftee stopping/the end of the antibiotics, the swelling and pain came back. The antibiotics were prescribed by two different dr's, but neither one worked. I then started taking echinacia three after the second round, and within a couple of days the swelling went down, there was no more pain, and the infection finally went away.

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #61 on: October 13, 2009, 11:27:01 PM »
Sandman, I would be glad to shed some light.

"Question: I often hear laypeople giving advice that any serious toothache needs a trip to the dentist as it can develop into a 'life-threatening' situation. I'm sure this is true at some point, I'm just not sure where that point is. Can you shed some light on the question of what to do when you are either quite a ways away from any dental clinics deep out in the bush, or perhaps you are just too destitute to consider going to a dentist unless you felt like you were dying?

What signs and symptoms would alert a first responder to make the decision to drag the patient out of the bush for an emergency dental trip? I'm assuming some visible abscesses can be lanced, drained & disinfected. And the book "Where There is No Dentist" shows how to safely pull teeth. But I wouldn't assume there would be antibiotics available in the field."

I tried to compose a response a few minutes ago and I inadvertently made it disappear. I hope I am not double posting!

While it is true that folks still die from dental abscesses, we can save most of them if we can get to it early enough. I can appreciate your interest in being able to triage in the bush!

The most simply to handle is a person that has broken a tooth while eating, and has damaged an otherwise healthy tooth. Look at the tooth with a very bright light source. If the area that was broken has no black color, appears to be solid, about the color of vanilla ice cream, and no obvious blood, then you are probably looking at sheared dentin that has lost the enamel layer. While not life threatening, it is very uncomfortable. You could probably use the temporary filling paste to cover the exposed area to effect some temporary degree of symptomatic relief.

If there is blood seeping from the center of the exposed area, the person has an exposed pulp. This is more than very uncomfortable. Apply clove oil directly to the exposure. This will temporarily numb it. Give the person significant pain med. I normally give my patients Amoxicillin or Pen, for patients who are not allergic to such.. However, for obvious liability reasons, I am not recommending  you do the same. While not immediately life threatening, this has the potential to develop into such within days. This situation needs a dental professional within a couple of days. While the pain will probably be manageable short term, don't expect it to be long term.

Both of the preceding assume no swelling. If swelling is present you are dealing with infection. Different types of infection require different antibiotics. You need the advice of a dental professional on this. Don't just throw any antibiotics you have at it. Use cold packs. 15 minutes on, 15 minutes off. The degree of swelling is an indicator of how serious the infection is. I'll start with the smaller.

If you see a "bubble" on the side of the gum the size of an English pea, or smaller, this is not really bad yet. If you do nothing at all, it will get larger. The extreme opposite end of the spectrum is when it is the size of a prune. This usually swells up under the eye or under the jaw. Now you are at the life threatening stage. Now you need to do whatever possible to get them to a dentist!

NEVER use warm compresses for this type of swelling. You will make it worse. Use cold.

A totally different kind of dental infection can make the tooth get very loose. This one doesn't usually get as dangerous as the one I just described. Usually in these cases the tooth continues to get more and more loose, until you can just numb it up with clove oil and ice and take it out.

At any time you find it necessary to remove a tooth, have handy some gauze soaked in ice water. As soon as the tooth is out, put the ice cold gauze on the site. It will help it feel better and help stop the bleeding faster. This goes for baby teeth as well.

Hope this is what you were asking.
DrBob

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #62 on: October 13, 2009, 11:31:13 PM »
MamaBear,

That's fantastic. That means you were not experiencing an endodontic abscess, which is what I was addressing. I am glad yours was not as bad as the situation I was talking about.
DrBob

Offline Doc K

  • "King of the Medicine Cabinet"
  • Survivalist Mentor
  • *****
  • Posts: 357
  • Karma: 108
  • Military Physician
    • Temperate Climate Permaculture
Re: Dental Emergency Preps
« Reply #63 on: October 14, 2009, 01:52:49 PM »
Great info, DrBob.
Your experience is invaluable here.
Since I have done very little dental work ever (not a scheduled rotation for Family Med docs), I am thinking about taking a few days here and there to work with one of our base dentists to learn how to do some extractions and blocks.
For those of you not privy to this kind of mentoring, here is a video on tooth extraction that was pretty decent.
Tooth Extraction Demonstration

Doc K

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #64 on: October 14, 2009, 04:58:05 PM »
Doc K,
That's a great video. He and I use the same anesthetics as our first choice; pertty much the same set-up. One thing he mentioned that you could probably get your hands on, was the chlorhexadine gluconate. That's a great oral disinfectant that has a lot of applications.

I think the dentist on the base would be glad to have you sit in on just about any procedure you want to see. In my state many of the bases are served by contracted mobile units with civilian dentists. The mobile units use a hand held radiographic tube head for the radiographs. It would be pretty cool if they have one of those to show you.

He would have you doing infiltration in five minutes. The blocks just take knowing where your target foramen is. I think you would have a blast at it! Give me a shout if you get hooked with them. I'd like to know what you thought.

DrBob

Offline mamabear

  • Survivalist Mentor
  • *****
  • Posts: 846
  • Karma: 35
Re: Dental Emergency Preps
« Reply #65 on: October 14, 2009, 07:34:17 PM »
One more question I have about dental health and infections: Does rinsing/gargling warm salt water really help prevent/treat infection? I have been told that before, last time I had a tooth infection by a doctor, not the dentist though. I know it helped give relief, but not sure if it was "topical" relief or real relief.

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #66 on: October 15, 2009, 10:33:35 AM »
MamaBear,

The short answer is yes, to a degree. It really depends on how deep the source of infection is. It is particularly good for surface irritation or infection. An example is a canker sore or mouth ulcer. The ulcer is usually not deep, even though it may "feel" like it is, or even may have a bit swelling surrounding the area. Usually that kind of swelling feels like it is confined to the cheek area, inside of the lip, or the edge of the tongue. For sores in these areas, I personally prefer the salt water approach over Anbesol or the paste type of dressing. This is not the swelling that forms on the side or bottom of the jaw bone, or under the eye. These are more serious, and require different approach.

When there has been an injury such as a tortilla chip cut your gums, use the salt water rinse. If you see a red border (rather than pink) on the gum tissue around the neck of the tooth, this is the beginning of gingivitis or early periodontitis. The salt water rinse will definitely help it to feel better. It may not make the source of the irritation go away, in which case the irritation returns. But it will make it feel better.

I hope this addresses what you were looking for.
DrBob

 

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #67 on: October 15, 2009, 10:40:08 AM »
MamaBear,

I'm sorry, I only answered part of your question. In the first paragraph, when I addressed the canker sole and ulcer, it will really help it to get well. In the second paragraph where I addressed periodontitis, it is somewhat temporary relief.
DrBob

Sandman

  • Guest
Re: Dental Emergency Preps
« Reply #68 on: October 15, 2009, 11:21:53 AM »
Thanks for your insight DrBob. It's much appreciated.

Would you feel that lancing abscesses in the field is normally OK, or contraindicated?

If a first responder gets someone with an exposed pulp or large abscess in a long-term disaster scenario, where there is little to no chance of professional dental assistance, would pulling the tooth, or what's left of the tooth, be indicated? I can think of very few other options at that point.

Do you know if, in the past, anyone has used sulfa drugs to successfully treat tooth/mouth infections?

Thanks a lot.

- SM


Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #69 on: October 16, 2009, 10:20:30 PM »
Hey SandMan,
There is one situation where a first responder would be doing the person/patient (just habit to call the person being treated the patient) a great service by lancing. When you see the pus bubble is on the gum tissue to the cheek side of the tooth (as opposed to the tongue side, below the tongue, side of the face, etc.). This is the only area you might consider lancing. Example: lower left first molar (6 year molar) is abscessed ... you see a bubble on the gum tissue, opposite side from the tongue, patient's left. Yes, using ONLY a sterile instrument, lance with a small incision ... dead center. My personal preference is a Bard-Parker #12. However, that is not the only thing that will work. Then use a Q-Tip to lightly roll back and forth over the bubble. As the pus flows out, soak it up with a cotton roll or more Q-Tips. Discard and change to fresh cotton as fast as you soak it. (It is handy to have someone assisting to hand these items to you when things start happening fast!) When no more pus oozes out, put a wet, cold gauze pad on it with light pressure. (I guess I don't need to say the gauze needs to be sterile.)

Speaking of sterile: please, please don't pass a needle or blade through a match, propane lighter, or other flame source. That's just for movies. First choice in a tough situation is boiling water. Truth is, by the time the water reaches a rolling boil, all bacteria is history. It is not necessary to boil it for thirty minutes. Just bring it to a full boil, then you can cool it down and use it. Second choice is disinfection with alcohol or glutaraldehyde. This renders your instrument disinfected, not sterile. However, please use every precaution to NOT contaminate the sterile/disinfected instrument on the way to it's intended use.

As far as, when it's time to remove the tooth when there is no possible chance to find a dental professional, here are the guidelines/signposts. If the tooth has become very loose, without a physical blow, and it doesn't hurt much to wiggle it, this tooth most likely has suffered from advanced periodontal infection/abscess. This will probably be the easiest to get out.

If you see swelling spreading under the jaw,down the neck, or under the eye, and you have good reason to believe it is from an abscessed tooth, and you cannot get this person to a dental surgeon, the tooth needs to come out. Just make sure you have the right tooth. These are not always easy to get out. This abscess has developed to the critical stage. If this person can get to a dentist, they need to ASAP. This situation, caught early enough, in the hands of a dentist, can often even save the tooth.

Exposed pulp: if it is the result of a recent injury, don't be so quick to take that one out. Maybe someone tripped on a slick, mossy rock crossing a creek, and they fell and broke off half of their front tooth. This tooth is not abscessed, though it will be soon if not treated. If you can get this person to a dentist within a few days, treat the pain with topical anesthetic and pain meds. A week to ten days later, if they have not seen a dentist, they will be rapidly getting to the unbearable pain stage. Then you may have to remove it.

"Do you know if, in the past, anyone has used sulfa drugs to successfully treat tooth/mouth infections?"  No, I don't. I have never used Sulfas.

BTW, SandMan, are you a first responder?

See ya down the road!
DrBob

Sandman

  • Guest
Re: Dental Emergency Preps
« Reply #70 on: October 18, 2009, 04:55:44 PM »
Hey SandMan,
There is one situation where a first responder would be doing the person/patient (just habit to call the person being treated the patient) a great service by lancing. When you see the pus bubble is on the gum tissue to the cheek side of the tooth (as opposed to the tongue side, below the tongue, side of the face, etc.). This is the only area you might consider lancing. Example: lower left first molar (6 year molar) is abscessed ... you see a bubble on the gum tissue, opposite side from the tongue, patient's left. Yes, using ONLY a sterile instrument, lance with a small incision ... dead center. My personal preference is a Bard-Parker #12. However, that is not the only thing that will work. Then use a Q-Tip to lightly roll back and forth over the bubble. As the pus flows out, soak it up with a cotton roll or more Q-Tips. Discard and change to fresh cotton as fast as you soak it. (It is handy to have someone assisting to hand these items to you when things start happening fast!) When no more pus oozes out, put a wet, cold gauze pad on it with light pressure. (I guess I don't need to say the gauze needs to be sterile.)

Speaking of sterile: please, please don't pass a needle or blade through a match, propane lighter, or other flame source. That's just for movies. First choice in a tough situation is boiling water. Truth is, by the time the water reaches a rolling boil, all bacteria is history. It is not necessary to boil it for thirty minutes. Just bring it to a full boil, then you can cool it down and use it. Second choice is disinfection with alcohol or glutaraldehyde. This renders your instrument disinfected, not sterile. However, please use every precaution to NOT contaminate the sterile/disinfected instrument on the way to it's intended use.

As far as, when it's time to remove the tooth when there is no possible chance to find a dental professional, here are the guidelines/signposts. If the tooth has become very loose, without a physical blow, and it doesn't hurt much to wiggle it, this tooth most likely has suffered from advanced periodontal infection/abscess. This will probably be the easiest to get out.

If you see swelling spreading under the jaw,down the neck, or under the eye, and you have good reason to believe it is from an abscessed tooth, and you cannot get this person to a dental surgeon, the tooth needs to come out. Just make sure you have the right tooth. These are not always easy to get out. This abscess has developed to the critical stage. If this person can get to a dentist, they need to ASAP. This situation, caught early enough, in the hands of a dentist, can often even save the tooth.

Exposed pulp: if it is the result of a recent injury, don't be so quick to take that one out. Maybe someone tripped on a slick, mossy rock crossing a creek, and they fell and broke off half of their front tooth. This tooth is not abscessed, though it will be soon if not treated. If you can get this person to a dentist within a few days, treat the pain with topical anesthetic and pain meds. A week to ten days later, if they have not seen a dentist, they will be rapidly getting to the unbearable pain stage. Then you may have to remove it.

"Do you know if, in the past, anyone has used sulfa drugs to successfully treat tooth/mouth infections?"  No, I don't. I have never used Sulfas.

BTW, SandMan, are you a first responder?

See ya down the road!
DrBob
Thanks for all the good info. DrBob! It's certainly worth a karma point!

I used to be an EMT. And formerly, in the .mil, I was among other things a Combat Lifesaver.

Now, I just consider myself a disaster preparedness layman first responder.

Peace

- SM
 

Offline BerserkerPrime

  • Ice Humping Polar Bear
  • Moderator On Leave
  • Survival Demonstrator
  • *
  • Posts: 2079
  • Karma: 75
  • God, Guns and Oil!
Re: Dental Emergency Preps
« Reply #71 on: October 18, 2009, 07:37:09 PM »
Dr. Bob, thanks much, that's a printer/keeper!

+1

BP

Offline Orionblade

  • Taffeta Boy
  • Dedicated Contributor
  • ******
  • Posts: 1634
  • Karma: 44
  • Blacksmiths hit it while it's hot.
Re: Dental Emergency Preps
« Reply #72 on: October 18, 2009, 11:18:10 PM »
two questions - are the remineralization trays a good idea for someone prone to cavities in the past?

also, what might cause discoloration/bruising on gums? - lower wisdom teeth are crowned fully, but still moving up even with rest of lower molars - sore as hell quite often. Also have a few fillings in lower molars and upper incisors. Back when I was much younger, a dentist did a sealant job (the UV cured junk) which cracked, accumulated bacteria, and allowed cavities to form in the tops of my molars and in between my incisors. Grrr.

Anyhow, that's my sum total dental history. I'm 27 and when the pain comes on strong, it's more like a muscle soreness. Feels just like a flu shot or a charlie horse, but usually turns into a little headache just because of the muscles that tighten up. I'm just hoping you tell me bruising is common while the wisdom teeth come in. pain/inflammation seems to follow the trigeminal nerve. No history of herpes simplex or zoster, so i wouldn't expect neural infection, and I have no fever, and the persistene and duration of symptoms leads me to believe that an infection would have killed me months ago. Upper wisdom teeth were yanked about 18 months ago. Not impacted, just tight and I developed a cavity in the hardest to reach spot up near the gumline. noticed the discoloration then.

Thanks in advance! For some reason after a bad experience at one dentist, I now can't have anything "done" other than cleanings and such without GREAT anxiety. Long story short, I needed NOx, which performed admirably at making me feel warm and cozy like I used to. Without it, I was ready to get things over with, but my heart rate just jumped so high it was pathetic.

Anyhwho, thanks for some amazing information thus far.

Orion

Any input into what's going on might be helpful.

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #73 on: October 21, 2009, 08:57:56 PM »
Orion,

"..are the remineralization trays a good idea for someone prone to cavities in the past?"

Absolutely!!

I need more info on the bruising question.
What color is the bruise? Red, Blue, Dark gray. Are you sure the discoloration is a bruise? Is it very tender to touch?
Is any of the gum tissue still covering the back portion of the wisdom tooth?

I agree the symptoms do not sound like an infection. However, it may be a bruised ligament under the root. Depending on your answer to the color, the discoloration may be due to something else. Try using an over the counter anti-inflammatory like Advil.

The single most common cause of a bruised ligament these days that I see is stress induced clenching or grinding of the teeth. If it is happening while you are awake, you have to consciously make yourself stop it. If it happens in your sleep, you need to have your dentist evaluate your for a night-guard.

As far as emergency preps are concerned, the remineralization trays with accompanying gel or foam is a good idea. Also, if you are prone to cavities in the past, keep a box of baking soda in your emergency stores. (See earlier posts regarding acid and pH imbalance.) Probably the three most important items for gum health are floss ( "whoda thunk it?" ), the toothbrush, and Vitamin C.
DrBob

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #74 on: October 21, 2009, 09:16:32 PM »
Another dental prep idea just came to me I thought I would share. Most "Snore-guards", or sleep apnea devices, are constructed by dentists. Most patients don't sleep well without them once they have become accustomed to their use. Most folks who have them can attest to how a night's sleep can sometimes be shot when they forget to take the device with them out of town.

If you are one of the folks who depend on them for a good night's sleep, consider having a back-up constructed, then simply rotate using the extra. I can see this being almost as important as the extra pair of eyeglasses Jack recently recommended.
DrBob

Offline BerserkerPrime

  • Ice Humping Polar Bear
  • Moderator On Leave
  • Survival Demonstrator
  • *
  • Posts: 2079
  • Karma: 75
  • God, Guns and Oil!
Re: Dental Emergency Preps
« Reply #75 on: October 22, 2009, 03:26:16 AM »
OK, good call on not hijacking the thread Orionblade (though you came perilously close ;D_), and that's why I removed your question form the board.  

In the interest of keeping the thread and TSP forum as a whole, survival/preparedness oriented, I suggest we all keep requests for personal advice to the point (ie survival/prep).  If you want to go VFR direct with a subject matter expert, then IM them and ask if that is OK.  I don't need to run interference for Dr.Bob nor any other expert as they are adults and can choose to answer or not.  It's just that they are here for the same reason as we are and don't need to be over loaded with personal medical backgrounds when they face it everyday at work.  

No harm/no foul, just trying to keep the board information rich for all of us.  

Berserker Prime

Offline DrBob

  • Prepper
  • **
  • Posts: 34
  • Karma: 6
Re: Dental Emergency Preps
« Reply #76 on: November 10, 2009, 09:33:04 PM »
Cyanoacrylate:

I wanted to add a note that was prompted by the thread on using cyanoacrylate type of glue, such as a Super - Glue, as a way to hold superficial skin wounds together. It reminded me that I have seen LOTS of folks try the same product to put their crown back on the tooth, or a veneer back on.

My experience: I have seen on a lot of cases, the bond is of extremely short duration, owing largely to the solubility factor. It is totally worthless for use on a veneer. One of the biggest problems I see is that when it comes off, the person using the Cyanoacrylate simply puts more in without cleaning out the old layer. That approach creates ever thickening layer of old glue that makes it harder and harder to get the crown fully seated. When that happens, it makes the crown feel like it is so tall it is the only tooth biting. I just don't recommend the cyanoacrylate type of glue for recementing crowns. Any of the over-the-counter emergency dental kits have a better temporary cement than Super Glue.

Another temporary dental emergency idea for denture wearers. A fairly common denture problem I see is a front tooth knocked out of the denture. If you happen to be a nail technician that does artificial nails for ladies, the acrylic used is often the powder/liquid monomer type. If the denture tooth and the pink base is cleaned VERY well with alcohol,  a small amount of the nail acrylic placed into the denture base before re-seating the tooth will do a decent job of holding it in place. Hold the tooth into the pocket for several minutes for the initial cure. Then place the denture into fairly warm water for twenty minutes. You will be surprised how well this technique works!
DrBob

nkawtg

  • Guest
Re: Dental Emergency Preps
« Reply #77 on: November 03, 2011, 08:10:13 AM »

Offline LdMorgan

  • Dedicated Contributor
  • ******
  • Posts: 1400
  • Karma: 121
Re: Dental Emergency Preps
« Reply #78 on: November 03, 2011, 11:56:23 PM »
From what I understand, when a badly abscessed tooth just has to go, the faster it leaves the less pain the victim will have to endure.

One recipe for self-extraction I read suggested that the unfortunate patient tie a string around the offending tooth, and then use a hammer and a small billet of wood to knock the tooth out with a single stroke.

The patient was supposed to be sitting down (preferably on a bed), with the string tied tightly around the tooth, but with a little slack in the line.

The string was to prevent the tooth from being inhaled and strangling the patient as he fell back and lay unconscious across the bed. It would pull the tooth out of his mouth as he collapsed.

Booze was strongly recommended for agony abatement, particularly if opium was not available.

« Last Edit: November 04, 2011, 12:13:22 AM by LdMorgan »

Offline hd45hunt

  • Senior Survivalist
  • ****
  • Posts: 251
  • Karma: 9
Re: Dental Emergency Preps
« Reply #79 on: November 04, 2011, 03:13:13 PM »
Some great info on this thread.  Unfortunately I found it because I'm on antibiotics for an abscess in the root of my molar, so my dentist tells me.  The initial script of penicillin apparently wasn't strong enough as after two days the side of my face swelled and my neck (lymph node) was swelling and it felt like the lower right face/jaw area was numbed by Novocaine.   A 2:00 am visit to the ER got me some steroids for the swelling (I got nervous when the numbness started to affect my swallowing and the swelling worsened since I went to bed), stronger antibiotics and the explanation that the swelling was pushing on nerve endings causing numbness (who'd of thought it? felt like Novocaine to me and I knew I hadn't had any).  Anyway, just elevated dental health/preps several notches up on my priority list. 

Offline LdMorgan

  • Dedicated Contributor
  • ******
  • Posts: 1400
  • Karma: 121
Re: Dental Emergency Preps
« Reply #80 on: November 04, 2011, 08:56:07 PM »
There is one more thing I would like to contribute to this thread.

There is a technology that can pretty much eliminate dental abscesses without surgery or antibiotics.

It can be used when the SHW&THTF and nothing else is available.

I am referring to Magnetic Pulse Therapy.

By making a "coreless" electromagnet from 1 lb of 14ga magnet wire and popping the juice from any cheapo thrift store flash camera through it, you can alleviate an astonishing array of illnesses, including dental infections.

For those that would like to think outside the box, Google-up "Bob Beck" & "The Thumpy Files". Also any number of US Patents on the subject.

Pulse Therapy is one of the better-kept secrets in modern medicine. Among other things it can cure both HIV and cancer.

I've been using it for many years, and I know whereof I speak.

 

Offline BerserkerPrime

  • Ice Humping Polar Bear
  • Moderator On Leave
  • Survival Demonstrator
  • *
  • Posts: 2079
  • Karma: 75
  • God, Guns and Oil!
Re: Dental Emergency Preps
« Reply #81 on: November 23, 2011, 11:58:57 PM »
LD, what happens if you have metal filings or caps?