Dental issues are one of those problems that is generally not acutely life threatening but can have a serious impact on comfort, function, and the ability to hydrate and nourish. In some cases they can be life threatening but usually afford the patient some warning, if they are paying attention.
NOTICE: This is a blog article and not an instruction manual or training course. It is up to the reader to accept that they will not become a dentist or even a remote medicine practitioner by reading this article. Don’t rely solely on this article for the education necessary to treat dental issues even at the first aid level.
Because dental issues are generally not life threatening preparation for treating these issues gets little attention or concern and when something arises both patient and provider start to appreciate the level of discomfort that can come from a cavity or a fractured tooth, among other problems. Below I am going to provide a basic list of dental first aid items to handle common issues in the field until you can get to a provider who has a more capable knowledge base and tool box.
-Dental floss. For kits I often use non-waxed for cleaner packaging. Used for cleaning debris from between teeth and moving gums.
-Toothpicks. Used for manipulating tissue and filler material.
-Q-tips. Used for applying medication or drying surfaces.
-24″ of 30ga stainless wire. Used for buddy splinting a tooth among other more advanced techniques.
-Assortment of sutures, 3-0 and 5-0 generally work well. Used for securing a tooth in place or repairing a laceration.
-Temporary filling material. Obvious.
-Small tube of Benzocaine dental pain gel. Topical pain management.
-1/2 of an emory board (cut down). Reprofiling sharp tooth surfaces.
-Scalpel blade. I use #11 the most. Draining an abscess or manipulating tissue for wound repair.
-Dental wax. More temporary filler material.
-Cotton gauze or preferably the small cotton rolls. Saliva management!
All of this will fit in one of the large rectangular dental floss containers if you strip out the roller. Unfortunately these are harder to come by as most manufacturers have gone to the smaller cases. If you can’t come by one of these a small travel soap dish will work fine and give you a tray to work from. This is the basic kit and can accomplish a lot but for a minimal amount of time, think 1-2 days. If you have more space adding the following items with add a significant capability and ease to treatment BUT they take up space.
-Mirror. Visibility and manipulation.
-Probe. Manipulation and assessment.
-Eugenol liquid. Cleaning and pain control.
-Salt. Global oral cleaning.
With the total of the two above lists you can replace a filling, cement down a cap, stabilize a crown-root fracture, wire in a jaw fracture, repair an oral laceration, smooth off and seal chips/dentin exposures, treat thrush, among other items.
High yield concepts:
-An ounce of prevention is worth a pound of treatment. Take care of your mouth. Two cleanings per year, brush before and after sleep, and consume a good diet low in sugar.
-Address small issues before they become big issues. A small cut or a small cavity can be stabilized with regular brushing and mouth rinses. Fixing a small tooth fracture with a sharp edge early on will prevent the patient from rubbing their tongue raw compounding discomfort.
-A clean and dry workspace is necessary for any patch or filling to be effective. All but the most temporary coverings need to be put onto clean surfaces to prevent undermining healthy material. Non-dry surfaces will not hold sealant or filler. Breaking a healthy tooth yields clean surfaces, breaking a tooth due to a cavity yields a dirty tooth. Keep this in mind during your assessment and decision process.
-When in doubt rinse with saltwater. Got a cut in the mouth? Think you have an abscess? Think you have a cavity? Tooth fractured below the gum line? Rinsing with salt water can help improve or stabilize infection and bacteria/fungus growth in the mouth. Warm clean water mixed with table salt 4-6-8 times per day will stabilize many issues. This is not a cure-all but it is damn close.
-If you don’t know what to do, rinse with salt water and control pain.
Look for more dental info down the road. In the mean time, if dental treatment is an interest of yours “Where there is no dentist” is a great resource.