Is this a dental emergency?
May 29, 2011 8:11 AM   Subscribe

Trying to figure out whether to call my dentist's emergency number, see if this is something that can wait until Tues. or if it's something an urgent care could handle.

I have atrocious teeth. This is not new. ~ 3 weeks ago I saw my dentist for a regular cleaning and I mentioned I was having slight pain while biting that seemed to be coming from upper right. He did x-rays, for which I was due anyway, and between them and the cleaning saw a possible cavity on the upper right and "activity" near the root tip on a root canal that has been re-treated twice (not by him). He asked me how bad the pain was and I said "3" and only when biting. More annoying than "pain" and he opted to wait and see for two weeks and we scheduled a consult.

Two weeks was this past Monday and the "pain" was about the same. He took additional xrays of both spots and while the bottom one seemed the same, he could more clearly see the cavity on the top and filled it. I had the normal sensitivity after treatment, but nothing that 2 Advil didn't solve and I thought it was fine. He did give me a Z-Pack in case there was something going on with the bottom tooth and I completed that on Friday.

Also on Friday - I started to feel some whinging in the upper right when I wasn't chewing. Just like a toothache. I took Advil when I got home and didn't think anything of it. 6 AM Saturday I wake from pain in the tooth and ear. Not stabbing pain from a typical abscess (been there, done that - could write the book) but pain. Took 2 Advil, eventually fell back asleep. Ran errands, went to the gym yesterday and it was ok. Had a smoothie later and yeow, hello cold sensitivity. I "fixed" that by pressing my thumb to the tooth - an old remedy taught to me several dentists ago that was very helpful when I was overseas.

I took 2 Advil before bed so it wouldn't wake me up and I slept through to 9:30 (early for me on weekend). It's nagging but not in the ear. Worrisome? My cheek is red and warm to touch but no fever. Feels like a vice is tugging on the tooth/gum. I haven't yet taken Advil because if I do get it seen today, I want them to be able to "see" the pain.

Is this something I call the emergency number for? He doesn't live in the city but he's the type of person who came in in the blizzard to get the call list of appts. The one urgent care I know of said they treat dental emergencies when I called. Is that the best bet? I have medical and dental insurance coupled with an FSA so this isn't a case of "I can't afford it" but rather "is it an emergency?"

TL; DR: trying to assess if dental pain is an emergency, or if it can wait until Tues. (Holiday weekend here in the US).
posted by TravellingCari to Health & Fitness (9 answers total) 1 user marked this as a favorite
If the pain is controllable and the situation is stable, which it seems to be, then no it isn't an emergency.

I wouldn't bother with skipping the Advil so they can "see" the pain. Unless the dentist is a moron, they can calibrate their observations based on what you have taken.

This is a good question, though, because it makes me wonder if ERs have some kind of dentistry hook up at all? I have a feeling that you'd go to the ER, wait for hours, get expensive x-rays and walk out of there with a $5000 bottle of Tylenol 3.
posted by gjc at 8:19 AM on May 29, 2011

Response by poster: I wouldn't bother with skipping the Advil so they can "see" the pain. Unless the dentist is a moron, they can calibrate their observations based on what you have taken.

Point taken: was just basing it on one instance where he asked me to hold off on the Advil the morning of the appointment. because he wanted to see the pain reaction on tapping tooth, etc. and said pain meds might dull that reaction.

That was my question on the ER as well. I know my old dentist used to refer us to a specific hospital which may have had a dental set up but I don't know how a regular ER would have handled it. Was pleasantly surprised when the Urgent Care said they could. I know Duane Reade doc in the boxes said they can't.

That was my gut on the emergency factor as well, just wasn't sure how quickly this could/would progress. It's no worse than when I woke up 2 hours ago. Just still feels as if something is pulling on the tooth.
posted by TravellingCari at 8:44 AM on May 29, 2011

Oh god, for starters, YES, take some Advil. You go to the dentist (now or tuesday) and you say "It's been agonizing, I've been on steady Advil." You can describe the pain, that's FINE.

This is always a tricky call. It's nice to be treated by someone who knows your teeth and has recent x-rays! It's also nice to have extreme dental agony handled immediately. It's unlikely that something horrendous is going to happen to you between now and Tuesday, apart from the already horrendous experience of exposed nerves or what have you.

It really boils down to how comfortable you are having strangers work on your teeth.
posted by RJ Reynolds at 8:47 AM on May 29, 2011

Best answer: Call the dentist regular number, leave a voicemail with the spelling of your name, your date of birth and two phone numbers if possible where you can be reached You might be wondering why I was so specific about leaving two numbers? Because when I managed a dental office, voicemails that I could respond to immediately got responded to immediately. If I had to hunt for a chart, or wait for my assistant to hunt for a chart, you had to wait for me to get the chart. If one phone line was busy, I can call the second.

If this toothache woke you up (you don't need to tell the dentist what time) then whatever is going on is not good. Depending on the office set up, try the emergency number, but be honest about what's going on. (We once had a patient take a falling chainsaw in the face. That's an emergency. "I ran out of bleach gel and I have a date tonight," is not. You are somewhere in the middle.)

The doc may opt to wait until Tuesday, but I promise you, appointments after a Holiday weekend will be hard to get. If you call now, you can get worked into the schedule now, or be first in line to get called back on Tuesday morning. Be waiting at the phone.

If you call on Tuesday, you are behind anyone who called today, tomorrow and early oh-dark-a.m. Tuesday.

If your dentist is not available today but thinks you should be seen, he'll have some resources for where you should go.
posted by bilabial at 9:46 AM on May 29, 2011 [1 favorite]

Response by poster: Thanks all. Bilabial, thanks for the "inside" advice.

I'm comforted by the fact that it hasn't gotten worse (1:30 now). Light breakfast didn't send me through the roof. Left a detailed message including that it hadn't worsened and will trust his professional experience/his staff's judgement as to how soon I need to be seen. I think I was a little over worried by the fact of previous abscesses and not wanting that kind of pain.

I'm not too too worried about getting an appt. after the holiday weekend because he builds time into his schedule for such situations and the last time I had an emergency the week after new years, he got me in within two hours.

Knowing the Urgent Care is open tomorrow in case this gets OMG! awful is a good comfort as well..

Thanks again all, I'll update after I see him as to what "it" was.
posted by TravellingCari at 10:37 AM on May 29, 2011

Response by poster: update: got an appt for 2:30 today. We'll see what he said. When his staff called me this morning her first concern was whether I needed to be seen immediately or whether afternoon was OK. This is why I love him and his staff.
posted by TravellingCari at 7:41 AM on May 31, 2011

Yay! I hope everything turns out fine, and I love hearing stories of patients who love their dentists!

Not to be all up in your business, but please let the doc know his staff is awesome (or other adjective of your choosing).

Here's to feeling better soon.
posted by bilabial at 9:51 AM on May 31, 2011

Response by poster: Bilabial - oh I do, and regularly. His whole team is full of win. I think it's part of their recruiting strategy. They all seem to really care about the patients and talk to us while we're waiting etc. I also thank him in what I hope is the best way - business his way.

He did something to adjust the bite after numbing told him that might have been it. So far, knock on wood, so good. Not surprised the bite is FUBAR due to TMJ and multiple crowns done by multiple dentists so it's a puzzle work . Just hope this tinkering gets me through this weekend (bro's wedding). Then, he can get to do major work as needed on the twice root canaled tooth
posted by TravellingCari at 7:21 PM on May 31, 2011

Response by poster: so final? follow up. The aching pain after adjusting the bite stayed constant until yesterday when it began to feel as if there was an ice pick being shoved through my upper gum. I left him a message when it woke me in agony at 4 am this morning and he got me in this afternoon. After the bite stick sent me through the roof yeowling, emergency pulpectomy. He didn't finish it but he removed the inflamed stuff and put medication in it and a prescription for Vicodin, which I hope not to need. This is the tooth that he filled ~ month ago after the cavity. When he took out the filling, he could see the nerve... so that's where we are. Wasn't an emergency but needed treatment.
posted by TravellingCari at 3:01 PM on June 10, 2011

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