The First Step:

Our goal is to get you out of pain as soon as possible. Whether the tooth is damaged from deep decay, gum disease, or trauma, the first step is an examination and X-ray evaluation. Call our office immediately for an emergency appointment. We can arrange an appointment on the same day. If the tooth is restorable, a root canal procedure may be recommended. We can make the appropriate referral to an endodontist who specializes in root canal procedures. If the tooth is not restorable due to severe breakdown, then extraction is the only option.

You may take Tylenol or Advil to help you with pain until seen by the oral surgeon.

Painful or infected teeth should be removed as soon as possible. It is not advised or necessary to take several days of antibiotics before surgery. This can result in more complications. The best approach is early removal and then a follow-up with antibiotics.

Anesthesia for Emergency Extractions:

IV sedation is the best and most recommended anesthesia option for extraction of painful teeth with decay or infection. Infection can make local anesthesia less effective therefore making it difficult to achieve adequate numbness. Therefore, do not eat or drink anything for at least 6 hours in the event IV sedation is recommended for extraction. Also, have someone available to drive you home following the procedure.

Referral Process:

Your dentist may refer you for an immediate evaluation and treatment. We can often schedule an emergency appointment on the same day. Make sure to bring any avilable X-rays and a referral form from your dentist.

Getting a Temporary Tooth:

If the tooth recommended for extraction is in the front area (smile zone), your dentist may first obtain an impression to prepare a temporary prosthesis before the extraction is done at our office.  A temporary prosthesis can be made very quickly, sometimes on the same day, so you don’t have to go without a tooth for long. A transitional prosthesis may also be made for teeth in the back.

Tooth loss, fractured jaw bones, or cuts to the mouth and face are especially difficult for a person to cope with. People are often nervous and upset, and faced with long waiting times at emergency rooms. In addition, the hospital may not even have the right specialist on staff to treat oral and facial injuries.

Any facial injury should be taken very seriously. Be seen immediately, get appropriate care by an expert oral surgeon, and repair the injuries properly to avoid deformities or unnecessary scarring. If you have lost teeth, have them replaced immediately.

Dr. Kazemi, an oral and maxillofacial surgeon, and his team specializes in management of oral and facial injuries. We provide 24-hour immediate assistance with no waiting, and offer specialized care to treat any injury properly. Most injuries are managed readily and easily at our center. More significant injuries requiring hospitalization, are treated at Suburban Hospital or The Washington Hospital Center. Dr. Kazemi is on staff at both hospitals and can arrange immediate admittance.

We specialize in the treatment of:

• Teeth fracture or loss
• Fracture of upper or lower jaw bones
• Fracture of the cheek bone
• Laceration or cuts to the mouth or face

Common signs of injury:

Most injuries have obvious signs such as bleeding, cuts, or displaced or lost teeth. However mild injuries may not be as obvious. You may have suffered a fracture or injury if you are experiencing one of these symptoms:

• A tooth that feels high when you bite down
• Pain associated with a certain tooth or part of jaw bone
• Pain when opening or closing mouth
• Swelling or bleeding

Nature of maxillofacial trauma:

There are a number of possible causes of facial trauma such as motor vehicle accidents, accidental falls, sports injuries, interpersonal violence and work related injuries. Types of facial injuries can range from injuries of teeth to extremely severe injuries of the skin and bones of the face. Typically, facial injuries are classified as either soft tissue injuries (skin and gums), bone injuries (fractures), or injuries to special regions (such as the eyes, facial nerves or the salivary glands).

Bone injuries:

Fractures of the bones of the face are treated in a manner similar to the fractures in other parts of the body. The specific form of treatment is determined by various factors, which include the location of the fracture, the severity of the fracture and the age and general health of the patient. When an arm or a leg is fractured, a cast is often applied to stabilize the bone to allow for proper healing. Since a cast cannot be placed on the face, other means have been developed to stabilize facial fractures.

One of these options involves wiring the jaws together for certain fractures of the upper and/or lower jaw. Certain other types of fractures of the jaw are best treated and stabilized by the surgical placement of small plates and screws at the involved site. This technique of treatment can often allow for healing and obviates the necessity of having the jaws wired together. This technique is called “rigid fixation” of a fracture. The relatively recent development and use of rigid fixation has profoundly improved the recovery period for many patients, allowing them to return to normal function more quickly.

The treatment of facial fractures should be accomplished in a thorough and predictable manner. More importantly, the patient’s facial appearance should be minimally affected. An attempt at accessing the facial bones through the fewest incisions necessary is always made. At the same time, the incisions that become necessary, are designed to be small and, whenever possible, are placed so that the resultant scar is hidden.

Injuries to teeth and surrounding structures:

Isolated injuries to teeth are quite common and may require the expertise of various dental specialists. Oral surgeons usually are involved in treating fractures in the supporting bone or in replanting teeth that have been displaced or knocked out. These types of injuries are treated by one of a number of forms of splinting (stabilizing by wiring or bonding teeth together). If a tooth is knocked out, it should be placed in salt water or milk. The sooner the tooth is re-inserted into the dental socket, the better chance it will survive. Therefore, the patient should see a dentist or oral surgeon as soon as possible. Never attempt to wipe the tooth off, since remnants of the ligament that hold the tooth in the jaw are attached and are vital to the success of replanting the tooth.

Other dental specialists may be called upon such as endodontists, who may be asked to perform root canal therapy, and/or restorative dentists who may need to repair or rebuild fractured teeth. In the event that injured teeth cannot be saved or repaired, dental implants are often now utilized as replacements for missing teeth.

Cheek bone fracture occurs commonly in response to a blow or fall. The signs and symptoms are:Flat or depressed look of the cheek bone swelling or bruise around the eyes difficulty opening mouth numbness of side of face, nose, and under the eye.

Oral and Maxillofacial Surgeons are trained, skilled and uniquely qualified to manage and treat all oral and facial trauma. Injuries to the face, by their very nature, impart a high degree of emotional, as well as physical trauma to patients. The science and art of treating these injuries requires special training involving a “hands on” experience and an understanding of how the treatment provided will influence the patient’s long term function and appearance.