Every winter and every summer, the same thing happens. The Remarkables and Coronet Peak fill up, the bike park opens, and our appointment book starts collecting people who came off badly and put a tooth through their lip.
It is one of the more common reasons people walk into a Queenstown dental practice, and almost nobody knows what to do in the first hour. Which is a shame, because the first hour is where most of the difference is made.
First: is it a chip, or is the tooth out?
These are very different situations and the response is different too.
A chip or a crack is urgent-ish. You want it seen soon, but an hour or two either way does not change the outcome much.
A tooth knocked completely out is genuinely time-critical. The cells on the root surface start dying within minutes of the tooth drying out, and the chance of successfully replanting it drops steeply with every half hour. If that has happened, stop reading and ring us.
If the tooth is out
For an adult tooth, do this and do it now.
- Pick the tooth up by the crown - the white part you normally see. Do not touch the root.
- If it is dirty, rinse it briefly in milk or saline. Do not scrub it, and do not use tap water - both damage the cells you are trying to save.
- If you can face it, put it straight back into the socket the right way round and bite gently on a clean cloth to hold it there. This is the single best thing you can do.
- If you cannot, put it in milk. Saliva will do - hold it in your cheek if you must, and only if there is no risk of swallowing it. Never let it dry out and never wrap it in a tissue.
- Ring us immediately on 03 441 8248 and come in.
If it is a chip or a crack
Rinse gently with warm water and save any pieces you can find in milk or saline - a fragment can sometimes be bonded straight back on, and it is worth the attempt.
If there is a sharp edge shredding your tongue, cover it with a piece of sugar-free chewing gum or dental wax until you can be seen. A cold compress on the outside of the cheek helps with swelling, and ordinary over-the-counter pain relief taken as directed handles the soreness.
Then get it looked at, even if it does not hurt. A chip exposes the layer beneath the enamel, and that layer is a direct route for bacteria towards the nerve. Small chips are also far cheaper to fix than what they turn into.
The bit people miss: your bite
After a decent knock, pay attention to how your teeth meet. If your bite feels different - if one tooth is hitting first, or something feels 'high' - that matters, and it is worth mentioning when you ring.
A tooth can be knocked out of position without coming out altogether, and it can be repositioned. There is also the possibility of a fracture in the bone that holds it. Neither is something to sit on until you get home.
ACC covers more than people expect
This is the part visitors are most often surprised by. ACC covers accidental injury that happens in New Zealand, and that includes dental injury, and it includes many visitors - not only residents.
So if you came off a bike at Skyline or caught an edge on the Remarkables, the treatment is very often partly covered. You do not need to have lodged anything before you come in. We complete the ACC form as part of the appointment.
ACC generally contributes rather than covering everything, so there may be a surcharge depending on what is needed. We will tell you the figure before we start, not after.
If you are flying out tomorrow
Tell us when you ring. It changes what we do.
There is usually a difference between the treatment that finishes the job and the treatment that makes a tooth safe, comfortable and stable enough to travel on. If you are getting on a plane in the morning, the second one is what you want, and then your own dentist completes it at home.
Worth knowing: air pressure changes at altitude can make an inflamed tooth considerably more painful. If a tooth is already sore, dealing with it before the flight is a good deal more comfortable than dealing with it at 35,000 feet.
We keep room for this
We are at 12 Lake Esplanade in central Queenstown, with free off-street parking. We keep space in the day for emergencies and can often fit people in at the end of the afternoon. You do not need to be an existing patient.
Outside our Monday to Friday hours there is an on-call emergency service by request - ring the practice number and follow the instructions.
General information, not a diagnosis. Written and reviewed by Dr Adrian Paul, BDS (Otago), principal dentist at Lakeside Dental Practice, Queenstown. If something is worrying you, see a dentist.
