At the Tropic of Capricorn

In my December 2009 Christmas Newsletter #3 I mentioned I was returning to South Africa to visit my family and to celebrate my Granny’s 90th birthday. The trip was wonderful. Catching up with friends and family was a real pleasure.

Other than family and friends, the thing I miss most about my home country is the wildlife, so with an Uncle and Aunty we had a week long safari in the Kruger National Park. The highlight was sighting the ‘Big Five’, and all in one day!

The big five are: Lion, Leopard, Elephant, Rhino and Buffalo. They are known as the big five because they are all animals that will attack as a form of defence when threatened, unlike even some large animals like hippos that would rather take flight into the water despite having the reputation of killing more humans than the crocodile.

To put the sighting of all five species (and in one day) into perspective one must realise that many seasoned safari-goers can go a lifetime without sighting all five animals in the wild.  In fact, my Aunty had never seen a leopard in the wild before (or a cheetha – not a big five animal, but one we did see close up on our first day in the park).  I personally had seen both leopard and cheetha previously, but in parks outside South Africa.

Here is the evidence of our sightings on 5th January 2010: 

Elephant herd crossing road

Buffalo bull

Male Lion

Leopard and kill in tree

White Rhinocerous

If you are a patient of our practice and have an emergency after hours call me on my mobile phones: 021 399 801.

If you are not a patient of our practice please first try the Emergency Dentist-on-call on 025 923 475.

Here are some common dental emergencies and how to handle them:

Bleeding

Cut lips, tongue or gums
Rinse the wounds and clean gently with cold water or salt solution.  Apply pressure with a damp cloth.  Call us or get to your nearest Accident and Emergency clinic.

Extraction wounds
Take a clean handkerchief, wet it, wring it out, fold it, place over the bleeding socket and bite firmly.  Keep it there for at least 10 minutes.  Sit down -  do not move about.  If bleeding persists, reapply the handkerchief with a damp tea-bag folded inside the cloth (don’t allow burst bag to spill tea leaves into the wound), and leave for a further ten minutes.  Avoid smoking, hot drinks, alcohol and exercise for the following 12 hours.  If the bleeding persists call us or the Emergency Dentist.

Teeth bumped, displaced or loosened
If possible, gently push the tooth back into position.  Hold it in while you apply pressure around the tooth with a damp cloth for several minutes.  Call us or get to the Emergency Dentist as soon as possible.

Teeth knocked out
Baby/Milk tooth
If the tooth is completely knocked out then there is no treatment for that tooth other than stopping the bleeding.  You may contact us for advice and to set up an appointment to check no other damage has been done.

Adult Tooth
Time is critical.  If you can replace the tooth immediately or keep it moist and make it to the dentist within thirty minutes, there is a good chance that the tooth can be saved.  The chances of successful re-implantation reduce dramatically with time, so act swiftly.

Find the tooth.  Do not  touch the root – hold it by the crown.  Do not scrub or attempt to disinfect it, as you may kill some of the living cells on the root.

If it is clean immediately after dislodgment:  Try to put it back in place yourself. Hold it by the crown and push it gently back into its socket, checking that it is inserted in its original position and the right way round. Hold it in place and apply pressure around the tooth with a damp cloth for several minutes.  Contact a dentist as quickly as possible.

If it is not clean: Do not touch the root – hold it by the crown.  Do not scrub or disinfect it.  In order of preference rinse it with milk or weak salt solution (one level teaspoon in a large mug of cold water) or cold water or have the patient suck it clean before gently pushing it back into place.  Hold it in place and apply pressure around the tooth with a damp cloth for several minutes.  Contact a dentist as quickly as possible.

If you can’t put the tooth back into its socket: In order of preference place it in a cup of milk or salt solution (one level teaspoon in a large mug of cold water) or cold water.  Alternatively, put it under the patient’s tongue or in the cheek pouch.  Do not let it become dry. Do not put it in disinfectant. Call us or the Emergency Dentist immediately.

Note for Doctors: Start prophylactic antibiotics immediately.  If the tooth or mouth has contacted soil, consider administering tetanus anti-toxin.  Refer to a dentist for splinting ASAP.

Loose Filling or Crown

See your dentist as soon as possible.  If it is not repaired within a few days, decay can reach the tooth nerve, which may require root canal treatment.  Do not try to use hardware glues like ‘superglue’ or ‘epoxy’ to re-cement the restoration yourself.

If your crown (cap) has come out, carefully scrape out the loose old cement inside the crown and place a layer of Vaseline inside the crown.  Rinse the tooth well to remove all loose cement or food particles.  Place the crown over the tooth and gently press into place.  Bite down gently to seat the crown.  Wipe away the excess Vaseline.  This should create a temporary seal until you see a dentist.

If a filling has come out and the sharp edges are cutting your tongue or the tooth is sensitive,  rinse out the cavity and fill it with well chewed sugar-free chewing-gum or the soft wax on the outside of some cheeses.  If you can’t get to a dentist soon be sure to remove the temporary packing and brush the cavity thoroughly before replacing with a new temporary stopping.

Broken dentures

The first choice is to seek the help of a dentist or clinical dental technician to have a proper repair done.  If you desperately need to do a temporary home repair remove the denture/pieces,  clean them well and dry them off.  Do several practice runs at fitting the pieces together and holding them there.  Once you are confident you can do this accurately use a small amount of cyanoacrylate ‘superglue’ to glue the denture together.  Don’t use any other type of glue.  Once the glue is dry rinse the denture and make sure no un-hardened glue is left before inserting the denture back into your mouth.  Don’t use superglue directly in your mouth!  See your dentist/technician as soon as possible to have a permanent repair done.

Toothache

If you have pain from a tooth ache, contact your dentist for an appointment as soon as possible. In the meantime, try applying oil of cloves (available at chemists). You can also use commonly available pain-killers such as aspirin, paracetamol (Panadol®) or ibuprophen (Nurofen®).  Do not place painkillers directly under your tongue or on teeth, cheek or gums – you can cause chemical burns by doing this.

Abscess or gum boil

This problem should be attended to quickly.  If a dentist is not available, see your Accident and Emergency clinic.  Usually antibiotics are required.  The tooth may require root canal treatment or extraction.

If you have severe swelling of the face or neck or are feverish or having difficulty breathing seek medical help IMMEDIATELY!

Ulcers and infected wisdom teeth

Contact your dentist for an appointment as soon as possible.  In the meantime keep your mouth and teeth as clean as possible by maintaining your regular brushing and flossing routines.  You can rinse with warm salt solution (one level teaspoon in a large mug of water) as often as possible.  A commercial mouthwash, especially with chlorhexidine, such as Colgate Savacol® or Oral-B® mouthwash, can be used three or four times daily between salt rinses.  Antibiotics and anti-inflammatory painkillers can be helpful in some cases, so if a dentist is not available see your Accident and Emergency clinic for a prescription.  Do not use someone else’s ‘leftover’ pills!

If you are not allergic to Iodine, Betadine® mouthwash can also helpful for mouth ulcers.

Deck Project