By Dr. W. Gifford Jones
What should you do if you develop an abscessed tooth in Mexico? Or if a tooth is knocked out in Berlin? Or if hemorrhage occurs after a recent extraction while travelling to Moscow? There are some important do's and dont's if you seek dental care in a foreign land.
Dental problems abroad are usually initiated at home from years of neglect. Most travellers have the wrong idea about rust. They think it just causes holes in drainpipes. But dental rust (periodontal gum disease) is the main cause of tooth loss in people over the age of 35. It's an insidious process starting as "gingivitis" in which gums turn from a natural pink colour to red.
Gingivitis usually progresses to periodontitis. Eventually the gums pull away from the crown and root of the tooth. This causes deep pockets to form where bacteria accumulate and slowly destroy the firm cement-like structures supporting the teeth. One result may be an abscessed tooth. Or the infection may seep under an old filling spreading to the tooth's root causing an apical abscess.
Dr. John M Symington, professor of oral surgery at the University of Toronto , says on rare occasions an abscess can be treated by just giving penicillin. At other times the abscess can be drained by making an incision into the gum. But usually,like an inflamed appendix, the pulp and nerves must be removed by a root canal procedure.
The cardinal rule is to hold on to a tooth whether you're in Canada or overseas. Pulling out a tooth is an old time remedy. It provides speedy relief and may appear to be the simple answer when time is a factor on a trip. But never part with a tooth lightly. A gap in the gum means opposing teeth have nothing to support them during chewing. They too may become loose and more susceptible to decay. An upper tooth may fall down into the hole or drift out of position changing the normal bite.
But some travellers will needlessly lose a tooth because the root canal operation is surrounded by misconceptions. They've heard the procedure is terribly painful, and rarely works. This thinking is as outdated as the model-T Ford.
An overseas dentist may quickly perform the initial step by removing the nerves in the root. This relieves pressure , drains the abscess and stops the aching. Major work can then be done at home after the inflammation has simmered down. The dentist carefully reams out the roots of the tooth, sterilizes the cavity, then fills the root canals with sealant. Later a cap is placed over the tooth to provide support.
Suppose a tooth is knocked out during a trip? Dr. Symington cautions travellers not to toss the tooth away. This is an emergency situation and success or failure in saving the tooth depends on time. First, place the tooth in milk. Milk has the proper pH factor to maintain the viability of the cells on the tooth's surface. Or place the tooth under your tongue, or wrap it in a wet gauze. Then rush to a dentist. He will remove the blood clot, clean the exposed socket and reimplant the tooth. It will be held in place by splints and wires for a month to determine if the implant will take.
Some patients will have a tooth extracted a week before a trip. If infection occurs it can destroy the clot.This along with a change in the atmospheric pressure can cause a hemorrhage at 30,000 feet. The best treatment is to place a handkerchief in hot water , ring it out and bite on it. If this doesn't work bite on a warm tea bag. The tannic acid in tea helps to coagulate protein.
Here are some other tips for dental emergencies. If a filling falls out, protect the tooth from exposure by sticking a piece of sugarless gum into the cavity. Sugar is more likely to cause pain. Should a cap fall off stick it back on until dental care is available. If you suffer from toothache, take one or two codeine tablets. Placing a small piece of gauze moistened with clove oil over the tooth is another effective painkiller.
Finding good dental care depends on location. London, England has five hospitals with emergency dental departments. In other countries go to the nearest hospital or seek the guidance of the hotel manager or friends. Be prepared to pay for good dental care. Don't be like the Scotchman who said, "$25.00 is lot of money for pulling out a tooth , just two seconds work." To which the dentist replied," If you wish I'll pull it out slowly." Or another Scot who asked, " If it costs $25.00 to pull out the tooth how much will it cost just to loosen it?"
W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is: Docgiff.com
My book, �90 + How I Got There� can be obtained by sending $19.95 to:
Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1
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