Emergencies

Due to COVID-19, our surgeries are now closed except for genuine dental emergencies (pain, swelling, bleeding, trauma and deterioration of your health). Should you have an emergency please contact our reception team,  if you have tried and are unable to alleviate at home.

PLEASE CALL OUR PRACTICES, DO NOT ATTEND WITHOUT BEING TRIAGED OR SPEAKING TO A DENTIST FIRST.

In these unprecedented times, we are receiving a high volume of telephone, e-mail and other communication at present that is manned by our skeleton team and therefore the response time may be delayed. We thank you for your patience and apologize for the inconvenience.

SELF HELP ADVICE

If you have toothache, there are things you can do to ease it while you wait for an appointment.

  • take painkillers, like ibuprofen or paracetamol (children under 16 shouldn’t take aspirin) – a pharmacist can advise you
  • try rinsing your mouth with salt water (children shouldn’t try this)
  • use a pain-relieving gel for your mouth – this can be bought from pharmacies or supermarkets
  • eat soft foods, like yoghurt or scrambled eggs, and try to avoid chewing with the sore tooth
  • do not eat foods that are sweet, very hot or very cold
  • do not smoke – it can make some dental problems worse

Please call us if

  • that last more than 2 days
  • that doesn’t go away when you take painkillers
  • with a high temperature, pain when you bite, red gums, or a bad taste in your mouth, keeping you awake at night
  • and your cheek or jaw are swollen

Don’t go to your GP as they won’t be able to give you dental treatment.

Please call us Urgently or Call 111, if

  • the area around your eye or your neck is swollen
  • swelling in your mouth or neck is making it difficult for you to breathe, swallow or speak

Bleeding gums after a tooth extraction, dental implant or periodontal surgery can  is to be expected after dental surgery. It’s important to identify and address excessive or abnormal bleeding and to contact your dentist if you have any concerns. Bleeding is usually the worst for the first 24 hours and can look much worse than it really is. When blood mixes with saliva, it looks like blood… lots of blood. See below- A few tips on how to stop the bleeding on your own.

Please call us if

  • If despite multiple attempts to stop the bleeding with direct pressure is not successful.
  • Medically, you still feel healthy

Please call us Urgently or call 111 

  • If there is uncontrollable bleeding following dental surgery/extraction (mouthfuls of blood) 
  • A realistic threat to life (you feel systemically well)
  • or A&E (out of hours) 

 A few tips on how to stop the bleeding on your own.

  1. Apply a wet gauze compress to the gums – Place the gauze on top of the empty tooth socket or other procedure site. Then bite down on the gauze to apply firm pressure for about 30 minutes to an hour. If you do not have gauze on hand, a wet, folded paper towel can be used instead. Bleeding should be significantly slowed or stopped after 60 minutes of pressure.
  2. Keep your head elevated above your heart – Bleeding can be slowed if blood pressure is lowered by propping your head up in bed with some pillows. Keeping your head higher than your heart can lower blood pressure.
  3. Bite on a black tea bag for 30 to 45 minutes – When using the tea bag method, it is important to make sure that the tea bag is wet and is black tea as black tea leaves have tannic acid which is a coagulant. This should help encourage the blood to clot more quickly.
  4. Rest – Avoid strenuous activity or exercise as this may activate more bleeding and prolonged healing.
  5. Be careful of what you eat and drink – There are many food items or drinks that can negatively impact the surgical site. Do not drink from a straw for several days following a tooth extraction or surgery as this can dislodge the blood clot. Smoking also can dislodge the clot and spread harmful chemicals around the wound site contributing to painful infection called “Dry Socket”. Other things to avoid are hot beverages and carbonated beverages as these can dissolve the blood clot. It is important to stay away from crunchy or chewy foods as these may dislodge the blood clot. It is best to stick with soft foods such as warm (not hot) soups, applesauce, and smoothies following oral surgery.
  6. Vitamins and Herbs – Some common vitamins and herbs such as Vitamin E or Ginkgo biloba can also significantly affect the bodies ability to form a blood clot.
  7. Medication – There are a number of medications that increase the risk of excessive bleeding. Some are very typical over the counter drugs such as Asprin and Ibuprofen. 
  8. Show your dentist your medication – We encourage all of our patients to bring in their regular medications (pharmacy prescription) when calling / attending for an emergency appointment.
  9. Avoid alcohol – Abstain from alcohol consumption for about 24 hours in order to help their body’s ability to clot blood and heal efficiently. The presence of alcohol in the blood slows platelet production and so blood does not clot as quickly as it naturally would.
  10. Don’t Swish Vigorously or Use Over-the-counter Mouth Rinses – While it may seem like you are keeping the dental surgery site clean or removing food and debris, you are actually removing the blood clot which has all of the growth factors necessary for healing. It’s also important to note that products such as Scope or Listerine may inhibit healing of the surgical site and should be avoided until your bleeding has stopped or the dentist advises that you it is safe to resume.

Facial swelling is not uncommon and can happen as a result of an injury, allergy, medication, infection, or other medical condition.

Drug allergies range in severity and the types of symptoms they cause. Skin rashes on the face and arms are common with medication allergies. Drug allergies can also cause rash/hives, a generalised swelling of the face, and anaphylaxis.

Surgery Unlike other causes of inflammation, swelling due to a surgery can take at least several days (5-7) to go down. 

Using an ice or cold pack on your face is one of the best things you can do.

  • You can apply ice to the swollen area for 10 to 20 minutes at a time. 
  • Depending on your tolerance, most dentists will tell you to do this at least three times a day.
  • The type and extent of any surgery or infection can also dictate how long and extensive the  facial swelling is and lasts.
  • Keep your mouth as clean as possible by brush your teeth and rinsing with salt water at least three times a day.
  • Take anti-inflammatory tablets, if possible.

Please call us if

  • If despite multiple attempts to stop the swelling is not successful.
  • Medically, you still feel healthy

We may contact you via video link to see the swelling. Take selfies photos if you can 

Please call us Urgently or call 111 

  • If the swelling is spreading to your eye or neck
  • Does it affect your vision, speech or cause you to drool?
  • A realistic threat to life (you feel systemically unwell)
  • or A&E (out of hours) 
  • Or call 999

Mouth ulcers are common and should clear up on their own within a week or 2. They’re rarely a sign of anything serious, but may be uncomfortable to live with.

Mouth ulcers need time to heal and there’s no quick fix.

Avoiding things that irritate your mouth ulcer should help speed up the healing process, reduce pain, reduce the chance of it returning

  • use a soft-bristled toothbrush
  • drink cool drinks through a straw
  • eat softer foods
  • get regular dental check-ups
  • eat a healthy, balanced diet
  • do not eat very spicy, salty or acidic food
  • do not eat rough, crunchy food, such as toast or crisps
  • do not drink very hot or acidic drinks, such as fruit juice
  • do not use chewing gum
  • do not use toothpaste containing sodium lauryl sulphate
  • antimicrobial mouthwash, painkilling mouthwash, gel or spray or corticosteroid lozenges can be bought without a prescription, but they may not always work.

If you have several mouth ulcers, this can be a symptom of:

Most single mouth ulcers are caused by things you can try to avoid, such as:

  • biting the inside of your cheek
  • badly fitting dentures, braces, rough fillings or a sharp tooth
  • cuts or burns while eating or drinking – for example, hard food or hot drinks
  • a food intolerance or allergy
  • damaging your gums with a toothbrush or irritating toothpaste
  • feeling tired, stressed or anxious

Sometimes they’re triggered by things you cannot always control, such as:

  • hormonal changes – such as during pregnancy
  • your genes – some families get mouth ulcers more often
  • a long-term condition – such as inflammatory bowel disease (IBD), coeliac disease or Behçet’s disease
  • a vitamin B12 or iron deficiency
  • medicines – including some NSAIDs, beta blockers or nicorandil
  • stopping smoking – people may develop mouth ulcers when they first stop smoking

Please call us if

  • If the lesion has been present for 2 weeks with no obvious cause.
  • If you are feeling any prolonged tingling sensations, the area constantly bleeds, if it affects other areas on your body.

We may contact you via video link to see the swelling. Take selfies photos if you can 

Call 111 if out of hours

Knocked a tooth out? Don’t panic!

*** Never try to re-insert a baby tooth ***

PICK IT, LICK IT, STICK IT- Here’s what to do to help save your tooth. Do this as quickly as possible. 

  1. Pick the tooth up by the crown only (do not touch the root)
  2. Lick the tooth clean if it is dirty, or rinse it in water (10 seconds)
  3. Stick the tooth back in position (adult teeth only)
  4. Bite on a handkerchief to hold it in place.
  5. Please call us.
  6. We may contact you via video link to see the trauma. Take selfies photos if you can.  
  7. or Call 111 if out of hours

If the tooth is to be transported to the surgery it should be placed in a small container of the patient’s own saliva or milk.

Please call us Urgently or call 111 

  • If patient you experience trauma with loss of consciousness/vomiting/nausea/stiffness of neck/ or blurred/double vision.

Most orthodontic appliances can be the mouth for some months without detriment to the patient if the patient continues with the usual after care instructions;

  • Exemplary oral hygiene – brushing 3 times a day with their standard toothbrush, followed by interproximal brush use. As an adjunct, use of a fluoride mouthrinse eg. Fluoriguard (225ppm), once a day.
  • Low sugar diet – Where possible avoid all snacking on sugars and drinks with ADDED SUGAR. Fizzy drinks should be avoided in particular.
  • Avoid hard, sticky and hard foodstuffs that could break the brace wire or fracture brackets (debond) off a tooth.

Home advice

1. Wires digging in  

  • If a thin wire, it may be possible for the patient or family member to use tweezers to replace wire in the tube/band or tweezers and a nail clipper/scissors to shorten the long end 
  • It may be that a thin wire is the correct size but may have rotated round the teeth so that it is short on one side and long on the other. Using tweezers a pencil with a rubber on the end or a teaspoon, it may be possible to push the wire back round to prevent the long end digging in. 
  • If the wire is very thick and stiff (discuss with your orthodontist) it may not be possible to cut the wire with home instruments. If this is the case it may be necessary to cover the wire to prevent it being sharp. Relief wax/silicone may be sent to you or you can buy it online (Orthodontic Wax) Failing that using a wax covering from hard cheese (baby-bell, cheddar), Blue tack or even chewing gum may help 

2. Broken bonded retainers 

  • Push wire back down towards the tooth as much as possible. (Fingers or tweezers) 
  • Cover with best medium available (Ortho wax, Cheese wax, Blu tack, chewing gum) 
  • Cut the exposed unbonded wire using tweezers and nail clippers/scissors 
  • Gently pull the wire to remove the whole retainer 
  • Try using your removable retainers, if present 

3. Lost Retainers  

  • Contact your orthodontist – it may be that your unit has access to your final moulds and can make a new retainer remotely which can be posted out to you 
  • If it is not possible to get a replacement retainer you could consider ordering online a ‘boil in the bag’ (heat mouldable) gumshield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse. Please contact your orthodontist before investing in this strategy to ensure all aspects of this compromise for retention are understood 

4. Gold Chains  

  • If the gold chain was recently place and is now dangling down, it may be possible to cut it short. Gold is quite a soft metal and it may be possible to cut the chain using some nail scissors or nail clippers. Always hold the loose end with tweezers or similar item. If possible, leave at least 5 links through the gum so it can used later by your orthodontic team 
  • If you have a none dissolvable coloured stitch discuss with your dentist about the feasibility of removing it at home using nail scissors to prevent a minor infection in the gum.

5. Orthognathic Post-Op 

  • Discuss with your local hospital team your specific concern/problems for the best advice 
  • Consult www.yourjawsrugery.com for general post op advice 
  • Stop or reduce post surgery elastic wear as advised by the orthodontist. 

6. Aligner therapy 

  • If your current aligner is in good order keep wearing it as much as possible 
  • If your current aligner is broken or ill fitting, step back to your previous aligner 
  • If neither option is open to you, ring you HPC for advice. 

It may be possible to have a new aligner at the correct stage made for you and sent out to you 

  • Or with advice from your orthodontist a ‘boil in the bag’ (heat mouldable) gumshield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse. Please contact your orthodontist before investing in this strategy to ensure all aspects of this compromise for retention are understood 

7. Bracket off 

This is not urgent unless it is causing trauma to the soft tissues. 

  • It may be possible your orthodontist  can guide the you on how to remove the bracket from the wire via video if it is causing trauma. 
  • It may be the possible to leave the bracket if it is not causing any problems at present. Consider contacting your orthodontist for advice. 

8. Elastic Bands 

  • At this time if you run low or out of elastics your orthodontist may either send you a some more out via the post or advice cessation of wear. 

9. Band off 

  • If band is very loose your orthodontist may be able to talk you through removal of the band and trimming of the wire depending upon your stage of treatment. 
  • It may also be also be the case your orthodontist advises you to leave the band in place. If this occurs please ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth. 

10. Band off Quadhelixes, RME, TPA +/- Nance 

  • Discuss with your HPC about the nature of the looseness and take advice accordingly. 
  • Push band back onto tooth if it will locate and ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth. 
  • Remove appliance 

11. Removable/Functional appliances 

  • Check for comfort and retention 
  • If unsure about how much to continue to wear the appliance discuss with your orthodontist  
  • If fractured or ill-fitting do not wear the appliance 

12. Separators 

  • These should be removed at the earliest opportunity – Attempt removal with end of safety pin, small paper clip or wooden tooth pick 

13. Lost module(s) 

  • No action required – try and make wire where the module has been lost secure with dental wax, cheese wax or blu tack and chewing gum 

14. Temporary anchorage Devices TADS 

  • Remove power chain with tweezers if necessary 
  • Your orthodontist may assist you in removing and springs or elastic chain moving the teeth 

15. Headgear 

Home advice – Stop wear

16. Lost spring 

Home advice – No treatment required 

17. Fractured/Frayed power chain 

  • Accept situation– most power chain will denature in 4-6 weeks and become passive 
  • Remove power chain with tweezers if necessary 
  • Cut frayed end as short as possible to improve comfort • 

18. Exposed end of wire tie – long ligature or short ligature. 

  • Re-tuck sharp end under wire/bracket using tea spoon or tweezers 
  • Remove wire if broken with tweezers if possible 
  • Cut frayed end as short as possible to improve comfort with nail cutters or scissors 
  • Cover for comfort using Ortho wax, Cheese wax, Blu tack, chewing gum 

 

Medically, you still feel unwell, call us immediately. 

  • If you feel very unwell with a high temperature.
  • Having difficulty opening your mouth, swallowing or breathing
  • a spreading infection of your face/ Neck.

Please call us Urgently 

  • or Call 111
  • or A&E (out of hours)
  • or Call 999

Please click here for more online Self Help at the bottom of this web page.

Non-urgent dental conditions
This may include but limited to: 

Patients not in pain

  • Aesthetic problems (broken tooth, dislodged crowns and bridges)
  • Patients with broken dentures
  • Patients requiring permanent restorations
  • Non traumatic problems with orthodontic appliances
  • Patients who have no significant pathology (oral lesions)
  • Patients requiring a second opinion for routine dental care
  • Patients with minor gum and dental implant problems
  • Requiring surgical extractions (wisdom teeth) and are not in pain. 

Surgery hours

 Weekdays:  9 am – 4 pm

Bradwell 01493 662717 Lowestoft 01502 567519
Caister-on-Sea      01493 728351 Oulton Village 01502 582294
Gorleston 01493 604666 Costessey 01603 744007
Gt Yarmouth 01493 842559 Thorpe St Andrew    01603 700990
Hemsby 01493 732433 Wymondham 01953 601501

We can appreciate how much of a stressful and painful ordeal it can be when having a toothache, or dental emergency, and the urgency to be dealt with as soon as possible. This is why at John G. Plummer & Associates Dental Surgeons we can offer a number of emergency solutions in helping ease your pain.

NHS fees range from £22.70. Proof of exemption also required.  The treatment aims to relieve the immediate problem, you may therefore still be require in the future to see your own dentist for futher treatment. This service is also extended to NEW Patients.

OUTSIDE Surgery Hours, Weekends, Public holidays 

Our Practice closes at 4 pm and will reopen for treatment at 9 am weekdays. Please call 111 after opening hours, weekends and public holidays.