Media Coverage

Media Coverage

Wait Till Morning

Singapore Health NOV/DEC 2011

Patients can manage the pain of toothaches at home with painkillers rather than visiting the accident and emergency department.

A toothache might hurt badly, but it’s not considered an emergency unless there’s an infection and swelling.

About 80 per cent of all dental cases seen at the A&E of Singapore General Hospital (SGH) are toothaches. While traumatizing, they do not warrant a trip to the A&E and can wait till the morning.

The real emergencies
Dr Lai Juen Bin, Associate Consultant, Department of Oral & Maxillofacial Surgery, National Dental Centre of Singapore (NDCS) explained that the A&E is only equipped to handle urgent dental cases such as road accident victims who have a fractured upper or lower jaw, mid-face, or teeth. Facial fractures need immediate attention because if left untreated, the bones will set unevenly, leading to a misaligned jaw and subsequent difficulty in eating.

Emergency cases – usually injuries from accidents or trauma – need immediate attention. They include uncontrolled bleeding (from the gums), facial swelling due to dental infections, loosened or dislodged teeth, broken teeth, mid-face fractures, and severe cuts to the gums, lips or cheek.

Others are severe tooth infections which have spread to the face, causing facial swelling or neck swelling. These must be treated immediately. If left untreated, the swelling can eventually cut off air supply.

Non-emergency cases
In contrast, common dental problems such as extractions, root canal treatments, scaling, dentures, crowns, bridges and implants are considered non-emergencies.

Dr Lai said the A&E is not fitted with the necessary equipment for these common dental problems. For example, there’s no dental X-ray. Because of this, patients with toothache who seek A&E treatment may be reluctant to undergo a procedure as permanent as tooth removal – especially when it’s uncertain exactly which tooth is causing the trouble.

But no one is turned away. “Patients who come in will be treated. However, it is advisable that they seek dental treatment afterwards, at NDCS or any other dental clinic.”

Pain relief at home
Dr Lai said toothaches can be alleviated at home with over-the-counter painkillers most of the time.

For simple toothaches, painkillers such as paracetamol or aspirin, or anti-inflammatory drugs are prescribed. These can be taken at home.

In the A&E, walk-in patients are registered, triaged by a nurse, examined by a medical officer, then, depending on the severity of the problem, seen by a dental officer or an oral maxillofacial surgeon.

What may also be given for temporary relief is a local anaesthetic injection and medicated dental fillings to soothe the tooth. Patients who get these fillings must return to a dentist to have the temporary fillings replaced with proper ones.

NDCS operates from Mondays to Fridays, 8am to 5.30pm. Consultation is by appointment only. For more information on toothaches, dental trauma and emergencies, visit the Conditions and Treatment Glossary at NDCS’ website –

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