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Filling In With an Emergency Kit : A minor dental problem can seem major on the road. Here are tips on packing key items.

Pasadena dentist Jack Broussard Jr. recently surprised two safari-bound patients with a going-away gift. It was a dental emergency kit, filled with such first-aid supplies as a tiny mouth mirror and temporary filling material. If either of the Africa-bound travelers lost a filling, chipped a tooth or came down with a mysterious toothache in the middle of nowhere, Broussard reasoned, the kit might just come in handy.

Even if your destination is less exotic, toting your own dental first-aid kit is a good idea. That’s doubly true if you have a history of dental problems or your travels take you to countries in which sterilization techniques are inferior to those in the United States.

To assemble such a kit, pack: gauze, cotton balls, tweezers, floss, mouthwash, toothache remedy, over-the-counter pain relievers, oral antibiotics (prescription), denture pain medication, temporary filling material (available over-the-counter), denture repair kits, orthodontic wax and a mouth mirror (available over-the-counter at many pharmacies).

What might be a minor dental problem at home can seem major on the road, especially if you cannot locate a dentist in an unfamiliar locale. But a combination of self-help measures and ingenuity can minimize the pain, and perhaps even reduce the risk that you’ll look like a chipmunk in your souvenir photos.

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A tooth abscess is one of the most painful and serious dental problems that might strike a traveler, said Ronald Mito, UCLA adjunct associate professor and chair of hospital dentistry. It can occur when bacteria invade the tooth’s pulp, which contains the nerves and blood vessels that fill the central part of the tooth. Usually an abscessed tooth is painful and can throb, Mito said. Biting or chewing can be painful. The gum around the tooth can be swollen, red and tender.

An abscess demands professional attention. A dentist will try to save the tooth. It might need to be drained and might require root canal treatment (in which the pulp is refilled with dental material).

Finding a dentist on short notice is relatively easy if you are traveling within the United States, said Broussard. “Look up the local dental association in the telephone book and call for a referral,” he said, adding that most associations have emergency referral services.

If you are traveling internationally, finding a dentist can be trickier. Dentists suggest calling the U.S. Embassy in the country you are visiting. “Typically, it (the embassy) will give you a list of dentists,” Broussard said. Or ask your own dentist for such a list before you leave home. For immediate attention, consider calling or checking with a nearby hospital to see if there is a dental specialist on staff or on call, experts advise.

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Lost fillings, another common problem, “can be painful or pain free,” said Nicholas Zacharczenko, a Schenectady, N.Y., prosthodontist who has researched dental emergencies. In either case, you should protect the tooth by rolling up cotton and placing it inside the cavity, Zacharczenko said. Or try an over-the-counter temporary filling material.

No matter how tempting, don’t stick chewing gum into the cavity, Zacharczenko warned, especially if the gum contains sugar. Gum could irritate the pulp, Mito agreed. Better to stick in orthodontic wax, which won’t irritate the area.

Toothache could be a symptom of an abscess, but not always. Some toothaches occur due to gum recession or a cavity, said Zacharczenko. One way to decide: If you apply an over-the-counter toothache remedy, an abscessed tooth probably won’t feel better, he said. For toothache pain, don’t put aspirin directly on the gum, expecting fast relief. This could cause a chemical burn, Broussard said. However, taken orally it can be useful in treating pain.

If you knock out a tooth, quick action is vital. “If you can’t put it right back into the socket, put it in your mouth under your tongue,” Broussard said. Get professional help quickly. If you can’t reinsert it into the socket and don’t want to put it in your mouth, wrap it in a wet paper towel, Broussard said. “The main thing is to keep it moist.” The reattachment rate is high: about 80% for adults and even higher for children, who generally heal more quickly, he said.

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Orthodontic problems can crop up, too. Most common, experts say: a wire breaks or a bracket comes unattached. “Take the wire and bend it gently away (from lips, gums or tongue) with a tweezers,” Broussard said. Place orthodontic wax over the rough parts. Don’t try to reattach a bracket, he added. Rather, keep it in a safe place until you can visit the orthodontist.

Broken dentures can be tricky to fix, dentists agree. While the temptation to fix them with over-the-counter, super-stick non-dental glue can be great, Mito vetoes the idea. “You could glue the dentures back and misalign the parts, causing a poor fit,” he said. “You could get glue on the mouth tissue,” a potential irritant.

People with chronic gum disease might suffer flare-ups during travel. One of the most common reasons, Broussard said, is that a tiny piece of food such as a popcorn kernel gets stuck in the teeth and causes inflammation of the gums. Clean the area well, Broussard said, and try to dislodge the foreign object. Use floss, Mito suggested. If that doesn’t work, knot the floss and run it through to see if it dislodges the object. If it still won’t budge, you should seek dental care. Travelers with a history of gum disease and other dental problems might consider getting a prescription to take along oral antibiotics, Mito suggested.

If you do seek out a dentist in a foreign country, “the biggest consideration is (adequacy of) sterilization procedures,” Broussard said. Consider seeking out a dentist affiliated with a local university if possible, experts advised, and ask if heat (not cold) sterilization is used, Broussard advised. “Cold sterilization has been shown not to be adequate to kill disease organisms such as the hepatitis viruses,” Broussard said. “The standard of care now is heat sterilization.”

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It’s impossible always to schedule travel during periods of peak oral health, but dentists agree it is unwise to travel extensively in the middle of a root canal procedure, especially if the trip involves air travel.


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