*Dentistry in a Survival Situation*
By rgrigs

Looking at Dentistry in a survival situation is different than looking at emergency dental procedures in a regular clinic environment. In all normal scenarios you are backed up by a dental specialist or a hospital. In a survival situation this may be possible, but not likely. Most probably, you will be the primary, and possibly only, dental care available.

Remember that 98% of all dental treatment requires special tools and equipment that are found usually only in a dental office. So, to properly address the survival situation I have to leave my office and all its conveniences and imagine working without any equipment and with a minimum of tools.

In a survival situation, we must be prepared to treat;

(1) Oral pain

(2) Broken teeth or fillings-which can lead to oral pain.

To treat broken fillings it is best to replace the filling as soon as possible. This can be done by using any temporary filling material, such as DenTemp. This can be purchased at any drug store. The temporary filling should be a zinc oxide and eugenol (oil of cloves) based material, as this will provide a sedative action to the nerve. "Cavit" is a good temporary that can be obtained through your friendly Dentist. This is good because it requires no mixing (easy to use) and comes in a small tube (easy to carry). Probably the best temporary is "IRM" which can be pricey and needs to be purchased through a dentist. IRM comes in liquid and powder and must be mixed. There is enough to do many temporary fillings. This material holds up very well and seems to have the longest life of any of the temporaries. It was used in Vietnam by medics as a dental temporary in the field.

Placing a dental temporary in the tooth is akin to putting putty in a nail hole. The temporary filling must be checked frequently to insure that it stays in place.

Oral pain is a difficult problem to deal with because of the many causes. Oral pain can be one of the most debilitating pains known. If you have ever had a toothache, you know what I mean! The causes of oral pain are many and will determine the treatment.

Toothache due to a broken tooth or filling: Putting a dental temporary as we have discussed above can solve this. In many cases, a temporary filling may be applied to the broken tooth with a good result. In some cases where the broken tooth is severely destroyed, it will have to be extracted.

Oral pain due to tooth decay: Generally this will have to be treated or the tooth will become abscessed. Decay is dark and spongy soft. If you happen to have a small spoon excavator, the decay can be carefully removed. These instruments can be obtained in some hobby shops. A medicated temporary should be put into the cavity to sedate the nerve and seal the tooth. A form of zinc oxide and eugenol temporary will work well here. One can get some pain relief from the pain associated with decay or a broken tooth by the application of dilute oil of cloves (eugenol) or by placing "Anbesol" or "Orajel" on the tooth. Also, you will find relief by taking an anti-inflammatory such as ibuprofen. The homeopathic medicine Arnica may also be taken with good results.

NOTE: A note here is in order about Arnica. Of all the homeopathic medicines that are available, I believe that Arnica is the most important for any dental work. It seems to control bleeding and pain, heals sore gum tissue and helps prevent infection. Many consider it a dental "do it all" remedy. I have Arnica in liquid form and I give one to two drops for any tissue traumatizing treatment and it seems to work wonders. Arnica will also help to control bleeding and pain after an extraction.

A toothache can also be due to an abscess. An abscess is caused because the nerve has been so traumatized that it has died. The resulting decaying nerve tissue has caused a pocket of infection and debris within the nerve chamber of the tooth and in the bone surrounding the tooth root. This pocket in the bone expands as the puss and gas build causing pressure, pain and swelling. This boney pocket surrounding the root of the tooth is called an abscess. You cannot get permanent relief from this pain by treating the tooth directly. There are only two options for an abscessed tooth;

1. A root canal treatment, which can only be done in a dental office.

2. Extraction of the tooth.

If the tooth has been neglected, then most likely the tooth will be badly broken down and this might complicate the extraction. In the survival situation without the aid of the proper equipment the best remedy is to extract the tooth. For palliative treatment, antibiotics, if available, may be employed along with an anti-inflammatory medicine such as ibuprofen. If the nerve chamber is accessable then it must be left open to drain. 

1. "DenTemp" or other brands which are commercially available emergency temporary fillings. They are available at local drug stores. Most of these are zinc oxide and eugenol based.

2. "Cavit"- this is good because it is very convenient and easy to use. Can be procured from your friendly Dentist.

3. "IRM"- this is a zinc oxide and eugenol based temporary filling material that is used by many dentists. It is somewhat difficult to use because of the mixing but is considered by many dentists to be the best. It can be considered expensive but there is enough material to do a lot of fillings. It must be procured from a dentist.

4. Wax or paraffin can be used as a temporary filling. These materials are the most temporary of all the temporary fillings.

1. Any ibuprofen medicine is very good and readily available. Remember this is an anti-inflammatory, which is very useful in combating dental pain.

2. Arnica, this is a homeopathic medicine and probably considered the best one for dental maladies. Obtained through health food stores, etc.

3. Echinacea, this is considered to be a pain medication by many, I have tried it more as a homeopathic anti biotic for fighting infections.

4. Anbesol or Orajel, these are commercially available pain medications for teeth. This is applied directly to the tooth. Most of these contain oil of cloves as their active ingredient.

5. Eugenol (oil of clove) can be applied directly to the tooth but must first be diluted.

1. Tea bags, to aid in controlling bleeding at an extraction site.

2. Cayenne powder, this can be used to treat and control bleeding.

3. Extraction forceps, can be found with some searching at antique stores. These have not changed in the last 100 years. The old ones will work as well as the new ones. You will find many different forceps but generally you will only need two, one curved for access to the upper teeth and one curved to allow access for the lower teeth. The forceps with skinny beaks are generally for anterior (front) teeth. You would be better if you can find forceps with a broad beak.

4. Suture material; recommend 000 silk with needle attached. This is best for any suturing needed in the mouth. Remember that silk sutures must be removed in one week.

In considering all the items needed for survival dentistry it becomes obvious that the greatest single thing to consider is prevention! Make sure your teeth are cleaned and checked for cavities and periodontal disease on a regular basis. Survivalists are prepared and prevention is part of preparation. Make sure all necessary work is done ahead of any expected emergency. Basically, keep current with your dental health and your chances of requiring emergency dental help will be decreased. Have extra toothbrushes, toothpaste and floss on hand.

After thinking about what I have written above I believe that any group would be helped by enlisting a dentist as a participant. Hope I have been some help if you have any questions you may contact me at rgrigs@aol.com.
rgrigs

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