Call first
If something has gone wrong with a tooth, the most useful thing you can do is phone as soon as you can rather than wait to see whether it settles. Many dental problems are far simpler to deal with early — a knocked-out tooth in particular is a matter of minutes, not days.
It helps to have a few things ready when you call: what happened and when, which tooth or area is affected, how bad the pain is and whether it is getting worse, whether there is any swelling or fever, and any medications you take. That lets the team judge how urgently you need to be seen.
Office hours and directions are on the contact page.
Some problems that start in the mouth are medical emergencies rather than dental appointments. Go to the nearest emergency room, or call 911, if you have any of the following:
- Facial swelling that is spreading — across the cheek, toward the eye, under the jaw or down the neck — especially with a fever.
- Any difficulty breathing or swallowing.
- Bleeding from the mouth that does not stop after 15 minutes of firm, steady pressure with clean gauze or cloth.
- An injury to the jaw — if it may be broken or dislocated, or the teeth no longer meet the way they did.
- A blow to the head, particularly with dizziness, confusion or loss of consciousness.
A dental infection that spreads into the tissues of the face and neck can affect the airway, which is why swelling with difficulty breathing or swallowing should never wait for a dental office to open. Once the urgent problem is under control, the tooth that caused it will still need dental treatment.
What counts as a dental emergency
Call the practice as soon as you can for any of these:
- Severe or worsening toothache, or pain that keeps you awake.
- Swelling of the gum or face, or a pimple-like bump on the gum that may be an abscess.
- A knocked-out or pushed-out tooth, or a tooth that has become loose after an injury.
- A cracked or broken tooth, especially one that hurts.
- A lost crown or filling that leaves a sharp or painful edge.
- Bleeding after an extraction or injury that is slow to stop.
Some things feel alarming but can usually wait a day or two for an appointment: a small chip with no pain, a filling that has fallen out of a tooth that does not hurt, or mild sensitivity to cold. They still need looking at — a lost filling leaves the tooth open to decay and further breakage — but they are not the same as an infection or a knocked-out tooth.
A knocked-out adult tooth
Pick it up by the crown — the part you normally see — and not the root. If it is dirty, rinse it briefly under cold running water without scrubbing it or touching the root. If you can, gently push it back into the socket and bite on a clean cloth to hold it. If that is not possible, keep it moist in milk or in saliva (in the mouth beside the cheek, for an adult) and get seen straight away. Do not let it dry out and do not store it in plain water. For a baby tooth, do not try to put it back.
A broken or cracked tooth
Rinse with warm water, keep any pieces you can find, and hold a cold compress to the outside of the cheek to limit swelling. If there is bleeding, press a piece of gauze against the area.
A lost crown or filling
Keep the crown if you have it and avoid chewing on that side. A temporary dental cement from a pharmacy can cover a sharp edge or hold a crown in place for a short time. Never use household glue.
Toothache
Rinse with warm salt water and floss gently on both sides of the tooth in case something is caught there. Over-the-counter pain relief taken as directed can help. Do not hold aspirin against the gum — it burns the tissue.
Swelling or a suspected abscess
Rinse with warm salt water and use a cold compress on the outside of the face, and call. If the swelling spreads or you develop a fever or any difficulty breathing or swallowing, go to the ER.
A bitten lip, cheek or tongue
Clean the area gently with water and apply firm pressure with gauze or a clean cloth, with a cold compress to the outside for swelling. If the bleeding has not stopped after 15 minutes of pressure, go to the ER.
Something caught between the teeth
Try to remove it gently with dental floss. Never use a pin or anything sharp, which can cut the gum or scratch the tooth.
What an emergency visit usually involves
The first aim of an emergency appointment is to find the cause and relieve the pain. That usually means an examination of the area and an X-ray, since an infection at the root tip or a crack below the gum is often invisible from the surface.
Sometimes the problem can be fixed at that visit. Sometimes the right step is to stabilize it — a temporary filling, smoothing a sharp edge, re-cementing a crown, or starting to drain an infection — and plan the permanent treatment for a separate appointment. That might be a filling, a crown, root canal treatment or, where a tooth cannot be saved, an extraction. You should leave knowing what was found, what was done, and what the options are.
Not every emergency can be prevented, but a good share can. Most severe toothaches come from decay or a crack that was small for a long time before it hurt, which is what regular cleanings and exams are there to catch.
A mouthguard for contact sports protects against the knocked-out and broken teeth that account for many dental injuries. If you grind or clench at night, a night guard protects teeth and restorations from the steady force that cracks them. And it is worth avoiding the habits that break teeth outright: chewing ice or hard candy, and using your teeth to open packets or bottles.
Frequently Asked Questions
Is a toothache a dental emergency?
A mild ache that comes and goes can usually wait for a normal appointment, though it is still worth booking one. Severe pain, pain that keeps you awake, pain that is getting worse, or pain with swelling or a fever should be seen as soon as possible.
How quickly does a knocked-out tooth need to be seen?
As quickly as you can — ideally within the hour. The cells on the root surface begin to die once the tooth is out of the mouth and drying, and a tooth replanted quickly has a far better chance of surviving. Keep it moist in milk or saliva on the way.
What if a child knocks out a baby tooth?
Do not try to put a baby tooth back in the socket — it can damage the permanent tooth developing underneath. Keep the tooth, control any bleeding with gentle pressure, and call so the area can be checked.
Can I take painkillers?
Over-the-counter pain relief taken as directed on the label is reasonable if it is safe for you to take. Never hold aspirin or any tablet against the gum next to a sore tooth — it burns the soft tissue and does nothing for the tooth.
My crown came off. Can I glue it back on?
Not with household glue, which can damage the tooth and stop the crown being refitted properly. Keep the crown somewhere safe and avoid chewing on that side. A temporary dental cement from a pharmacy can hold it for a short time, but the crown still needs to be checked and re-cemented.
Will antibiotics fix a tooth infection?
Antibiotics can help control an infection that is spreading, but they do not remove its source. The infected tooth still needs treatment, usually a root canal or an extraction, or the infection tends to return.
When should I go to the ER instead of calling a dentist?
Go to the emergency room or call 911 for swelling that is spreading across the face, toward the eye or down the neck, any difficulty breathing or swallowing, bleeding that does not stop after 15 minutes of firm pressure, or an injury to the jaw or head.
