Toothache has a habit of arriving on a Friday evening. Most of it can be managed for a short period, but some of it genuinely cannot wait and needs emergency dental care — and the difference is worth knowing before you are in it.
Do not wait for these
Facial swelling, particularly swelling that spreads toward the eye or under the jaw. Any difficulty breathing or swallowing. A fever alongside dental pain. Bleeding that will not stop. These are not “call in the morning” symptoms — spreading infection is a medical emergency, not a dental inconvenience.
A knocked-out permanent tooth is also time-critical. Handle it by the crown and never the root, and if it is clean, try to reseat it in the socket. If you cannot, keep it in milk or in saliva — never in water, which damages the root surface cells that make reattachment possible.
What helps in the meantime
Rinse with warm salt water. Floss gently either side of the tooth in case something is lodged there, which is a more common cause than people expect. Over-the-counter pain relief taken as directed. A cold compress on the outside of the cheek for swelling, twenty minutes on and twenty off.
Sleeping propped up rather than flat often makes a throbbing tooth more bearable, because it reduces the blood pressure in the area.
What makes it worse
Do not hold aspirin against the gum. It is a persistent piece of folk wisdom and it burns the soft tissue, leaving you with a chemical burn as well as a toothache. Avoid very hot or very cold food and drink, and chew on the other side.
And heat. A warm compress on a swollen face can encourage an infection to spread. Cold, not heat.
Why pain that stops is not good news
A tooth that hurts badly and then goes quiet has often not recovered. The nerve inside may simply have died, which ends the pain and leaves the infection to carry on into the bone underneath — the problem root canal treatment exists to deal with. It is one of the more common reasons a straightforward problem becomes a complicated one, and a tooth that could have been saved ends in a tooth extraction.
