Emergency dental care

The ADA treats three problems as potentially life-threatening: bleeding that will not stop, a spreading infection with swelling that could block the airway, and an injury to the facial bones that could affect the airway (ADA). These need an emergency room.

Other problems are urgent and need a dentist soon, often the same day. Examples include (ADA):

• Severe tooth pain
• An abscess, an infection with pain and swelling in one area
• A broken tooth that hurts or cuts your cheek or tongue
• A tooth that is knocked out or pushed out of place
• Pain around a wisdom tooth, or a painful socket after an extraction
• A lost or broken temporary crown
• A brace wire or appliance that is cutting your mouth

Swelling of the upper or lower jaw is a very serious sign of a tooth abscess (MedlinePlus). If you have jaw swelling with a fever, get care the same day. If the swelling spreads or affects breathing or swallowing, go to an emergency room.

For urgent problems that are not life-threatening, call a dentist first. Many dentists keep time for emergency patients. Describe what happened and your symptoms in as much detail as you can (ADA). If your dentist is closed, ask whether the practice has an after-hours number. If you do not have a dentist, ask a practice whether it sees new patients for urgent problems.

Knocked-out adult tooth

Time matters. The AAE advises (AAE):

1. Pick up the tooth by the crown, the part you chew with. Do not touch the root.
2. If it is dirty, rinse it gently with water only. Do not scrub it, dry it or wrap it in tissue or cloth.
3. If you can, put it back in the socket right away. Hold it in place with your fingers or by gently biting down.
4. If you cannot, keep it moist: in milk, in your mouth next to your cheek, or in a tooth preservation kit. Do not keep it in tap water.
5. See a dentist as soon as you can, ideally within 30 minutes, and bring the tooth.

These steps are for adult teeth. If a child knocks out a baby tooth, call a dentist for advice before doing anything.

Broken or cracked tooth

Rinse your mouth with warm water. Hold a cold compress on your face to keep swelling down, then call a dentist (ADA).

Toothache

Rinse with warm water and floss gently to remove any trapped food. Do not put aspirin on the tooth or gum (ADA). Over-the-counter pain medicine can help if you cannot see a dentist right away. Get care if the pain is severe, lasts more than a day or two, or comes with a fever, earache or pain when you open your mouth wide (MedlinePlus).

Bitten lip or tongue

Clean the area gently with water and apply a cold compress (ADA). If bleeding will not stop, go to an emergency room (ADA).

Something stuck between your teeth

Try to remove it gently with floss. Do not use a sharp or pointed tool (ADA).

Pain after an extraction

Severe pain that starts 1 to 3 days after a tooth is pulled can be a dry socket. Call your dentist (MedlinePlus). Read more in our extraction guide.

The dentist examines the tooth, usually takes X-rays and works out the cause. For an abscess, treatment can include antibiotics, a root canal, removing the tooth or draining the infection. Some people with severe infections need a hospital stay (MedlinePlus). Often the first visit relieves pain and controls the problem, and the full repair happens at a later visit.

A tooth abscess that is not treated can get worse. The infection can spread to the jaw, the blood or other parts of the body, and it can become life-threatening (MedlinePlus). A tooth infection can also lead to Ludwig angina, an infection under the tongue that can cause trouble breathing (MedlinePlus). If you are prescribed antibiotics, take them as directed and go back if you do not improve.

• Whether the visit is during or after normal hours.
• The exam and X-rays.
• The treatment you need today, such as a filling, a root canal or an extraction.
• Medicines, and any follow-up visits.
• What your dental or medical plan covers.

Ask what today's visit will cost before treatment starts, if your condition allows. For follow-up work, ask for a written estimate with the CDT code for each procedure (ADA).

1. Can you see me today?
2. What do you need to do today, and what can wait?
3. Can this tooth be saved? What are my options?
4. What will today's visit cost?
5. Which signs mean I should go to an emergency room?
6. Who do I call if it gets worse tonight?