Dental emergencies are stressful largely because they are unfamiliar. Most people have never had to decide whether a tooth can be put back in, or whether a swelling warrants a hospital visit, and they are making that decision while in pain.
These are the three problems we see most often in urgent appointments, what to do in the first hour, and what we can do when you arrive.
1. Severe Toothache
What It Usually Means
Toothache is often the late stage of decay that has been developing quietly. Mild, short-lived sensitivity usually means decay has reached the dentine beneath the enamel. A persistent, throbbing pain that lingers after hot or cold, wakes you at night or worsens when you lie down generally indicates inflammation or infection of the nerve inside the tooth. Sharp pain on biting can point to a crack. Pain with gum swelling suggests an abscess.
What to Do Before Your Appointment
- Rinse with warm salt water (about a teaspoon of salt in a glass of water) and floss gently around the tooth to dislodge trapped food
- Take over-the-counter pain relief as directed on the packaging, if it is suitable for you. After an injury with bleeding, avoid aspirin, which can increase bleeding
- Hold a cold compress against the outside of your cheek
- Sleep with your head slightly elevated, which often eases night pain
- Avoid very hot, cold and sugary foods
Do not place aspirin or other tablets directly against the gum, as this burns the tissue. Clove oil is a traditional remedy that may dull the sensation briefly, but it does nothing about the cause and can irritate the gum.
What We Do
We examine the tooth, carry out sensitivity tests and take digital X-rays to find the source. Treatment depends on the cause and may involve a filling, adjusting the bite, treating the gum, draining infection or beginning root canal therapy. Pain relief is the first priority.
Pain that suddenly stops after being severe is not necessarily good news, as it can indicate the nerve has died. It still needs assessing.
2. Broken or Chipped Tooth
What It Usually Means
Teeth break for two reasons: a sudden force, such as a fall or a sporting knock, or an underlying weakness, such as a large old filling or a crack that has been developing for months. A small chip may be painless. A break that exposes the inner layers is usually sensitive to air and temperature.
What to Do Before Your Appointment
- Rinse gently with warm water
- Save any broken pieces in milk or saliva and bring them with you
- Apply gentle pressure with clean gauze if there is bleeding
- Use a cold compress to limit swelling
- Cover a sharp edge with dental wax or sugar-free gum to protect your tongue and cheek
- Avoid chewing on that side
What We Do
We assess the extent of the break, check whether the nerve is involved and take X-rays. Small chips may be smoothed or repaired with tooth-coloured composite. Where a clean piece of enamel has broken away, it can sometimes be bonded back onto the tooth, which is another reason to save it. Larger breaks often need a crown, which in many cases can be made and fitted in a single visit. A break that extends deep below the gum may mean the tooth cannot be saved, in which case we discuss extraction and replacement options such as a dental implant. If the nerve is affected, root canal therapy may be required. Our page on a broken tooth goes through the options in more detail.
3. Knocked-Out Tooth
Why It Is Urgent
An adult tooth that has been completely knocked out has the best chance of survival when it is replanted within about 30 minutes. The cells on the root surface begin to die once the tooth dries out, so how you handle it in those first minutes matters enormously.
What to Do Immediately
- First make sure the injured person is safe and there is no other serious injury needing attention
- Pick the tooth up by the crown, the part you normally see, and avoid touching the root
- If it is dirty, rinse it briefly in milk or saline. Do not scrub it
- If you can, place it back into the socket the right way round and bite gently on a clean cloth to hold it
- If you cannot replant it, keep it in milk, or hold it in your mouth between your cheek and gum. Do not use the cheek method for a young child or anyone who is drowsy or not fully alert, as the tooth could be swallowed or inhaled
- Call us immediately and come straight in
Never store the tooth dry or wrapped in tissue. Never put a knocked-out baby tooth back in, as this can damage the developing adult tooth beneath. For children, our page on children's dental emergencies explains the differences.
What We Do
We examine the socket and surrounding teeth, take X-rays and reposition the tooth if it has not already been replanted. A flexible splint usually holds it in place for a few weeks while healing occurs, and root canal therapy is often needed in the following weeks. Follow-up reviews continue for months afterwards.
A Note on Dental Abscesses
An abscess is a pocket of infection at the root of a tooth or in the gum beside it. It often shows as a painful swelling or a pimple-like bump on the gum, sometimes with a bad taste. Rinse with warm salt water and book promptly. Abscesses do not resolve on their own, and infection can spread beyond the mouth, so swelling that is increasing needs same-day attention.
Other Urgent Problems
Food wedged firmly between teeth, a painful partially erupted wisdom tooth, cuts to the gum or cheek, burns from hot food or drink and badly bitten lips are also common reasons to call. The same principles apply: keep any broken pieces, keep the area clean, protect it from further injury and get it checked. If something happens after hours and you cannot reach us, contact another available dentist or, for serious injuries, a hospital emergency department.
When to Go Straight to Hospital
Some situations need emergency medical care rather than a dental appointment. Call 000 or go to your nearest hospital emergency department if there is facial swelling affecting breathing or swallowing, swelling spreading towards the eye or neck, bleeding that will not stop with 15 minutes of firm pressure, a suspected jaw fracture, or any head injury or loss of consciousness.
Reducing the Risk
Most dental emergencies are either preventable or catchable early. Regular check-ups identify cracks, failing fillings and developing infection before they become urgent. A custom mouthguard protects against sporting injuries far better than a boil-and-bite guard. And avoiding ice, hard nuts and using teeth as tools removes a surprising number of the breaks we see.
Call Us if Something Goes Wrong
We set aside time each day for urgent care and will do our best to see you the day you call. Learn more about our Emergency Dentistry, call Precision Dental on (07) 3852 1160 or book online.
Prefer to watch? 3 Causes of Toothache is a short video from our team.
