What counts as a dental emergency?

By Vulpesco, written for this demo from the cited sourcesPublished October 2, 20264 min read

Clinical review: Not reviewed by a dentist and not medical advice

The short answer

A dental emergency is a problem that cannot safely wait for a regular appointment: severe or constant pain, a knocked-out adult tooth, bleeding that will not stop, or swelling that spreads. Some need a hospital emergency department or 911, and others need a dentist the same day.

If you are not sure, call a dentist and describe what is happening. This page is general information, not a diagnosis.

Call 911 or go to a hospital emergency department

Call 911 or go to a hospital emergency department right away, without calling the practice first, if you have trouble breathing or swallowing; swelling of the face, jaw or neck that is spreading or affects your breathing or swallowing; a fever with facial swelling; bleeding you cannot stop; a suspected broken jaw; or a serious head or face injury.

MedlinePlus lists jaw swelling, fever with dental pain, and trouble breathing or swallowing as serious warning signs with a tooth abscess, because an untreated infection can spread.

Needs dental care the same day

A severe or constant toothache, a knocked-out adult tooth, or a broken tooth with pain needs dental care the same day. Call us on 512-555-0142 when we are open. When we are closed, or cannot see you in time, go to a hospital emergency department rather than waiting for us to open.

Examples:

• A knocked-out permanent tooth. This is the most time-sensitive dental problem. See the next section.
• A loosened or displaced permanent tooth after an injury, even if it feels like it is still in place.
• A broken or cracked tooth with pain , or one with sharp edges cutting your tongue or cheek.
• A bubble or pimple on the gum , with or without a bad taste. This can be a sign of an abscess. With swelling or a fever, treat it as urgent.
• A lost crown or filling with pain , or a temporary crown that has come off.
• A deep cut to the tongue, lip or cheek that may need stitches.

What can usually wait

A small chip, a lost filling without pain or mild sensitivity can wait for a regular visit. Call us when we open.

A knocked-out adult tooth

The International Association of Dental Traumatology (IADT) calls an avulsed (knocked-out) permanent tooth one of the few real emergencies in dentistry. It says minimizing the time the tooth is dry is critical, and that after about 30 minutes dry, most of the cells that attach the root are no longer viable. After more than 60 minutes of total dry time (time out of the mouth and not in milk or another storage liquid), those cells are likely not viable. Whatever the time, a dentist still decides what can be done, so go straight away.

1. Make sure it is a permanent tooth. Baby (primary) teeth should not be put back.
2. Pick the tooth up by the crown, the white part. Avoid touching the root.
3. If it is dirty, rinse it gently in milk, saline or the person's own saliva.
4. Try to put it straight back into the socket. The IADT recommends doing this at the place of the accident, then biting on gauze, a handkerchief or a napkin to hold it in place.
5. If it cannot go back, keep it moist at all times. The American Dental Association (ADA) lists three options: between your cheek and gums, in milk, or in a tooth preservation product with the ADA Seal of Acceptance. The IADT lists, in descending order of preference, milk, a tooth-saving solution (HBSS), saliva (spit into a glass) or saline. It calls water a poor medium, but better than letting the tooth air-dry.
6. Get to a dentist or an emergency room right away. Take the tooth with you.

A safety caution added for this demo, not quoted from the ADA or the IADT: do not hold the tooth in the cheek of a young child, or of anyone who is unconscious, drowsy or could swallow or breathe it in, and do not try to put it back into the mouth of someone who is unconscious. Keep it in a clean container filled with milk or another storage liquid listed above, never in an empty container.

What not to do

• Do not scrub the tooth or touch the root.
• Do not put aspirin or another pain pill directly on the tooth or gum. The ADA advises against it.
• Do not use a pin or other sharp object to remove something stuck in your teeth.
• Do not ignore swelling because the pain has stopped. A tooth that suddenly stops hurting can mean the nerve has died, and infection can still be present.

When to ask your dentist

Keep your dentist's number in your phone. An emergency visit usually deals with the immediate problem: relieving pain, protecting the tooth and stopping infection. Longer treatment, such as a crown or an implant, is often planned for a later visit.

At Brazos Street Dental, we hold time each weekday for emergency patients and offer same-day appointments when the schedule allows. We do not offer after-hours or weekend emergency care. Call 512-555-0142 as early as you can.

Brazos Street Dental is a fictional practice in a Vulpesco demo.