Six signs you need emergency dental care today
Most dental problems can wait for a normal appointment. These six cannot, and one of them is a hospital trip rather than a dental one. Here is how to tell the difference.
Most dental problems can wait a few days. A handful cannot, and the difference is worth knowing before you are trying to work it out at ten at night.
Here are the six, roughly in order of urgency.
Before the list: the one that is not a dental appointment
Facial swelling with difficulty breathing or swallowing goes to a hospital emergency department. So does swelling combined with a fever, or swelling that is spreading towards the eye or down into the neck.
That is a spreading infection and it is a medical emergency. Do not ring a dental clinic and wait for a slot. Go.
Everything below assumes you do not have those signs.
1. Severe pain that will not settle
Pain that wakes you at night, that over-the-counter pain relief barely touches, or that throbs continuously rather than coming and going.
That pattern usually means the nerve inside the tooth is involved. It does not settle on its own, because the tissue in there cannot heal and the pressure has nowhere to go.
The specific tell for nerve involvement is pain that lingers well after something hot or cold has been removed. Brief sensitivity that stops immediately is a much less urgent problem.
What to do now: pain relief as directed on the packet, a cold compress on the outside of the cheek, and sleep with your head propped up, since lying flat increases pressure and pain. Do not hold a painkiller against the gum, which burns the tissue.
2. Swelling in the face, jaw or gums
Swelling means the infection has left the tooth and reached the surrounding tissue.
A small pimple-like lump on the gum near a tooth is a sign of a draining abscess. People often ignore these precisely because they hurt less, since the pressure has found a way out. It is still an active infection.
Swelling of the face or jaw is more urgent. Antibiotics may be prescribed to control it, but understand what they do: they buy time and reduce swelling. They do not cure it, because the source is inside the tooth where the blood supply has been destroyed and antibiotics cannot reach properly. The tooth still needs treating.
3. A knocked-out adult tooth
This is the one where minutes genuinely matter, and quick action often saves the tooth.
- Pick it up by the crown, the chewing part. Never touch the root.
- If dirty, rinse briefly in milk or saline, never water, and never scrub it.
- Put it back in the socket the right way round if you can, and bite gently on a clean cloth.
- If you cannot, keep it in a container of milk.
- Come now.
Do not let it dry out, and do not wrap it in tissue.
For a baby tooth, do not put it back, because that can damage the adult tooth developing underneath. Ring us for advice.
Full steps: knocked-out tooth.
4. Uncontrolled bleeding
Bleeding after an extraction that has not stopped after applying firm pressure for a good while, or bleeding from an injury that will not settle.
What to do: fold clean gauze over the site and bite down with firm, steady pressure for a solid stretch without lifting to check, because checking restarts the clock each time. Stay upright. Avoid rinsing, spitting and hot drinks, all of which dislodge the clot you are trying to form.
If it continues despite that, ring us. If it is heavy and will not stop at all, that is a hospital.
5. A cracked, chipped or broken tooth
Urgency depends on what you find.
See us today if there is pain, if you can see a pinkish spot in the middle of the break, or if the tooth has moved or feels loose.
See us promptly, but not necessarily today, if it is a small chip with no pain. Still get it looked at, because a sharp edge cuts your tongue and an untreated crack tends to spread. The repair is much smaller in week one than in month six.
There is a fuller guide at broken tooth and here: what to do when you break a tooth.
6. A lost filling, crown or restoration
This one rarely hurts, which is exactly why people leave it.
An exposed tooth without its covering is vulnerable. It can become sensitive quickly, it collects food and decay, and the remaining structure can crack under chewing forces. A crown that came off cleanly can often simply be re-cemented if you act quickly. Left for weeks, the tooth underneath frequently shifts or decays and the crown no longer fits, and a small appointment becomes a new crown.
What to do: keep the crown, do not glue it back yourself with household adhesive, chew on the other side, and ring us.
What is not an emergency
Worth saying, so you can stop worrying about the wrong things.
Mild sensitivity to cold that stops immediately. A small chip with no pain and no sharp edge. Food stuck between teeth, unless it will not come out with floss. Gums that bleed a little when you brush, which is a real problem but a slow one.
All of those need an appointment. None need one tonight.
Getting seen
Call 1800 833 844. We keep emergency room across all six clinics, and we offer after-hours access for urgent problems, where the prompts will guide you.
If you are anxious about dental treatment and that is part of why you have been putting this off, say so on the phone. It changes how we handle the appointment, and there is more on that here: if it is the drill and the needle you dread.
Emergency dentistry FAQ
What counts as a real dental emergency?
Uncontrolled bleeding, a knocked-out adult tooth, facial swelling, and severe pain that will not settle. Facial swelling accompanied by difficulty breathing or swallowing, or a fever, is a medical emergency and needs a hospital rather than a dental clinic.
Can I wait until Monday?
For a chipped tooth with no pain, or a lost filling that is not sensitive, usually yes, though you should still be seen promptly. For severe pain, swelling, or a knocked-out tooth, no. Those get worse rather than better, and in the case of a knocked-out tooth the chance of saving it falls away quickly.
What do I do with a knocked-out tooth?
Pick it up by the crown, never the root. If dirty, rinse briefly in milk or saline, never water, and do not scrub it. Put it back in the socket if you can and bite on a clean cloth. If not, keep it in a container of milk and get to a dentist immediately.
Will antibiotics fix a dental infection?
They can settle swelling temporarily, but they do not resolve the cause. The infection is inside the tooth where the blood supply has been destroyed, so antibiotics cannot reach it properly. Without treating the tooth itself, the problem returns once the course ends.
What if it is after hours?
Call 1800 833 844 and follow the prompts. We offer after-hours access for urgent problems and will guide you on what to do next. If there is facial swelling with difficulty breathing or swallowing, go to a hospital emergency department instead of waiting.
