Emergency dental care

A toothache can come from a cavity, a crack, food stuck between teeth, or an inflamed pulp (the soft center of the tooth, where the nerve is). Only an exam can tell which.

What to do now

• Rinse your mouth with warm water.
• Floss gently around the tooth to remove any trapped food.
• Hold a cold pack against your cheek for 15 to 20 minutes at a time.
• A pain reliever you can safely take, used as the label directs, may help until you’re seen.

What not to do

• Don’t put aspirin or any other pill on the tooth or gum. It can burn the gum.
• Don’t put heat on your face.

Call the office right away, even if the pain fades. A tooth can stop hurting while the problem inside it gets worse.

Go to an emergency room or call 911 if you have:

• Swelling that spreads toward your eye or neck
• Trouble breathing or swallowing
• A high fever
• Bleeding that won’t stop
• A jaw injury after an accident

A small chip may only need smoothing or a filling. A bigger break can expose the inner layers of the tooth, and it may hurt or feel sensitive to air and cold.

What to do now

• Rinse your mouth with warm water.
• Save any pieces in a small container of milk or water, and bring them with you.
• If it’s bleeding, press clean gauze or a cloth on the spot for about 10 minutes.
• Hold a cold pack on your cheek to keep swelling down.
• Cover a sharp edge with sugarless gum or dental wax from a pharmacy.
• Chew on the other side, and avoid very hot or cold food and drinks.

What not to do

• Don’t glue the piece back or file the edge yourself.
• Don’t put aspirin on the gum or heat on your face.

Call the office right away, even if it doesn’t hurt. Cracks can spread.

Go to an emergency room or call 911 if you have:

• Swelling that spreads toward your eye or neck
• Trouble breathing or swallowing
• A high fever
• Bleeding that won’t stop
• A jaw or head injury after an accident

An adult tooth is most likely to be saved if it goes back in quickly.

For an adult tooth

1. Pick it up by the crown (the white part), not the root.
2. If it’s dirty, rinse it briefly with water. Don’t scrub or dry it.
3. If you can, push it gently back into the socket, facing the right way, and bite on gauze or a cloth to hold it.
4. If it won’t go back, keep it in milk or in your mouth next to your cheek. For a child, use milk. Don’t use water.
5. Call the office right away and bring the tooth. Try to be seen within 30 minutes, though a tooth can sometimes be saved later. If you can’t reach us, go to the nearest dentist or an emergency room.

For a baby tooth, don’t put it back: that can harm the adult tooth underneath. Keep it in milk and call the office. Do the same if you aren’t sure which it is.

Go to an emergency room or call 911 if you have:

• Swelling that spreads toward your eye or neck
• Trouble breathing or swallowing
• A high fever
• Bleeding that won’t stop
• A jaw or head injury after an accident

A lost filling or crown is rarely dangerous, but the tooth underneath can be sensitive, and it can break or decay more easily without its cover.

What to do now

• If a crown comes off in your mouth, take it out so you don’t swallow it. Keep it in a small bag or container and bring it with you.
• Gently brush and rinse the area to keep it clean.
• To cover a sensitive spot, press a little sugarless gum into the space, or use a temporary dental cement from a pharmacy. Follow the package directions.
• Chew on the other side, and avoid sticky, hard, or very hot or cold foods.

What not to do

• Don’t use household glue on a crown or a tooth.
• Don’t put aspirin on the gum.

Call the office right away. Sometimes a crown can be cemented back on, and sometimes it needs to be replaced.

Go to an emergency room or call 911 if you have:

• Swelling that spreads toward your eye or neck
• Trouble breathing or swallowing
• A high fever
• Bleeding that won’t stop
• A jaw injury after an accident

Swelling in your gum or face can be a sign of an abscess, a pocket of infection (pus) near the root of a tooth or in the gum. Other signs include throbbing pain, a bad taste, a bump on the gum, or a fever. An infection like this needs treatment, even if the pain eases.

What to do now

• Call the office right away.
• Rinse gently with warm salt water: about half a teaspoon of salt in a cup of warm water.
• Hold a cold pack on your cheek for 15 to 20 minutes at a time.
• A pain reliever you can safely take, used as the label directs, may help until you’re seen.

What not to do

• Don’t put heat on the swelling.
• Don’t squeeze or pop a bump on the gum.
• Don’t put aspirin on the gum.

Go to an emergency room or call 911 right away if you have:

• Swelling that spreads toward your eye or neck
• Trouble breathing or swallowing
• Trouble opening your mouth
• A high fever
• Bleeding that won’t stop
• A jaw injury after an accident

Spreading swelling, especially with a fever, can mean the infection is moving.