Dental Emergencies: What Cannot Wait, and What to Do Until You Are Seen
Not every toothache is an emergency, but some findings cannot wait. Which situations count as urgent, what can be done at home, and what to avoid.
Is Every Toothache an Emergency?
No. Some dental pain, while uncomfortable, can wait until the first suitable appointment. There are, however, findings where waiting makes the situation worse. Being able to tell the difference prevents both unnecessary anxiety and harmful delay.
Situations that cannot wait
- Swelling of the face or under the jaw: This may indicate the infection has spread beyond the tooth. If swelling is accompanied by fever, difficulty swallowing or spread towards the eye, do not delay.
- Bleeding that will not stop: Bleeding after an extraction or injury that continues despite applying pressure.
- A knocked-out tooth: A permanent tooth completely displaced by an impact is a race against time.
- Pain not controlled by painkillers: Pain that starts spontaneously, increases at night and wakes you from sleep.
- Suspected jaw fracture: Difficulty closing the mouth, teeth meeting differently.
What can be done until you are seen?
Most of what can be done provides temporary relief; it does not solve the problem. Keeping this distinction in mind is important.
- Cold application: Cold applied externally to the cheek through a cloth may reduce swelling and pain.
- Head position: Keeping the head raised above the body when lying down may ease throbbing.
- Painkillers: A medicine previously recommended by your doctor or pharmacist, which you know is suitable for you, may be taken.
- Warm salt water: May help remove food debris.
What not to do
- Placing a painkiller on the aching tooth: A common habit, but it can cause a chemical burn on the gum and cheek mucosa it touches. Painkillers should be swallowed.
- Applying heat to swelling: Heat may make it easier for infection to spread.
- Trying to burst an abscess yourself.
- Starting antibiotics on your own decision: Antibiotics used without assessment can mask the picture and make diagnosis harder.
If a tooth has been knocked out
Hold a permanent tooth by the crown, not the root. If dirty, rinse briefly under tap water without scrubbing. If possible, try to place it back; if not, keep it in milk or the person's own saliva and do not let it dry. Every minute counts. Reimplantation is not attempted for primary teeth.
For a fractured tooth
Keep the broken fragment if you have it; in some cases rebonding may be considered. If a sharp edge irritates the tongue or cheek, it can be covered temporarily with sugar-free gum or orthodontic wax.
Should you go to the emergency room, and are teeth extracted there?
General hospital emergency departments are not equipped for dental treatment; they usually assess the situation with a view to controlling pain, and extractions are not routinely performed there. Emergency dental procedures, including extraction, can be carried out at the on-call units of Oral and Dental Health Centres (ADSM). However, if there is widespread facial swelling, difficulty swallowing or breathing, inability to open the mouth or a high fever, the general emergency department should be attended without delay.
Contacting us
If any of the findings above are present, you can reach us on the telephone number on our contact page. For enquiries outside working hours, an assessment is attempted according to the urgency of the situation and availability at that time. If we cannot be reached, applying to the emergency service of the nearest oral and dental health centre is appropriate.
This article is for general information purposes and does not replace a clinical examination. The suggestions here are for temporary relief; diagnosis and treatment are made through clinical examination.
Frequently Asked Questions
Should I go to the emergency room for toothache?
General hospital emergency departments are not equipped to carry out dental treatment; they usually assess the situation with a view to controlling pain and then refer the patient to a dentist. For dental treatment, the on-call units of Oral and Dental Health Centres (ADSM) or a dentist should be consulted. However, if there is widespread facial swelling, oedema spreading towards the eye, difficulty swallowing or breathing, inability to open the mouth, or a high fever, the emergency department should be attended without delay; these can indicate that an infection is spreading.
Are teeth extracted in the emergency room?
Extraction is not routinely performed in general emergency departments; the procedure requires dental equipment and radiological assessment. The on-call dental units of Oral and Dental Health Centres can carry out emergency dental procedures including extraction. Current information on which centre is on call can be obtained by calling 182 or from the provincial health directorate announcements.
What can be done at home for severe toothache?
Rinsing with warm salt water, gently removing food impacted between the teeth with floss, and lying with the head raised may ease the pain for a while. A cold compress applied externally may be soothing where there is swelling. Placing an aspirin or similar tablet directly on the tooth or gum causes a tissue burn and should not be done. Painkillers should only be used with your dentist's knowledge and as advised. None of these removes the cause; assessment is required.
What should I do if toothache starts outside working hours?
Outside working hours, the on-call units of Oral and Dental Health Centres provide a service. At our clinic we endeavour to reach our patients outside working hours in urgent situations; this is not, however, an arrangement that can be guaranteed at every hour. If the pain is increasing, swelling is spreading or fever is present, the nearest on-call unit should be attended without waiting for the morning.