Is this an emergency?
Call immediately
- A knocked-out permanent tooth — the single most time-critical dental emergency
- Facial swelling, particularly if it affects your eye, neck or breathing
- Uncontrolled bleeding that does not settle with firm pressure
- Severe pain that is not responding to over-the-counter pain relief
- Trauma to the jaw, or a tooth pushed out of position
Swelling that is spreading, or accompanied by fever or difficulty swallowing or breathing, is a medical emergency. Go to your nearest emergency department or call 911 — do not wait for a dental appointment.
Urgent, but not same-hour
- A chipped or fractured tooth that is not painful
- A lost filling or crown with no significant pain
- A dull ache that comes and goes
- Food persistently trapped causing gum soreness
- A broken denture or orthodontic appliance
These should be seen promptly, but they are not situations where minutes matter.
What to do right now
If you are in pain
- Take over-the-counter pain relief as directed on the packet, unless you have been advised otherwise
- Rinse gently with warm salt water
- Apply a cold compress to the outside of the face for swelling
- Keep your head elevated, including at night — lying flat often makes throbbing worse
- Never place aspirin directly against the gum; it burns the tissue
If you are bleeding
- Apply firm, continuous pressure with clean gauze or a damp tea bag for fifteen minutes without lifting to check
- Stay upright and keep your head above heart level
- Avoid rinsing vigorously, which dislodges forming clots
- If bleeding continues beyond twenty minutes of firm pressure, seek care immediately
If a crown or filling has come out
- Keep the crown — it can often be recemented
- Avoid chewing on that side
- Temporary dental cement from a pharmacy can protect the tooth briefly, but it is not a repair
A knocked-out tooth
A permanent tooth that has been knocked out can sometimes be reimplanted successfully — but the odds fall sharply with every minute it is out of the socket. The first thirty minutes matter more than anything else you do.
- Pick the tooth up by the crown, never the root. The cells on the root surface are what allow it to reattach
- Do not scrub it. If it is dirty, rinse briefly in milk or saline — not tap water, and never with soap
- Try to reinsert it into the socket and bite gently on a cloth to hold it in place
- If you cannot reinsert it, keep it in milk. Saline works. Saliva — held inside the cheek — is better than nothing. Never store it in water
- Call us immediately and get to a dentist within the hour
A knocked-out baby tooth should not be reimplanted — doing so can damage the permanent tooth developing above it. Contact us, but do not attempt to put it back.
Severe toothache and swelling
Persistent severe toothache usually means the pulp — the nerve and blood supply inside the tooth — is inflamed or infected. Once infection is established, it does not resolve on its own.
A useful thing to know: pain that stops abruptly after being severe is not necessarily good news. It can mean the nerve has died, while the infection continues into the bone below. Get it looked at even if it has stopped hurting.
Warning signs that need urgent attention
- Swelling of the face, jaw or neck
- Fever alongside dental pain
- Difficulty swallowing, opening your mouth, or breathing
- A bad taste with sudden pain relief — often a draining abscess
- Pain severe enough to prevent sleep
Antibiotics alone do not cure a dental abscess. They can control spreading infection, but the source has to be treated — with root canal therapy or removal of the tooth.
Avoiding the next one
A meaningful proportion of dental emergencies are the end point of something that had been building for months and was visible at a checkup.
- Keep to regular examinations — decay and cracks are found before they reach the nerve
- Wear a custom mouthguard for contact sport; sports injuries are a leading cause of knocked-out teeth in children
- Wear a night guard if you grind — cracked teeth from clenching are common and preventable
- Do not use your teeth to open packaging
- Take care with ice, popcorn kernels and hard sweets, particularly if you have large old fillings
- Address small problems early — a lost filling left for months is how you end up needing a root canal
Our prevention hub covers this in more depth.
Emergency dental FAQ
What counts as a dental emergency?
+A knocked-out permanent tooth, uncontrolled bleeding, facial swelling, severe pain not responding to pain relief, or trauma to the jaw. Swelling with fever or difficulty breathing or swallowing is a medical emergency — go to an emergency department.
What should I do with a knocked-out tooth?
+Hold it by the crown, not the root. Rinse briefly in milk if dirty. Try to place it back in the socket; if you cannot, keep it in milk and get to a dentist within the hour. Never store it in water and never scrub the root.
Can I go to a hospital emergency room for a toothache?
+A hospital can manage pain and treat spreading infection, but emergency departments are generally not equipped to treat the tooth itself. For facial swelling with fever or breathing difficulty, go to hospital first. For dental pain alone, a dentist is the right place.
Will antibiotics fix a dental abscess?
+No. Antibiotics can control an infection that is spreading, but they do not remove its source. The tooth still needs definitive treatment — root canal therapy or extraction — or the infection returns once the course finishes.
My tooth stopped hurting on its own. Do I still need to be seen?
+Yes. Pain stopping suddenly after being severe can mean the nerve inside the tooth has died. The infection can continue into the bone without symptoms for a time. It should still be assessed.