What to do in a dental emergency

Posted on March 8, 2022 in General oral health

Dental emergencies come in many forms, and some situations are more urgent than others. People are often hesitant to call their dentist when they’re experiencing a dental emergency, wondering if the situation truly warrants emergency dental care and if a treatment will be covered by their insurance plan.

If you’re in severe pain, have a fever, or are experiencing swelling or bleeding that cannot be controlled, don’t delay contacting your dentist or visiting the hospital emergency room. Some problems can be life-threatening. Other problems may be less urgent, but avoiding immediate dental care can cause greater problems down the road. Play it safe and get a proper consultation. 

What is a dental emergency?^1,2,3

The American Dental Association defines dental emergencies as anything “potentially life-threatening and requiring immediate treatment to stop ongoing tissue bleeding [or to] alleviate severe pain or infection.” 

Life-threatening dental emergencies can include:

• Uncontrolled bleeding – may be from trauma, accident, health condition, or other cause
• Soft-tissue infections with intraoral or extraoral swelling that potentially compromises the patient’s airway. Be aware that tooth infections can spread into the soft tissues causing swelling without causing pain. 
• Trauma involving facial bones potentially compromises the patient’s airway.

Other dental emergencies may not be life-threatening but will require urgent care. Some of these include:

• Severe tooth pain from decay 
• Third molar/wisdom tooth pain
• Pain from post-extraction surgery or dry-sockets
• Abscesses or other infections causing pain and localized swelling
• Objects caught under the gums or between teeth causing pain and/or swelling
• Tooth chips, fractures, or lost fillings causing pain or trauma to the teeth, soft tissues, or both
• Trauma to the teeth causing one or more teeth to become loose, displaced, or even lost
• Orthodontic wires or other dental appliances becoming loose and cutting into the cheeks, gums, or both

What are the causes of dental emergencies?

Oral conditions such as tooth decay, gum disease, TMJ disorders, and large and older fillings contribute to the bulk of dental emergencies. However, multiple situations in daily life may accidentally lead to a dental emergency. Some examples include: 

• Playing contact sports
• Work-related accidents
• Car accidents
• Falls during normal activities or recreational play 
• Eating something hard
• Improper use of your teeth (e.g. ice chewing; opening bottles, packages, tough nuts; cutting tape; chewing pencils/pens; biting nails 
• Jaw joint pain or locking

The longer that dental issues go untreated, the more likely that they may result in permanent damage to your teeth, or that they may warrant serious and expensive treatments.

How to handle common dental emergencies

Here are some tips on how to handle common dental emergencies: 

1. Toothache

A toothache may not necessarily require emergency care. However, toothaches should be taken seriously since they could be an indicator of a bigger issue or lead to greater dental problems if ignored. There can be many sources of tooth pain including dental decay, a cracked tooth, an infected tooth, objects stuck between the teeth, gum disease, sinus infections, and more.

If you have a toothache, always contact your dentist – they’ll be able to help determine if you need to be seen immediately.

To deal with the pain of a toothache, try these tips:

• Floss carefully to remove any trapped food particles wedged between teeth that may be causing pain.
• Rinse your mouth with warm saltwater. Add 1/2 tsp of salt to 8 oz. of warm water.
• Take an over-the-counter pain reliever, such as acetaminophen. 
• Do not put aspirin on the sore area, it can burn the tissue.
• If your face is swollen place a cold compress on your cheek to help reduce pain and swelling. Swelling can mean infection and abscess.
• If pain persists, make an appointment with your dentist as soon as possible. 

2. Tooth trauma

Tooth trauma can happen in multiple ways and can result in chipped teeth, cracked teeth, or teeth that are knocked out of place or even entirely out of the socket. Here are some tips to consider:

Knocked-out tooth

If a child’s primary (baby) tooth gets knocked out, apply pressure to the area if there is bleeding. Then, you should call your child’s dental professional as soon as possible. Don’t try to place a baby tooth back into the socket, as this may damage the permanent tooth growing under the gum.

Here are steps to follow should you have a permanent tooth knocked out: 

1. Locate the tooth immediately, if possible. If you can locate the tooth, you need to hold it by the crown and not the root. 
2. Do not scrub or remove any tissue pieces from the root. Also, do not use soap or chemicals on the tooth or dry the tooth. 
3. Place the tooth back into the socket and hold it in place. The tooth must stay moist at all times. If you can’t place it in the tooth socket, keep it in your mouth next to your cheek. However, if this cannot be done, place the tooth in a clean holder with milk, saliva, or in an emergency tooth preservation solution (e.g. Save a tooth® - available at drugstores). Do not place the tooth in tap water. 
4. See your dentist right away. Within 30 minutes is best, but there is a chance the tooth may be saved even up to an hour after being out of the mouth. 

Chipped or broken teeth

Chipped, broken, or cracked teeth are the most common dental injury and most are usually minor. However, it’s important to note that immediate treatment can help prevent infection and may help save the tooth. Here are some tips to follow should you have chipped or cracked teeth:

• Rinse your mouth with warm water and assess for any rough edges, pain, or temperature sensitivity. 
• If you received a blow to the face, put cold compresses on the area to help reduce swelling.
• You will need to go to your dental professional’s office as soon as possible. If you can locate the piece of tooth, bring it with you. 

3. Bitten or cut tongue, cheek, or lip

If you bite or cut your tongue, cheek, or lip, first, stay calm. There are a lot of blood vessels in the mouth tissues, so even minor wounds may look worse than they are. Wash the area gently and control any bleeding by placing moist gauze or a towel on the injured area and keep firm pressure until the bleeding stops. Then place a cold compress on the area to reduce any swelling. Most injuries in the mouth aren’t serious and heal properly on their own. Keep the area clean to avoid infections. Rinse with salt water or a 1:1 mix of hydrogen peroxide and water several times a day to help things heal quickly.

If the area is bleeding and won’t stop, then contact your doctor or head to the nearest hospital emergency room. Make sure to contact your dentist or physician if the cut is deep, extends onto the face, or if there is a puncture through the lip or cheek. Also, contact if you see signs of infection, like swelling, redness growing wider around the wound, fever, pus, or the wound remains tender and painful.

If you or your child have orthodontic braces and a loose wire or bracket that is poking or cutting into cheeks or gums, then talk with your orthodontist about how to handle such a situation. They can provide you with some wax and some ways to take care of the problem at home or if you are away on vacation until you can get back into the dental office.

How to prevent dental injuries

Regardless of whether it was eating something hard, playing contact sports, or a fall, engaging in certain activities can increase the chances of harming your smile. Follow these suggestions to help prevent dental injuries: 

• Wear a mouth guard when playing sports or participating in recreational activities (like biking or skating).
• Always use a seatbelt while driving or riding in a car. Place young children in a car seat.
• Childproof your home to help prevent falls and other injuries.
• Schedule regular dental visits for everyone in your family.
• Avoid chewing on items or hard foods that can crack your teeth like ice, popcorn kernels, and hard candies.
• Do not use your teeth as tools to rip, tear, or cut things.

What if I have a dental emergency and am not sure what to do?

The first thing you should do is contact your dentist: they will be able to advise you on what to do. Since you never know when an accident will occur, we recommend reviewing and being familiar with your dental coverage, which will have information about how dental emergencies are covered. 

Final thoughts 

The most important thing to remember in the case of a dental emergency is that it’s better to take action sooner rather than later to avoid greater problems later on. If it is a severe condition, then you can go to the nearest hospital emergency department.  For dental emergencies that are not life-threatening, contact your dentist as soon as possible so that he or she will be able to help you resolve the situation on your own or let you know that you should make an appointment. 

¹Dental Emergency. (n.d.). January 18, 2021, from https://www.mouthhealthy.org/en/az-topics/d/dental-emergencies

²ADA. ADA Develops Guidance on Dental Emergency, Nonemergency Care, 2020, www.ada.org/en/publications/ada-news/2020-archive/march/ada-develops-guidance-on-dental-emergency-nonemergency-care. 

³What is a Dental Emergency? (2020, March 19). Retrieved from https://www.ada.org/~/media//CPS/Files/COVID/ADA_DentalEmerg_Patient_Flyer.pdf