Dental Emergencies

What is a Dental Emergency?

In general, anything that does not cause significant pain and or swelling is not considered a dental emergency. Having a tooth or restoration break or chip, a temporary or permanent crown come off or minor discomfort can be taken care of during regular office hours.

A dental emergency arises when a tooth (or teeth) is completely knocked out or is severely displaced, when significant soft tissue trauma to the mouth has occured and bleeding must be controlled, extensive swelling is noticable, or pain is severe.

Some questions to ask yourself if you are unsure about a situation being a dental emergency:

  • Do you have significant bleeding from the mouth, lips or tongue?
  • Are you experiencing severe pain?
  • Have you had trauma to your face, head or neck?
  • Do you have loose teeth that were not previously loose or teeth that have been knocked out?
  • Do you notice swelling of your face, neck or mouth?

If you answered yes to one or more of these questions, you should seek treatment immediately.

Knocked Out Tooth or Teeth

If a tooth or teeth are knocked out, immediate attention is needed. Seeing a dentist within an hour of the injury, can usually save the tooth. Delayed treatment can prevent the tooth or teeth from being saved. Here’s what to do in the event that a tooth is knocked out:

1. Locate the tooth and pick it up by the crown of the tooth, do not touch the root surface

2. Rinse the tooth gently with water to remove any visible debris. Do no scrub any part of the tooth.

3. If possible place the tooth back into the socket and bite down gently to hold it in place.

4. If you cannot put the tooth back in, put it in a cup of milk.

5. Call your dentist immediately. The longer the tooth is out of the socket the less likely it is to remain viable.

Teeth that have been knocked out completely will require root canal treatment if they can be reimplanted.

  • If the tooth or teeth that have been knocked out are primary (baby teeth) do not try to reinsert them as this can damage the underlying permanent tooth. If you are unsure if the tooth is permanent or primary, do not reinsert it, bring it with you to your dentist instead

Loose Tooth or Displaced Tooth

If a tooth or teeth are significantly loose and or displaced, contact your dentist as soon as possible. You can try to reposition the tooth or teeth with gentle pressure using your fingers. If the tooth or teeth do not move back into position easily, do not force them. Your dentist may splint your loose tooth or teeth to adjacent teeth to stabilize them. Often times splinting of the teeth once repositioned, is all that is necessary. Periodic follow up examination of the tooth or teeth with x-rays will be necessary to check on the vitality of the tooth or teeth. Sometimes teeth that have had trauma become non-vital and the nerve dies. If the tooth becomes non-vital you may notice one or more of the following symptoms: discoloration of the tooth, pain or swelling in the area, significant increase in sensitivity to hot and cold. Sometimes non-vital teeth are asymptomatic and can only be diagnosed with an x-ray or additional testing.

Broken, Chipped or Fractured Teeth

A chipped tooth that is not painful is not a dental emergency and can be dealt with during normal office hours. Depending upon the extent of the chip in the tooth, your dentist may just smooth rough edges or suggest a restoration to replace the chipped tooth structure. Until you are seen, be careful when chewing as not to chip more of the tooth.

A large fracture or broken tooth structure is a dental emergency that should be dealt with immediately. An x-ray will be necessary to determine the extent and depth of the fracture. If the fracture extends into the nerve of the tooth, a root canal and full coverage crown or cap will be necessary to save the tooth. If the fracture is to the level of the gum tissue or below, additional treament may be necessary, if the tooth can be saved at all. Some fractures are so extensive that the tooth cannot be saved andmust be extracted.

Soft Tissue Injury and Extensive Bleeding

If you have a soft tissue injury that involves significant bleeding this is a dental emergency and you should go to the Emergency Room or see an Oral Surgeon Immediately. If heavy bleeding occurs, locate the source and apply pressure to the area.
If the dental trauma is a result of an injury to the head and neck, it is important to go to the Emergency room before you seek your dentist. Trauma to the head and neck is far more serious and needs immediate medical attention. Once it has been confirmed that everything is okay with your head and neck you should contact your dentist.