What to do in a dental emergency, step by step

Most dental emergencies happen at the worst possible moment: a Saturday soccer game, a holiday dinner, a hard pretzel at your desk. The good news is that a few calm steps in the first hour can make the difference between saving a tooth and replacing it.

This guide walks through the situations we see most often at Northstar, what you can do at home right away, and how to decide whether you need a dentist today or the emergency room right now. It is general information, not a substitute for an exam.

First, decide if this is a dental or a medical emergency

Hospital emergency rooms are not equipped to fix teeth, but they are the right place for anything that threatens your airway or your overall health. Go to the ER, or call 911, if you have facial swelling that is spreading toward your eye or neck, trouble breathing or swallowing, a high fever with dental pain, or an injury to the jaw after a serious fall or accident.

For almost everything else, including severe toothaches, broken teeth and knocked-out teeth, a dentist is the faster and more effective option. Call our office during hours and we will fit you into one of the same-day slots we hold every weekday.

A knocked-out adult tooth: the clock is running

A permanent tooth that has been knocked out has the best chance of surviving if it is back in its socket within 30 to 60 minutes. The root surface is covered in living cells, and they start to die as soon as they dry out.

• Pick the tooth up by the crown, the part you normally see, and never by the root.
• If it is dirty, rinse it for a few seconds with milk or saline. Do not scrub it or wrap it in tissue.
• Try to push it gently back into the socket and bite on a clean cloth to hold it in place.
• If that is not possible, store it in a small container of milk or inside your cheek, and call us immediately.

A cracked or broken tooth

Rinse your mouth with warm water and save any pieces you can find. If there is bleeding, press gauze against the area for ten minutes. A cold compress on the outside of the cheek helps with swelling and pain.

Sharp edges can cut your tongue, so a piece of sugar-free gum or dental wax pressed over the edge is a useful short-term fix. Avoid chewing on that side. A small chip can often wait a day or two, but a crack that causes sharp pain when you bite or release usually means the nerve is involved, and that deserves a same-day visit.

Severe toothache or swelling

Throbbing pain that keeps you up at night, pain that lingers long after something hot or cold, or a pimple-like bump on the gum are signs of infection inside the tooth. Over-the-counter pain relievers can take the edge off. Follow the dosing on the label and check with your physician if you have medical conditions.

Please do not place aspirin directly on the gum. It burns the tissue. Antibiotics alone rarely solve the underlying problem, which is why we examine the tooth before prescribing. Often an emergency root canal or drainage gives relief within hours.

Lost fillings, loose crowns and braces wires

These feel alarming but are rarely urgent. Keep a lost crown in a safe container and bring it with you, since we can often recement it. A dab of denture adhesive or temporary dental cement from the pharmacy can hold it in place for a day. Never use household glue.

A poking orthodontic wire can be pushed flat with the eraser end of a pencil or covered with wax until your appointment.

How Northstar handles emergencies

We keep two emergency appointments open every weekday, and new patients are welcome in those slots. After hours, patients of record can call our emergency line and our on-call dentist will usually return the call within 30 minutes to talk through next steps.

When you come in, the first goal is getting you out of pain. We take a focused x-ray, explain what we find, give you the cost before any treatment beyond the exam, and schedule follow-up work on a calmer day. Keep our emergency number saved in your phone, and hopefully you never need it.

This article is general information and is not medical advice. Please see a dentist for an exam and personal recommendations.