Dental emergencies: what to do first

Dental emergencies happen at the worst times — late at night, on a Sunday, on the way to somewhere important. What you do in the first half hour often decides whether a tooth is saved or lost.

Keep this page bookmarked. Call the clinic before you travel, so we know you are coming and can tell you what to do on the way.

A knocked-out permanent tooth

This is the one real race against the clock. A tooth can often be put back if it is handled correctly and you get to a dentist fast.

Do this:

1. Pick it up by the crown — the white chewing part. Never touch the root.
2. Do not scrub it. The cells on the root surface are what allow it to reattach. Scrubbing kills them. If it is dirty, rinse it in milk or saline for a couple of seconds. Not tap water, and not for long.
3. Put it back if you can. If the tooth can be slipped back into its socket the right way round, that is the best possible transport medium. Bite gently on a clean cloth to hold it.
4. If you cannot, store it in milk. Milk is genuinely the best household option. Failing that, hold it inside your own cheek. Never store it in plain water — water damages the root cells.
5. Get to the clinic immediately. The chances drop with every ten minutes.

Milk teeth are the exception. A knocked-out baby tooth should not be put back — it can damage the permanent tooth forming above it. Bring the child in, but do not reimplant.

Facial swelling

Swelling of the face, jaw or under the eye that comes with a toothache means an infection has spread beyond the tooth into the surrounding tissue.

This is urgent — same day. Not next week when it is convenient.

Swelling that reaches the eye, or the floor of the mouth, or that makes swallowing or breathing difficult, is a hospital emergency, not a clinic one. Go to an emergency department.

Do not apply heat to the outside of the face. Heat encourages the infection to spread. Painkillers will mask it for a while, but the infection is still advancing.

Severe toothache that painkillers no longer touch

Pain that keeps you awake, throbs when you lie down, or has stopped responding to over-the-counter painkillers usually means the nerve inside the tooth is infected. That does not resolve on its own — the pain may fade for a few days when the nerve dies, and people take that as recovery. It is not. The infection then moves into the bone.

In the meantime: take your usual painkiller as directed, keep your head raised when lying down, and avoid very hot or very cold food on that side. Never place an aspirin against the gum — it burns the tissue.

A broken or chipped tooth

• Rinse gently with warm water
• Save any pieces you find and bring them
• If there is a sharp edge cutting your tongue or cheek, cover it temporarily with orthodontic wax or sugar-free chewing gum
• Avoid chewing on that side

A chip in the enamel can usually wait a day or two. A break that exposes the pink inner part of the tooth, or that hurts sharply with air and cold, needs attention quickly.

A lost filling or crown

Not usually painful, and not usually an emergency — but do not delay it either. An open cavity collects food and decays faster, and a tooth without its crown can crack under normal chewing, after which it often cannot be saved.

Keep the crown if you find it; it can frequently be recemented.

Bleeding that will not stop after an extraction

Some oozing on the first day is normal. Steady bleeding is not.

Fold a clean gauze or cloth, place it over the socket, and bite firmly for 20 minutes without checking. Lifting it every two minutes to look is the most common reason the clot never forms. If it is still bleeding heavily after two full attempts, call us.

Also for the first 24 hours: no rinsing, no spitting, no straws, no smoking. All four dislodge the clot and cause a dry socket, which is considerably more painful than the extraction was.

What is not an emergency

• Mild sensitivity to cold that passes in seconds
• A small chip with no pain
• Food stuck between teeth — floss it out gently
• Mild soreness for a day or two after treatment

These deserve an appointment, not a panic.

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In any dental emergency in Andheri West, call the clinic first. Tell us what happened and we will tell you what to do on the way in — and be ready when you arrive.