Dental pain tends to arrive without warning, often in the evening or on a weekend. The first question is whether it can wait for a regular appointment or needs attention now. Some problems get worse quickly, and what starts as discomfort can become more serious within hours or days.
1. Severe or worsening toothache
Not all tooth pain is an emergency. Mild sensitivity to hot or cold may just be enamel wear, and can be checked at a routine visit. Pain that is sharp, throbbing, constant or getting worse is different: it often means infection reaching the nerve, deep decay, or a crack that has exposed the inside of the tooth.
In the meantime, take an over-the-counter pain reliever as directed on the packet, and don’t put heat on your face, as it can make swelling worse. Call the clinic and describe how bad the pain is.
2. Swelling of the face, jaw or gums
In the mouth, swelling usually means infection, such as an abscess. Dental infections don’t clear up on their own and can spread to nearby tissue and the jawbone. Treatment deals with the source, for example by draining the infection, root canal treatment or removing the tooth, and antibiotics are sometimes needed as well.
If facial swelling comes on quickly or affects your breathing or swallowing, go to a hospital emergency department straight away. For swelling of the gum or jaw that isn’t affecting your airway, call a dentist urgently.
3. A knocked-out adult tooth
This is one of the most time-sensitive dental emergencies. The chance of successfully putting a knocked-out adult tooth back falls quickly, so aim to reach a dentist within the first hour.
- Pick the tooth up by the crown, the white part, not the root.
- If it’s dirty, rinse it briefly with clean water. Don’t scrub it.
- If you can, put it gently back in the socket and bite softly on a clean cloth to hold it.
- If not, keep it moist in milk, or for an adult, held inside the cheek, and get to a dentist.
Don’t wrap it in dry tissue: it damages the cells on the root that are needed for it to reattach. Baby teeth that are knocked out usually aren’t put back, because that can affect the adult tooth underneath, but call a dentist for advice. See children’s dentistry.
4. A broken, cracked or badly chipped tooth
A small chip with no pain and no sharp edge can usually wait for a standard appointment. Call promptly if:
- The break is large and has exposed the inside of the tooth
- It hurts to bite, chew, or with hot and cold
- A sharp edge is cutting your tongue or cheek
- A large part of the tooth is affected and it feels unstable
A crack that runs into the root is serious and may need a referral. Until you’re seen, chew on the other side. If a piece has broken off, keep it: your dentist may be able to bond it back. Temporary dental cement from a pharmacy can cover the tooth and reduce sensitivity. Depending on the damage, your dentist may talk about a crown.
5. A lost filling or crown that hurts
Sometimes a filling or crown comes out without pain. Other times the tooth underneath is very sensitive, a sign it needs protecting soon, because without its cover it’s open to bacteria, food and temperature changes.
Don’t glue a crown or filling back with household glue: it isn’t safe in the mouth. Temporary dental cement from a pharmacy can seal it for a short time. Avoid hard or sticky food on that side, and if it’s painful, call the clinic.
6. Signs of a dental abscess
- A persistent, throbbing toothache that may spread to the jaw, neck or ear
- Swelling and redness in the gum near the tooth
- A small raised bump or blister on the gum that may weep fluid
- Sensitivity to pressure, hot or cold that doesn’t settle
- Fever, feeling unwell, or swollen glands in the neck
If you notice these, call rather than waiting to see if they improve. An abscess won’t clear up without treatment. If the pain suddenly stops, the abscess may have burst and released pressure, but the infection is still there and still needs treating.
7. Bleeding that won’t stop
Gums that bleed a little when you brush or floss are common and worth raising at your next check-up, but they’re not an emergency. Get urgent care for:
- Bleeding that continues for more than 20 to 30 minutes after a tooth is removed
- Heavy bleeding after an injury to the mouth
- Bleeding in the mouth with no obvious cause that doesn’t settle
Press firmly on the area with clean gauze or a cloth, or bite on the gauze after an extraction. If it doesn’t slow, call the clinic or go to a hospital emergency department.
What can wait, and what can’t
Usually fine for a scheduled appointment: mild sensitivity without pain, a small chip or rough edge that isn’t cutting you, a loose filling that doesn’t hurt and is still partly in place, or mild gum soreness without swelling.
Call straight away for: severe or worsening pain, visible swelling, a knocked-out or badly broken tooth, signs of infection such as fever or a gum blister, or bleeding that won’t stop.
If you’re unsure, call and describe your symptoms. The team can tell you whether to come in or book a regular appointment.
Be ready before it happens
- Keep a small kit at home: dental wax or temporary filling cement from a pharmacy, sterile gauze, pain relief suitable for everyone in the house, and a small lidded container for carrying a knocked-out tooth in milk.
- Save your dentist’s number in your phone.
- Keep up regular check-ups, so small cracks, early decay and gum disease are found before they turn into emergencies.
Emergency dental care near Casula
We see patients from Casula at our Prestons clinic, Shop 6, 1975-1985 Camden Valley Way, and our Moorebank clinic, 95 Nuwarra Rd. We prioritise dental pain and urgent cases throughout the day. After-hours help may be available depending on Dr Amgad’s availability: call the clinic and the call may be redirected to him. See emergency dentistry.
This article is general information only and isn’t a substitute for advice from your own dentist. If you have pain, swelling or an injury, contact a dentist promptly.