Dental Emergencies

What Counts as a Dental Emergency?

A dental emergency is anything that needs a dentist (or, occasionally, a hospital) within hours rather than days. The clearest examples are a knocked-out adult tooth, swelling in the gum or face, bleeding that won't stop with pressure, a serious injury to the mouth or face, and pain that painkillers can't keep under control.

Plenty of other problems are unpleasant but not urgent. A painless lost filling, a small chip or a crown that has come off cleanly can usually wait a day or two, as long as you protect the tooth. If you're unsure, phone us: we'd rather you asked.

How Quickly Do I Need Help? A Quick Triage

Use this as a rough guide. It doesn't replace advice from a dentist or NHS 24.

If a problem in the "can wait" row starts to hurt, swell or keep you awake, move it up a row.

Knocked-Out Adult Tooth: The First 30 Minutes Matter

This is the one dental problem where minutes genuinely count. The cells on the root surface start to die once the tooth dries out, so the outlook is best when it's back in the socket within about half an hour.

What to do, in order:

1. Find the tooth and pick it up by the crown (the white part you normally see), never by the root.
2. If it's dirty, rinse it briefly in milk or under cold running water for no more than about ten seconds. Don't scrub it, use soap or wrap it in tissue.
3. If you can, push it gently back into the socket the right way round, then bite on a clean handkerchief or folded gauze to hold it in place.
4. If you can't put it back, keep it moist: in a small container of milk, or held inside your cheek if you're an adult and fully alert. Don't store it in water.
5. Call us straight away on 0131 332 3971. Out of hours, call NHS 24 on 111.

We'll check the position, take an X-ray and usually splint the tooth to its neighbours for a couple of weeks. Most replanted adult teeth need root canal treatment afterwards, and we'll monitor the tooth for some time.

Broken or Chipped Tooth

How urgent a broken tooth is depends on how much has gone and whether it hurts.

• Rinse your mouth gently with warm water.
• Keep any fragments in a little milk or water. A clean piece of a front tooth can sometimes be bonded back on.
• Cover a sharp edge with sugar-free chewing gum or dental wax from a pharmacy so it doesn't cut your tongue or cheek.
• Chew on the other side and avoid very hot, cold or hard food.

If you can see a pink or red dot in the broken surface, or the tooth is very painful, the nerve may be exposed and you should be seen the same day. The repair could be a bonded filling, an onlay or a crown, sometimes with root canal treatment first. Our broken tooth page explains the options.

Swelling and Dental Abscesses

An abscess is a collection of infection at the tip of a root or in the gum beside a tooth. Typical signs are throbbing pain, a swollen gum or face, a bad taste, a weeping spot on the gum and a tooth that feels "high" when you bite.

Swelling is never something to sit on for days. Call us the same day. If swelling is spreading quickly, you have a temperature or you feel generally unwell, don't wait until the morning: call NHS 24 on 111.

Call 999 or go to A&E if swelling is affecting your breathing or swallowing, or is closing or pushing on your eye.

Meanwhile, take pain relief as directed on the packet, use a cold compress on the outside of the face and don't try to burst the swelling. Antibiotics are sometimes needed when infection is spreading, but they don't cure an abscess on their own: the source has to be treated, usually with root canal treatment or removing the tooth. See our dental abscess page.

Severe Toothache

Toothache varies from an occasional twinge to a relentless throb. The kind that counts as urgent:

• keeps you awake or wakes you up
• throbs on its own without a trigger
• lingers for minutes after something hot or cold
• comes with swelling, a bad taste or a raised temperature

This usually means the nerve inside the tooth is badly inflamed or infected, and it won't settle for long on its own. Take an over-the-counter painkiller following the packet dose, and ask a pharmacist if you're unsure which is safe for you. Never hold an aspirin against the gum: it burns the tissue. Call us first thing and we'll aim to see you the same day.

A brief twinge with cold drinks is worth booking in for but rarely needs an emergency slot.

Lost Crown or Filling

If a crown comes off, keep it somewhere clean and safe and bring it with you. Often it can be cleaned and cemented back on, which is £80. Pharmacy temporary cement can hold it for a day or two if the tooth isn't painful. Never use household glue.

If a filling falls out, keep the area clean and chew on the other side. Sugar-free gum or a temporary filling kit from a pharmacy can cover the hole for a short while. We can place a temporary filling for £60 to make the tooth comfortable until a permanent repair is planned.

If the tooth underneath has broken or decayed, the old crown may not go back. We'll explain the options, such as a new crown, and confirm any fee in writing first.

Bleeding After an Extraction

Some oozing and pink-tinged saliva for the first day after a tooth is removed is normal. Steady bleeding that fills your mouth is not.

To stop it:

• Roll up a clean piece of gauze or a clean cotton handkerchief, place it over the socket and bite down firmly for 20 minutes without checking.
• Sit upright rather than lying flat.
• Don't rinse, spit, smoke, drink alcohol or have hot drinks for the first 24 hours.

If it's still bleeding after two rounds of firm pressure, call us during opening hours or NHS 24 on 111 out of hours. If bleeding is heavy and won't stop, call 999 or go to A&E. Tell us if you take blood thinners.

Pain that worsens two to four days after an extraction may be a dry socket. It isn't dangerous but it's sore, and we can dress the socket to settle it.

Children's Teeth and Dental Injuries

A knocked-out baby tooth should not be put back. Replanting it can damage the adult tooth developing underneath. Press a clean cloth on the gum to stop the bleeding, comfort your child and call us.

Adult front teeth usually come through between about six and eight years old. If an older child knocks out an adult tooth, follow the adult steps above. If you're not sure whether it's a baby or adult tooth, keep it in milk and call straight away.

Even if a knocked tooth looks fine, it's worth a check, as teeth can darken or need monitoring afterwards. Our plan members' children are seen under the NHS at Comely Bank Dental; see our children's dentistry page. For any serious facial injury, call 999 or go to A&E.

Getting Help: Weekdays, Evenings and Weekends

We offer emergency appointments on weekdays. The fee is £75 for registered patients and £99 if you're not registered with us. Call 0131 332 3971 as early in the day as you can, as same-day slots fill up.

We'll find the cause, relieve the pain and make the tooth safe. If you need further treatment, we'll explain the options and agree the fee in writing before we start.

We're open Monday to Friday, 9am to 5.30pm, and closed at weekends. Out of hours in Scotland, call NHS 24 on 111 for urgent dental advice. Call 999 or go to A&E for swelling affecting breathing, swallowing or the eye, heavy bleeding that won't stop, or a serious facial injury.

We're in Comely Bank, a few minutes' walk from Stockbridge, but you don't need to live nearby or be registered with us to be seen.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.