What Counts as a Dental Emergency, and What to Do First

What counts as a dental emergency depends on two things: whether the problem threatens more than your teeth, and whether waiting will make it worse. Swelling that affects your breathing, bleeding that won’t stop, or a jaw you think is broken belong in a hospital emergency department. A knocked-out adult tooth, a cracked tooth that hurts, a severe toothache or a swelling on the gum need a dentist the same day. A lost filling that doesn’t hurt, a small chip or a rubbing aligner can usually wait for the next available appointment. Most people can place their own situation in one of those three groups within a minute. Here’s how to sort it out.

When should you go to the hospital instead of the dentist?

Some problems start in the mouth but stop being dental problems. Go to the nearest hospital emergency department, or call 911, for any of the following:

• Swelling that makes it hard to breathe or swallow, or that is spreading toward your eye or down your neck.
• Bleeding that doesn’t stop after several minutes of firm, steady pressure.
• A jaw you suspect is broken, or that you can’t open or close normally.
• Facial trauma with any sign of head injury, such as loss of consciousness, confusion or vomiting.
• Facial swelling together with a fever.

A dental office isn’t set up for airway problems, fractures or head injuries, and the hospital can bring in whatever help you need. Once you’re stable, a dentist can deal with the teeth.

Which problems need a dentist the same day?

This middle tier is where most true dental emergencies sit. If any of these describes you, call for emergency dental care in North York as soon as you can:

• A knocked-out adult tooth. The sooner it is back in its socket, the better its chances. This is the most time-sensitive item on the list.
• A broken or cracked tooth that hurts. Pain usually means the nerve is exposed or the crack runs deep. Teeth grinding is a common reason a tooth cracks without any obvious accident.
• A severe or throbbing toothache, especially one that wakes you at night or doesn’t ease with over-the-counter pain relief.
• A dental abscess. This shows up as a swelling or a pimple-like bump on the gum, sometimes with a bad taste. It is an infection, and infections in the mouth can spread.
• A crown or large filling that has come out and left the tooth painful. An exposed tooth can be sensitive enough to stop you eating or sleeping.

Novus Dentistry accepts emergencies, and for pain or emergencies every effort will be made to see you that day. Call (416) 488-7454 and describe what’s happening. The person who answers can tell you what to do until you arrive.

What can usually wait for a regular appointment?

Not every dental surprise is an emergency. These are worth a call to book the next available appointment, but they rarely need same-day care:

• A lost filling or crown with no pain. Keep the crown if you still have it, avoid chewing on that side, and ask about crowns and bridges when you book.
• A small chip with no pain and no sharp edge cutting your tongue or cheek.
• Mild sensitivity to hot, cold or sweet foods. Sensitivity that lingers is worth raising at your next dental exam, since it can be an early sign of a cavity or gum recession.
• A broken or rubbing Invisalign aligner. Step back to your previous aligner if you kept it, or wear the current one as best you can, and let the Invisalign team know so the next set isn’t delayed.

The dividing line is pain and risk. No pain and no chance of the problem getting worse quickly means it can wait. If you’re unsure what counts as a dental emergency and what doesn’t, call anyway. A short conversation on the phone sorts it out faster than a search engine can.

What should you do first for a knocked-out tooth?

For an adult tooth, act quickly and gently:

• Pick the tooth up by the crown, the part you normally see. Don’t touch the root.
• If it’s dirty, rinse it briefly under cool water. Don’t scrub it, don’t wrap it in tissue, and don’t let it dry out.
• If you can, slide it back into its socket, facing the right way, and hold it in place by biting gently on a clean cloth.
• If you can’t reinsert it, keep it in a small container of milk, or tucked inside your cheek if you’re an adult who won’t swallow it.
• Get to the dentist as quickly as possible. Minutes matter.

For a baby tooth, the advice flips: do not put it back in. Reinserting a baby tooth can damage the adult tooth developing underneath it. Keep the tooth if you can find it, comfort your child, and call. A parent or guardian must attend the first visit with any patient under 16, and children’s dentistry at Novus covers this kind of visit.

What helps a toothache or swelling until you’re seen?

For a toothache, rinse gently with warm salt water and floss carefully around the tooth in case trapped food is the cause. Never place an aspirin, or any painkiller, directly against the gum or the tooth. It burns the soft tissue and doesn’t reach the pain.

For swelling, hold a cold compress against the outside of your cheek in short stretches. Don’t use heat, which can encourage an infection to spread.

For pain relief, follow the directions on the package or ask a pharmacist which product suits you. Don’t take more than the label allows in the hope of getting through the night. If the pain is beyond what over-the-counter medication can manage, that itself is a reason to be seen the same day.

For a cracked tooth or a lost crown, stick to soft foods, chew on the other side, and keep the area clean. A painful cracked tooth can often be repaired; the examination decides how.

The Canadian Dental Association also publishes general guidance on dental emergencies at cda-adc.ca.

What if it happens at night or on a holiday?

Use the three tiers. If the problem is in the hospital tier, go now; don’t wait for a dental office to open. If it’s in the same-day tier, follow the first-aid steps above, keep the tooth safe if there is one, and call for emergency dental care as early as you can. If it’s in the wait tier, you can book normally and stop worrying.

Still not sure what counts as a dental emergency?

You don’t need to be certain what counts as a dental emergency. If a problem is frightening, painful or getting worse, that’s enough reason to phone. Novus Dentistry is at the north-east corner of Yonge and York Mills, directly above York Mills subway station, with free underground parking and wheelchair access, and our team sees patients of all ages. An examination decides what the tooth needs; the phone call decides how soon. Meet the doctors, or contact us at (416) 488-7454 if you think you’re dealing with a dental emergency today.