What to Do in a Dental Emergency: The First Hour

In a dental emergency, what you do in the first hour matters. Stay as calm as you can, check whether you need the emergency room, control bleeding and swelling, protect any tooth or broken pieces, and call your dentist as early in the day as possible. For a knocked-out tooth, put it in milk and call immediately, because a knocked-out tooth can be saved if you are seen quickly enough.

This step-by-step guide from the Timonium office of Dr. Steven W. Haywood, DDS covers first aid for the most common situations, what to tell the office when you call, what not to do, and how to get seen for emergency dentistry in Timonium. To understand which problems are most urgent, read the 5 common dental emergencies.

Step 1: Decide whether you need the emergency room first

Most dental emergencies are best handled by a dentist, but a few situations need emergency medical care before anything else:

• Swelling in the face or neck that makes it hard to breathe or swallow
• Bleeding that will not slow with firm pressure
• A serious head injury, or an injury with loss of consciousness

Dental infections should never be ignored. An abscess can spread through the jaw and cause swelling, and that swelling can become life threatening. If breathing or swallowing is affected, go to the emergency room or call 911.

Step 2: Call the office, as early as you can

Call (410) 453-9399 as soon as you are in pain or have had an injury, ideally early in the day so the practice can care for you around scheduled patients. Do not wait until the end of the week or until you are off work, when offices may be closed.

When you call, it helps to have a few details ready:

• What happened, and when
• Which tooth or area hurts, and how badly
• Whether there is swelling, bleeding or a fever
• Whether a tooth, crown or filling has come out, and whether you have it
• Any medications you take and any allergies

Step 3: First aid for your situation

A knocked-out permanent tooth

1. Pick the tooth up by the crown, the part you chew with. Avoid touching the root.
2. If it is dirty, rinse it gently with water. Do not scrub it or remove any tissue attached to it.
3. Put the tooth in milk so it does not dry out.
4. Call the office, or any dentist, immediately and come in as quickly as you can.

Knocked-out teeth can be treated for patients of any age, and cuts from the injury can be stitched. Baby teeth are different: a knocked-out baby tooth should not be pushed back into the socket, because that can damage the permanent tooth developing underneath. Call for advice. For protecting children’s teeth during sports, read sports mouthguards for kids.

A broken or chipped tooth

• Rinse your mouth gently with warm water.
• Save any pieces and bring them with you. A piece that broke off probably cannot be reattached, but it is still worth bringing.
• If the area is bleeding, press a clean piece of gauze against it.
• Hold a cold compress against your cheek to reduce swelling and ease pain.
• Avoid chewing on that side until you have been seen.

A lost filling

• Keep the area clean by brushing gently and rinsing after eating.
• Avoid chewing on that tooth and try to keep food out of the hole.
• Take an over-the-counter pain reliever as directed on the label if you need one.
• Call to schedule a visit. The practice is mercury-free, so a replacement filling is tooth-colored composite, completed in a single visit.

A crown or temporary crown that came off

If a temporary crown comes off, you can place a little Fixodent, available at any pharmacy, inside it, put it back on and call the office during business hours to have it re-cemented. Do not leave the temporary off, even if the tooth feels fine, because teeth can move and affect how the permanent crown fits.

If a permanent crown comes off, keep it safe, avoid chewing on that side and call the office. Do not use household glue or other adhesives on a crown. Learn more about dental crowns.

A toothache with swelling

• Call the office right away. Swelling with tooth pain can mean an abscess.
• Hold a cold compress against the outside of your cheek.
• Do not put aspirin or other tablets directly against your gum or tooth, which can irritate the tissue.
• If a doctor has prescribed antibiotics, take them as directed, but remember that antibiotics slow an infection rather than fixing the tooth. You still need dental treatment.

Read more about the signs and dangers of oral infections.

Bleeding after a tooth extraction

• Bite on a gauze pad for 30–45 minutes so a blood clot can form. You may need to repeat this.
• If oozing continues, bite on a moist tea bag wrapped in gauze.
• For 72 hours, do not rinse vigorously, use straws, smoke, drink alcohol or brush next to the site.
• If you have heavy bleeding, severe pain, swelling that continues for 2–3 days or a reaction to medication, call the office immediately.

Full aftercare is on the post-op instructions page.

A jaw that locks open or closed

Call the office. A locked jaw can need emergency treatment. Medications and emergency NTI splints are often used for acute TMJ pain, and a locked jaw can be fixed nearly all the time.

Step 4: What to bring

• The tooth in milk, or any broken pieces, crown or filling
• A list of your medications and allergies
• Your dental insurance details, so the office can file your claim

What not to do in a dental emergency

• Do not wait it out. Tooth pain generally gets worse with time, and delaying can mean more extensive treatment later.
• Do not assume it is over when the pain stops. An abscess does not always hurt, even while the infection remains.
• Do not wait until Friday afternoon. Call early in the day and early in the week.
• Do not use household glue on a crown, filling or broken tooth.
• Do not put aspirin on the gum.

Emergency dentistry in Timonium, MD: getting seen

Dr. Haywood is available anytime for true dental emergencies for existing patients and their friends and families. New patients with emergency needs can be seen on weekdays during normal business hours, based on the schedule’s availability. Hours are Monday 8:30 AM to 6:30 PM, Tuesday 8:30 AM to 5 PM, Wednesday 8:30 AM to 3:30 PM, Thursday 8:30 AM to 4:30 PM and Friday 8:30 AM to 4 PM, closed on weekends.

If you have not seen a dentist in a while, the standard of care calls for the necessary X-rays and a thorough exam before treatment, and Dr. Haywood then walks you through your options. Treatment focuses on relieving your pain, whether that means a root canal, an extraction or repairing a cracked tooth. See emergency dental care for more.

Paying for emergency care

Emergency care is paid at the time of service. The practice is out of network with all dental insurance companies, and the office files the claim on your behalf so your plan can reimburse you for what it covers. Health savings and flex plans are welcome. Financing is available through CareCredit, with no-interest options for up to 12 months, and Cherry, with payment plans from 3 to 24 months. See financing options.

Frequently asked questions

Should I go to the emergency room or the dentist?

Go to the emergency room if swelling affects your breathing or swallowing, bleeding will not stop, or you have a serious head injury. For tooth pain, a broken tooth or a knocked-out tooth, call the dentist.

Can I glue a crown back on myself?

Not with household glue. A temporary crown can be put back with a little Fixodent until the office re-cements it. For a permanent crown, keep it safe and call.

What if my emergency happens on a weekend?

Existing patients and their friends and families can reach Dr. Haywood anytime for true dental emergencies. New patients are seen on weekdays during business hours, based on availability. If swelling affects breathing or swallowing, go to the emergency room.

How quickly do I need to act for a knocked-out tooth?

Immediately. Time is of the essence, and a knocked-out tooth can be saved if you are seen quickly enough.

Save the number before you need it

Add (410) 453-9399 to your phone contacts now, so you are not searching for it in an emergency. For less urgent problems, request an appointment. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093. Test yourself with the dental emergency quiz.