Dental Emergencies: What to Do Until You See a Dentist

A knocked-out permanent tooth: every minute counts

If a permanent tooth is knocked out by a fall or blow, the chance of saving it is better the sooner it is put back, ideally within less than an hour. Follow these steps:

• Find the tooth and hold it by the crown, the white part you see in the mouth, without touching the root.
• If it is dirty, rinse it with milk, saline or cold water for a few seconds only; do not scrub it or use soap.
• If you can, push it gently back into place the right way round, then bite on a clean cloth to hold it.
• If you cannot put it back, place it in a cup of milk or saline, or keep it inside the mouth against the cheek if the person is an adult and fully alert.
• Do not wrap it in a tissue or let it dry out; a dry root lowers the chance of survival.
• Go to a dentist immediately.

What if it is a baby tooth?

A knocked-out baby tooth should not be put back, as this can damage the permanent tooth developing underneath. Press on the bleeding area with clean gauze and see a dentist to check for any other injury to the mouth or nearby teeth.

Do not keep the tooth inside a young child's mouth, as they could swallow it or choke.

A broken or cracked tooth

If part of a tooth breaks off, keep the fragment in milk or water, as the dentist can sometimes bond it back. Rinse your mouth with warm water, use a cold compress on the cheek if there is swelling, and avoid chewing on that side.

If you see a pink or red dot in the middle of the break, or the pain is severe, the nerve may be exposed and you need an urgent same-day visit. A small chip on the edge needs an appointment within a few days.

Severe toothache

Severe, constant pain, especially if it throbs or wakes you at night, usually points to nerve inflammation or an abscess, and painkillers alone will not fix it. Until you reach a dentist you can:

• Rinse with warm water and floss gently to remove any trapped food.
• Take an over-the-counter painkiller such as paracetamol or ibuprofen as directed on the pack, and ask a pharmacist if you are pregnant or have a long-term condition.
• Never place an aspirin or any painkiller directly on the gum, as it causes a burn.
• Do not take antibiotics on your own; they need a doctor's prescription and do not replace treating the cause.

A lost filling or crown

A lost filling or crown is usually not a serious emergency, but it needs a prompt appointment so the tooth does not break or decay. Keep the crown in a clean container and bring it with you, avoid chewing on that side, and keep the area gently clean.

Pharmacies may sell temporary dental filling material or cement that can be used for a short time. Never use household glue to stick a crown back on.

When should you go straight to hospital emergency?

Facial swelling from a dental abscess can spread, and some injuries go beyond the teeth. Go to the nearest emergency department or call the Saudi Red Crescent on 997 if you have:

• Facial swelling spreading to the eye, neck or under the jaw.
• Difficulty breathing or swallowing, or being unable to open your mouth.
• A high fever with swelling and feeling generally unwell.
• Bleeding that does not stop after 15 to 20 minutes of steady pressure.
• A head injury with fainting, vomiting or dizziness, or a suspected broken jaw.