Routine appointments with your usual dentist can take days if not weeks to organise. If you have a dental emergency you will need help much more quickly but deciding exactly what constitutes a dental emergency can be difficult.
Most dentists will provide advice if you call in or phone them during working hours to tell them you have an urgent problem, or will have an answer phone message to let you know what to do in the case of a dental emergency. If you need emergency dental care with a 24-hour dentist, this message should tell you how to contact them, or you can phone your Primary Care Trust helpline, or NHS Direct.
What kind of injury is classed as a dental emergency?
If you have been in an accident and have had any sort of head injury, it is best to go to your nearest accident and emergency department. A traffic accident, falling of a bike, falling down stairs, or sustaining a sports injury can all cause an impact that breaks or loosens teeth, but your most serious injury could be concussion. You may need urgent assessment and observation to make sure that the accident has not caused any bleeding within your brain.
If you have no signs of a head injury, but you have experience one or more of the following, your dental emergency definitely warrants a visit to an out-of-hours dentist:
An avulsed tooth, or avulsed teeth. Avulsed means knocked out completely. If this happens you are likely to be in a lot of pain, and your mouth will be bleeding. You need to retrieve your tooth or teeth, or get someone nearby to help with that, and then get help from a 24-hour emergency dentist within the next hour. Prompt action can mean the difference between saving your teeth, and losing them permanently.
An extruded tooth. This is a similar type of injury, usually caused by impact, but the tooth has not actually come out. It might have been knocked away from its usual position, or it might be hanging in by thin threads of tissue. After pushing the tooth back into position if you can, you need to see an emergency dentist as soon as possible, particularly if you are in a ‘hanging by the thread’ situation.
A broken tooth. If the end of the tooth has broken away, but there is no bleeding, this is less of a dental emergency. It may be possible to wait until the next day to see an emergency dentist in working hours. If the broken tooth has also been knocked out of position, and the broken edge is sharp, this is a dental emergency that needs to be seen immediately because of the danger of your tongue or lips being damaged by the rough edge.
Damage to your teeth that causes severe pain. If you have been involved in an accident and have had a blow to your mouth or jaw, and you have severe pain in your teeth, there may be serious damage even though no teeth are obviously missing or broken. You will need an X-ray or other investigation to find out if you need treatment. Most dentists agree that severe pain after trauma always qualifies as a dental emergency.
Severe dental bleeding. Any damage to the teeth that causes significant bleeding, particularly blood loss that does not stop within a few minutes, is a dental emergency.
What if I have a post-treatment dental emergency?
If you develop severe pain, swelling, or bleeding develop within a couple of days of having a tooth extraction or other dental procedure, this is a dental emergency. You will need to see an emergency dentist for an urgent assessment to find out what problem has developed, and emergency dental treatment to prevent tooth loss and avoid infection.
Is a tooth abscess a dental emergency?
Tooth abscesses do not generally develop very suddenly, but it is possible for a nagging toothache to develop into a serious swelling with severe pain between close of business on a Friday and lunchtime on a Bank Holiday Monday. If you have a serious dental infection that is giving you severe pain and flu-like symptoms, this is a dental emergency. If the swelling is making it difficult for you to breathe or swallow you need to go to A&E urgently.
Is it a dental emergency when I lose a crown or a filling?
This is probably not a dental emergency that warrants a visit to an emergency dentist at 2am. However, you do need to see a dentist at the next available opportunity as a tooth that has lost a filling or a crown is in danger of being damaged every time you eat. It may even start to break up spontaneously. Most dentists have capacity in their timetable for this type of dental emergency, but you may face a wait.
If you lose a crown on a tooth on which you have not had root canal treatment, this can expose the nerve, causing significant pain. This may prevent you from eating, so it is important to see an emergency dentist to have a temporary repair until you can have it fixed properly by your own dentist.
What doesn’t count as a dental emergency?
It may seem serious to you at the time, but none of the following problems are a true dental emergency. They are best treated using self-help until you can get an appointment with your usual dentist:
Toothache: this can be severe, but if there is no injury, bleeding, or obvious serious infection, a bout of toothache is not a dental emergency
Losing a veneer: this is never classed as a dental emergency.
A gum abscess or gum boil: these can develop quickly and grow quite large in a small time, suggesting a dental emergency, but they are rarely as painful as a tooth abscess, and tend to go down within a couple of days.
Breaking your braces: This is occasionally a dental emergency if your mouth becomes damaged, but broken braces can usually be repaired temporarily or left off for a short time while you can make an appointment with your usual dentist.
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