Dental emergencies never happen at a convenient time. A cracked molar at dinner, a child's tooth knocked out on the playground, a toothache that keeps you awake all night. In more than 30 years of practice in Northeast Philadelphia, we have seen again and again that what you do in the first hour often decides whether a tooth can be saved.

This guide walks you through what counts as a dental emergency, how to tell how urgent your problem is, step-by-step first aid for the most common emergencies, and when to go to a dentist instead of the ER. Bookmark it now so you have it when you need it. For care at our office, visit our emergency dentist page.

What counts as a dental emergency?

A dental emergency is any problem with your teeth, gums or jaw that involves bleeding, severe pain, visible swelling or trauma. Temple University's Kornberg School of Dentistry uses the same definition for its urgent and emergency care clinic.

Some problems need care within minutes. Others can safely wait a day or two. The key questions to ask yourself are:

• Is a tooth knocked out or pushed out of place?
• Is there swelling in your face, jaw or gums?
• Is the pain severe, constant or waking you up at night?
• Is there bleeding that will not slow down?
• Do you have a fever or feel generally unwell along with tooth pain?

If you answered yes to any of these, call a dentist today.

How urgent is it? A quick guide

This urgency approach is similar to Penn Dental Medicine's emergency guide. It is a guide, not a diagnosis. When in doubt, call.

What causes most dental emergencies?

Many "sudden" dental emergencies have been building quietly for months. The most common causes we see are:

• Untreated cavities that reach the nerve and cause infection or an abscess
• Cracked teeth from chewing ice, hard candy, popcorn kernels or nuts
• Teeth grinding or clenching at night, which weakens enamel and old fillings
• Old or large fillings that finally break or fall out
• Sports and falls, especially in children and teens without a mouthguard
• Gum disease, which can lead to loose teeth and painful gum infections
• Impacted wisdom teeth pushing against other teeth or becoming infected

Knowing the cause helps us fix the real problem, not just the symptom.

First aid for common dental emergencies

1. Knocked-out adult tooth

This is the most time-sensitive dental emergency. The American Association of Endodontists advises seeing a dentist within 30 minutes for the best chance of saving the tooth.

1. Pick the tooth up by the crown (the chewing part). Never touch the root.
2. If it is dirty, rinse it gently with water for a few seconds. Do not scrub it, use soap, or dry it.
3. Try to place it back in the socket, facing the right way, and bite gently on a clean cloth to hold it.
4. If it will not go back in, keep it moist in milk, in your mouth between your cheek and gum, or in a tooth-preservation kit. Do not store it in tap water or wrap it in a tissue.
5. Call us right away and come straight in.

2. Tooth pushed out of place (loosened)

If a tooth has been knocked loose or pushed in, out or sideways, gently press it back toward its normal position with light finger pressure only. Do not force it. Bite down softly to keep it steady and call us the same day.

3. Chipped, broken or cracked tooth

Rinse your mouth with warm water and apply a cold compress to your cheek to reduce swelling, as the ADA recommends. Save any pieces in milk and bring them with you. Avoid chewing on that side. A small chip can often be bonded in one visit; a deeper break may need a dental crown. Read more in our guide on what to do if you chip your tooth.

4. Severe toothache

Rinse with warm water and gently floss around the tooth to remove any trapped food. Take an over-the-counter pain reliever as directed on the label. Do not put aspirin directly on the tooth or gum; the ADA warns it can burn the tissue. A cold compress on the outside of the cheek can help; avoid heat, which can make an infection worse.

A toothache that throbs, lingers after hot or cold, or wakes you at night often means the nerve is inflamed or infected. Learn the warning signs in do I need a root canal? and how root canal treatment can save the tooth.

5. Dental abscess or swelling

A pimple-like bump on the gum, a bad taste, swollen gums or face, or a fever can signal an abscess. This is a bacterial infection, and it will not heal on its own. Rinse gently with warm salt water and call us the same day. If swelling spreads to your eye, neck or under your tongue, or you have trouble breathing or swallowing, go to the ER immediately.

6. Lost filling or crown

Keep the crown and bring it with you; it can often be cleaned and re-cemented. Until your visit, avoid chewing on that side. A small piece of sugar-free gum or temporary dental cement from a pharmacy can cover a sensitive spot. Never use household glue.

7. Bitten lip, tongue or cheek

Gently clean the area with water and apply firm pressure with clean gauze or a cloth for 10–15 minutes. A cold compress helps with swelling. If bleeding does not slow, go to the ER.

8. Something stuck between your teeth

Try to remove it gently with dental floss. Never use a pin, toothpick, knife or other sharp object, which can cut the gums or scratch the tooth.

9. Broken or cracked denture

Do not try to glue it yourself. Household glues can be toxic and can warp the denture so it never fits again. Bring all the pieces to us. See what to do if you damage your dentures.

10. Wisdom tooth pain

Swelling, pain or a bad taste at the very back of the jaw can mean a wisdom tooth is infected or pushing against its neighbor. Rinse with warm salt water and call us. Learn more about wisdom teeth extraction.

Dental emergencies in children

Children's teeth get bumped, chipped and knocked out often, especially during sports and play. A few rules are different for kids:

• Never put a knocked-out baby tooth back in. It can damage the adult tooth developing underneath. Bring your child and the tooth to the dentist.
• A knocked-out adult tooth in a child should be treated like an adult’s: put it back or keep it in milk, and come in right away.
• Any blow to the face that causes a chipped or loose tooth should be checked, even if your child says it does not hurt.
• Toothaches in children are often caused by cavities and should not wait.

Our team sees children of all ages as a kid-friendly dentist, and we take extra time to keep young patients calm.

Emergency dentist or hospital ER: where should you go?

Many people head to the ER for tooth pain, but most hospital emergency rooms do not have a dentist on staff. They can manage pain and treat infection with medication, but they usually cannot repair a broken tooth, perform a root canal or save a knocked-out tooth. That often means a second visit, to a dentist, for the actual fix.

If you are not sure, call us. We will help you decide where to go.

What happens at your emergency dental visit

Knowing what to expect can make an emergency visit less stressful:

1. Your phone call: tell us what happened, when it happened, where it hurts and how bad the pain is. This helps us prepare and prioritize your care.
2. Exam and X-rays: we look at the tooth, gums and surrounding bone to find the real cause, not just the symptom.
3. Pain relief first: our first goal is to get you comfortable. The area is numbed before any treatment.
4. A clear plan: we explain what we found, your options and what each involves before we begin anything.
5. Treatment: depending on the problem, this may be smoothing or bonding a chip, re-cementing a crown, draining an abscess, starting a root canal, or an extraction when the tooth cannot be saved.
6. Follow-up: some repairs, such as a permanent crown, are completed at a second visit once the emergency is under control.

If a tooth cannot be saved, we will talk you through options for replacing missing teeth, including dental implants, bridges and dentures. We use modern techniques such as laser dentistry for some gum treatments, which can mean less bleeding and faster healing.

Caring for your mouth after emergency treatment

• Take any prescribed antibiotics until they are finished, even if you feel better.
• Use pain relievers as directed and keep a cold compress handy for the first day.
• Eat soft foods and chew on the other side until we say otherwise.
• Keep the area clean with gentle brushing and warm salt-water rinses.
• Avoid smoking, which slows healing.
• Call us if pain or swelling gets worse instead of better after two or three days.

Insurance and payment

We accept all major PPO insurance plans and work with each patient to find a way to get the care they need, with or without insurance. Payment options include CareCredit and Cherry payment plans, cash, check, major credit cards, Apple Pay, Venmo and Zelle. Visit our patient information page or call to confirm your coverage.

How to prevent dental emergencies

Most emergencies can be prevented with a few simple habits:

• Wear a mouthguard for contact sports, cycling and skateboarding.
• Wear a night guard if you grind or clench your teeth.
• Don’t chew ice, hard candy or popcorn kernels, and never use your teeth to open packages or bottles.
• Fix small problems early. A small cavity or a sensitive tooth today can become an abscess next month.
• Keep up with checkups. Regular dental checkups and preventive dental care catch weak fillings, cracks and decay before they turn into emergencies.
• Brush and floss daily. Our guide to oral hygiene basics covers what really matters.
• Watch your gums. Bleeding or receding gums are early warning signs. Read why gums bleed.

Frequently asked questions