Dental emergency: what to do first

Reviewed by Dr. Samar Fadavi, DDS

Short answer: In a dental emergency, stay calm, control any bleeding with clean gauze and gentle pressure, use a cold compress for swelling and call the clinic right away. Keep a knocked-out tooth moist in milk. Go to a hospital emergency department instead if you have trouble breathing or swallowing, spreading facial swelling or a serious injury to the head or jaw.

Why the first hour matters

Dental emergencies rarely happen at a convenient time. A tooth cracks on a popcorn kernel during a movie, a child falls off a scooter on a Saturday morning, or a dull ache turns into a throbbing pain overnight. What you do in the first hour often shapes how much of the tooth can be saved and how comfortable you are while you wait for care.

This guide explains what counts as a dental emergency, what to do first for the most common problems, what to avoid, what to bring and when the hospital is the right place instead of the dental clinic. It is general information for families in Scarborough, the Danforth and East Toronto, not a diagnosis. Our emergency dentist page explains how same-day visits work at our clinic.

What counts as a dental emergency

A dental emergency is any problem with the teeth, gums or jaw that needs care the same day to relieve severe pain, stop bleeding, control infection or save a tooth. Common examples include:

• A permanent tooth knocked out of its socket.
• A tooth that is badly broken, loose or pushed out of position after a fall or blow.
• Severe toothache that does not settle with over-the-counter pain relief.
• Swelling of the gum, cheek or jaw, especially with a bad taste or fever.
• Bleeding from the mouth that does not slow down with firm pressure.
• A deep cut to the lips, tongue or cheek.
• Pain and swelling after a recent extraction that gets worse instead of better.

Problems that can usually wait a day or two

Some problems feel urgent but are not dangerous. A lost filling with little pain, a crown that came off cleanly, a small chip with no sensitivity, or a broken denture can usually wait for the next available appointment. Call anyway: the team can tell you how soon you should be seen and what to do in the meantime.

When to go to the hospital instead

Some situations need a hospital emergency department or 911 rather than a dental office. Go to the hospital if you have:

• Trouble breathing or swallowing.
• Swelling that spreads toward the eye, down the neck or under the tongue.
• A high fever with facial swelling and you feel very unwell.
• A suspected broken jaw, or you cannot close your teeth together after an injury.
• A head injury, loss of consciousness, confusion or vomiting after a fall.
• Heavy bleeding that does not slow after 20 minutes of firm pressure.

Once the urgent medical problem is under control, the teeth can be treated at the dental clinic. Bring any tooth pieces with you to the hospital as well.

First steps for any dental emergency

1. Stay calm and check the whole mouth. Look for broken pieces, loose teeth, cuts and swelling. For a child, a calm adult voice helps more than anything else.
2. Control bleeding. Fold clean gauze or a clean cloth, place it on the bleeding area and bite or press firmly for 15 to 20 minutes without lifting it to check.
3. Reduce swelling. Hold a cold compress or a bag of frozen peas wrapped in a cloth against the cheek for 10 to 15 minutes at a time, with breaks in between.
4. Save any pieces. Keep a knocked-out tooth or broken pieces moist in a small container of milk. Do not let them dry out.
5. Call the clinic. Describe what happened, when it happened and how the person feels. The team will tell you how soon to come in.
6. Manage pain safely. Over-the-counter pain medicine taken as directed on the package can help. Check with a pharmacist if you take other medicines, are pregnant or have health conditions.

What to do for the most common emergencies

A knocked-out adult tooth

Time matters most here. Pick the tooth up by the white crown, not the root. If it is dirty, rinse it very briefly in milk or with saline. Do not scrub it or wrap it in tissue. If the person is calm and alert, try to push it gently back into the socket and have them bite on gauze to hold it. If that is not possible, store it in milk and get to a dentist as quickly as you can, ideally within 30 to 60 minutes. Baby teeth are never put back in. Our guide on knocked-out or broken tooth first aid walks through each step.

A broken or chipped tooth

Rinse the mouth with warm water, save any pieces in milk and use a cold compress if the lip or cheek is swollen. If the broken edge is sharp, cover it with orthodontic wax or sugarless gum to protect the tongue. A large break, pink or red in the centre of the tooth, or pain with air and cold needs same-day care because the nerve may be exposed.

Severe toothache

Rinse with warm water and gently floss around the tooth in case food is trapped. Take over-the-counter pain medicine as directed. Sleep with your head raised on an extra pillow, which can ease throbbing. Do not place pain tablets on the gum, which can burn the tissue. Toothache with swelling, a bad taste or fever may be an infection; our guide on dental abscess signs explains what to look for.

Swelling of the face or gum

Facial swelling is a sign that infection may be spreading. Use a cold compress on the outside of the cheek, never a heat pack, and call the clinic the same day. If the swelling moves toward the eye or neck, or swallowing or breathing becomes hard, go to the hospital.

A tooth pushed out of place or loose after a blow

Do not try to wiggle the tooth to test it. If it is pushed slightly out, you can try to gently press it back to its normal position with light finger pressure. Bite softly on a clean cloth and come in the same day. Teeth that have been moved need an x-ray to check the root and bone.

Cuts to the lip, tongue or cheek

Rinse gently with water and press clean gauze against the cut. A cold compress helps with swelling. A cut that is deep, gaping or still bleeding after 20 minutes may need stitches at a hospital or urgent care centre.

A lost filling or crown

Keep the crown in a small bag or container and bring it with you. A pharmacy can sell a temporary dental cement that covers the area or holds the crown in place for a short time. Do not use household glue. Avoid chewing on that side until you are seen.

Something stuck between the teeth

Use dental floss gently, sliding it up and down. Never use a pin, knife or other sharp object, which can cut the gum or scratch the tooth. If it will not come out, call the clinic.

Problems with braces

A poking wire can be covered with orthodontic wax. A loose bracket can usually wait for the next visit. Call if a wire is cutting the cheek and wax does not help.

Bleeding or pain after an extraction

Some oozing for the first day is normal. If bleeding continues, bite firmly on gauze or a damp black tea bag for 30 minutes. Pain that gets worse two to four days after an extraction, with a bad taste or smell, may be dry socket. Our tooth extraction page explains aftercare.

What to avoid in a dental emergency

• Do not put aspirin or other tablets directly on the gum or tooth.
• Do not use heat on facial swelling.
• Do not scrub, dry or wrap a knocked-out tooth in tissue.
• Do not put a baby tooth back in the socket.
• Do not use household glue on a crown, denture or tooth.
• Do not take more pain medicine than the package allows, or mix products that contain the same ingredient.
• Do not wait for an infection to settle on its own, even if the pain eases. Pain can fade when the nerve dies while the infection keeps spreading.
• Do not drink alcohol or smoke while you wait for care; both slow healing and can mix badly with medicines.

Build a small dental first aid kit

A few items kept at home, in the car and in a sports bag make a big difference:

• Clean gauze pads and a small clean cloth.
• A small container with a lid for a tooth or broken pieces.
• Saline solution for rinsing.
• Orthodontic wax.
• Temporary dental cement from a pharmacy.
• An instant cold pack.
• Over-the-counter pain medicine suitable for each family member.
• The clinic phone number saved in every phone: (647) 350-4500.

What to tell the clinic when you call

A clear description helps the team decide how soon you need to be seen and prepare the room before you arrive. Try to share:

• What happened and exactly when it happened.
• Which tooth or area is affected.
• Whether there is swelling, fever, bleeding or a bad taste.
• Whether a tooth is knocked out, broken or loose, and where the pieces are now.
• Any medical conditions, allergies and the medicines you take, including blood thinners.
• For a child, their age and whether the tooth is a baby tooth or an adult tooth, if you know.

What to bring to an emergency visit

• Any tooth, crown or broken pieces, stored in milk or a container.
• A list of your medicines and allergies.
• Your health card and dental insurance or CDCP details, if you have them.
• Someone to drive you home if you are in a lot of pain or have taken medicine that makes you drowsy.

We accept Canadian Dental Care Plan patients and bill many insurers directly. Our CDCP dentist page explains how coverage works at the clinic.

What happens at the emergency visit

The first goal is to relieve pain and make the area stable and safe. The dentist will ask what happened, look at the area and usually take x-rays to see the root and bone. Treatment depends on the problem. It may include smoothing or bonding a broken edge, splinting a loose tooth, placing a temporary filling, draining an infection, starting a root canal, or removing a tooth that cannot be saved.

Sometimes the emergency visit is the first step and the full repair is done at a later appointment once swelling and pain have settled. The dentist will explain the options and give you a written estimate before any planned treatment.

Dental emergencies in children

Children often hurt their teeth while learning to walk, playing sports or riding bikes. Stay calm, because children read the adult around them. Check for other injuries first. For baby teeth, never try to replant a knocked-out tooth because it can damage the adult tooth growing underneath. Call the clinic so the dentist can check the area, the bite and the developing teeth. Our children’s dentistry page explains care for young patients.

Dental emergencies for older adults

For older adults, emergencies often involve a broken denture, a cracked tooth under an old filling or a loose crown. Many older adults also take blood thinners, which can make bleeding last longer. Tell the clinic about all medicines when you call. Do not try to repair a denture with glue; bring all the pieces in. Our seniors’ dental care page explains how we care for older patients.

How to lower the chance of a dental emergency

• Wear a mouthguard for hockey, basketball, soccer, martial arts and other contact sports.
• Wear a night guard if you grind or clench your teeth.
• Do not chew ice, hard candy, popcorn kernels, pens or fingernails.
• Do not use your teeth to open packages or bottles.
• Treat small cavities and cracks before they become large.
• Keep regular check-ups so problems are found early. Our family dentistry page explains routine visits.
• Childproof stairs and use car seats and seat belts correctly to prevent falls and injuries.

When to see a dentist

Call the clinic the same day if:

• A permanent tooth is knocked out, loose or pushed out of position.
• A tooth is badly broken or you can see pink or red in the centre.
• You have a toothache that keeps you awake or does not settle with pain medicine.
• You have swelling of the gum, face or jaw.
• Bleeding after an extraction does not slow with firm pressure.

Our emergency dentist page explains same-day visits, and our walk-in dentist page explains walk-in and same-day slots. You do not need to be an existing patient.

Questions about dental emergencies

Should I go to the hospital or the dentist for a toothache?

For most toothaches, the dentist is the right place because hospitals usually cannot treat the tooth itself. Go to the hospital if you have trouble breathing or swallowing, swelling spreading to the eye or neck, or a serious head or jaw injury.

Can I be seen if I am not a patient of the clinic?

Yes. Same-day emergency visits are available, and you do not need to be an existing patient.

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

As fast as possible. A tooth replanted or seen by a dentist within 30 to 60 minutes has a much better chance of healing.

What can I take for dental pain?

Over-the-counter pain medicine taken as directed on the package can help. Ask a pharmacist which product is suitable for you, especially if you take other medicines, are pregnant or have health conditions.

Is a broken tooth always an emergency?

Not always. A small chip with no pain can wait a day or two. A large break, pain, bleeding or a visible pink spot in the centre of the tooth needs same-day care.

Will an antibiotic fix a tooth infection?

Antibiotics may help control spreading infection, but they do not remove the cause. The tooth still needs treatment, such as drainage, a root canal or an extraction.

What hours can I call?

The clinic is open Monday, Wednesday, Thursday and Friday 10 am to 7 pm, Tuesday 1 pm to 5 pm and Saturday 10 am to 4 pm. Outside these hours, go to a hospital emergency department for serious symptoms.