Stradbroke Dental

Dental Emergency at 2am? Here's Exactly What to Do

Save this page. When something goes wrong with a tooth at the worst possible time, the right first move in the first hour can make all the difference. Dental emergencies have terrible timing. They happen at sports on the weekend, at 2am, on the first day of a long weekend. Never during business hours with your dentist around the corner. This is the page to keep bookmarked for exactly those moments. Work out which situation you're in, follow the steps, and call for help.

A knocked-out adult tooth. The clock really matters

If a permanent (adult) tooth gets completely knocked out, you have a real but short window to save it. Teeth re-implanted within about 30 minutes to an hour have the best chance of surviving, so move quickly and calmly:

  1. Pick the tooth up by the crown, the white chewing part, and never by the root. The root surface has delicate living cells that you don't want to damage.
  2. Don't scrub it. If it's dirty, rinse it gently with milk or saline for a few seconds. Don't use soap, don't scrub, and don't dry it or wrap it in tissue.
  3. Try to put it back in the socket. Gently push it into place holding the crown, line it up with the neighbouring teeth, and bite softly on a clean cloth to hold it. This is the best possible place to store it.
  4. If you can't reinsert it, keep it moist in milk. Milk is the best storage option you'll have at home. Tucking it inside the cheek (for an adult who won't swallow it) or a saline solution also works. Do not store it in plain water. Water damages the root cells.
  5. Get to a dentist immediately, ideally within 30 minutes. Bring the tooth.

Important: do NOT try to reinsert a baby tooth. Pushing a knocked-out baby tooth back in can damage the adult tooth developing underneath. Keep your child calm, control any bleeding, and see a dentist, but leave the baby tooth out.

A cracked or broken tooth

Rinse your mouth with warm water to clean the area. If there's bleeding, press gently with clean gauze. Use a cold compress on the outside of the cheek to ease swelling, and if you find the broken piece, keep it (in milk) and bring it. Avoid chewing on that side. A cracked tooth doesn't always hurt straight away, but it should be seen promptly before the crack spreads.

Severe toothache or a suspected abscess

For a bad toothache, rinse with warm salty water and use over-the-counter pain relief as directed on the packet. A cold compress on the outside of the face can help. If you notice swelling, a gum "pimple," fever or a foul taste, that points to infection (an abscess) and needs to be seen. Antibiotics from the bathroom cabinet are not a fix. Don't hold an aspirin against the gum; it can burn the tissue.

A lost filling or crown

Usually uncomfortable rather than a true emergency. Keep the crown if you have it and bring it in. It can often be re-cemented. Keep the area clean, avoid chewing on that side, and you can cover a sharp edge temporarily with dental wax from the chemist. See your dentist in the next day or two.

When it's more than a dental problem. Go to hospital or call 000

Most dental emergencies are not life-threatening. But a dental infection occasionally spreads, and there are red flags that mean you stop reading and seek urgent medical help:

  • Facial or neck swelling that makes it hard to breathe or swallow.
  • Swelling spreading towards the eye, or that's getting rapidly worse, with fever.
  • Uncontrolled bleeding after trauma, or a head injury alongside the dental injury.

In those situations, call 000 or go to a hospital emergency department. Don't wait for morning, and don't drive yourself if you're struggling to breathe.

Who to call after hours in Melbourne

If you're not sure how urgent it is, these are the numbers worth saving:

  • healthdirect, 1800 022 222. A free 24-hour health advice line staffed by registered nurses, anywhere in Australia. A good first call when you're unsure.
  • Royal Dental Hospital of Melbourne (720 Swanston Street, Carlton) runs an emergency dental service, including weekends and public holidays. Call ahead, as they triage by urgency.
  • Dental Health Services Victoria. (03) 9341 1000 (metro Melbourne) or 1800 833 039 (outside metro) for public dental enquiries.
  • 000 for anything life-threatening, as above.

The best emergency is the one that doesn't happen

A mouthguard for sport prevents a huge share of knocked-out teeth, and keeping up with check-ups stops the slow-burn problems from erupting at the worst moment. But accidents happen to everyone. If you've had a dental emergency, get in to see us as soon as you can after the first aid above, even if you've managed the immediate crisis, the tooth still needs proper assessment. You can reach us at stradbrokedental.com.au.

Sources & further reading

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