What to do in a dental emergency — a calm 5-minute guide

If you’re reading this because something has just happened to your mouth, take a breath. Most dental emergencies look frightening for the first ten minutes and then settle into something quite fixable. The single most useful thing you can do in the next sixty seconds is call us on 020 3971 2000 — but if you’ve a moment first, here’s exactly what to do and what not to do for the most common situations.

This is general advice from the team at Campos Dental in Edgware. It does not replace clinical advice from someone who’s seen your mouth. If you’re in doubt, call us or NHS 111.

What counts as a “dental emergency”?

Not every problem needs a same-day appointment. A small chip you can’t feel with your tongue, a slightly loose crown that came out cleanly, a filling that fell out but isn’t sore — these can wait until the next routine appointment.

A genuine same-day situation is one of:

• Severe or throbbing toothache that’s keeping you awake or unresponsive to painkillers.
• A knocked-out tooth (the proper term is “avulsed”). The first sixty minutes matter enormously here.
• A broken or fractured tooth, especially if a nerve is exposed or the fragment is sharp.
• Lost crown, filling, bridge or veneer where the underlying tooth is now exposed and painful.
• An abscess — a small bubble on the gum, a foul taste in the mouth, facial swelling.
• Persistent bleeding from an extraction site, a bitten lip or a soft-tissue injury that won’t settle with pressure.

If any of those describe what’s happening, call us first thing in the morning (or right now if we’re open) and we’ll do our best to fit you in the same day.

The first hour

1. Call us before you do anything else

The earlier you call, the earlier we can get you in. We keep emergency slots back from the diary specifically so we can see same-day patients — but those slots fill quickly on Monday mornings. 020 3971 2000. Whoever picks up will triage you, talk you through what to do next, and book the appointment.

If you genuinely can’t talk on the phone — anxiety, a deeply bleeding mouth, a young child you’re trying to keep calm — the contact form gets us the same message and we’ll ring you back.

2. Take painkillers (sensibly)

Paracetamol or ibuprofen, following the dose on the packet, is the right choice for most dental pain. Don’t put aspirin or any painkiller directly on the tooth or gum — it’ll burn the soft tissue. Avoid aspirin entirely if there’s any active bleeding (it thins the blood).

A cold pack against the cheek for 15 minutes at a time can help with swelling.

3. Don’t poke at it

It’s hard to resist, but please leave the area alone. Don’t probe a hole where a filling used to be, don’t try to put a knocked-out tooth back in the wrong way round, don’t pick at a clot in an extraction socket.

Specific situations

Knocked-out tooth (avulsion)

This is the one with the most urgency — the chance of saving the tooth drops sharply after about an hour.

1. Find the tooth. Pick it up by the crown (the white part you bite with). Never touch the root.
2. Rinse it briefly in milk if you have it, sterile saline, or your own saliva. Avoid tap water — it’s hypotonic and damages the delicate cells on the root surface that the tooth needs to reattach to the bone. Don’t scrub it either.
3. Try to slot it back into the socket the right way round. The tooth keeps the socket open and the cells alive. Bite gently on a clean cloth to hold it in place.
4. If you can’t get it back in, put it in a small container of milk and bring it with you. Not water. Not tissue.
5. Call us immediately and get to the practice as fast as is safe.

Adult teeth can sometimes be re-implanted hours later, but the odds are best within the first 30–60 minutes.

Severe toothache

If it’s keeping you awake, throbbing, or unresponsive to painkillers, it’s likely an infection — either a deep cavity reaching the nerve, or an abscess. Either way, it needs us to see it; antibiotics from elsewhere will sometimes settle the symptoms but won’t fix the underlying cause.

In the meantime: paracetamol or ibuprofen at the packet dose, avoid very hot or very cold food, sleep with your head slightly elevated. A salt-water rinse (a teaspoon of salt in a glass of warm water) can take the edge off.

Broken or chipped tooth

Save the fragment if you can — sometimes we can bond it back. Put it in a clean container.

If the broken edge is sharp, you can cover it temporarily with sugar-free chewing gum or a small piece of dental wax (from any pharmacy) until you can see us. Avoid biting on that side.

Lost crown, filling or bridge

A crown that came out cleanly with the post intact can often be cleaned and re-cemented — bring it with you in a small container. A filling that’s fallen out leaves the underlying tooth weakened, so try to keep that area clean and avoid chewing on it until you can see us.

Dental-wax temporary fillings are available from most pharmacies — they’re not a long-term answer but they’ll cover the exposed dentine for a day or two.

Abscess or swelling

A localised “spot” on the gum, a foul taste, or mild facial swelling: that’s a same-day call to us. Severe, rapidly spreading swelling — particularly anything affecting your eye, your jaw line moving down the neck, or making swallowing or breathing difficult — is an A&E situation. Call 999 or go straight to the nearest hospital. Spreading facial infection is rare but it can be dangerous.

Bleeding that won’t stop

After an extraction, some bleeding is normal for the first hour or two. Bite firmly on a clean piece of gauze (or a tea bag — the tannins help) for 20 minutes without checking. Repeat if needed.

If bleeding hasn’t settled after an hour of consistent pressure, call us.

What it costs

Our same-day emergency appointment is £90. That covers:

• A focused examination of the area
• X-rays where they’re clinically needed
• Diagnosis and explanation of what’s going on
• Pain relief, antibiotics where appropriate, or a temporary fix to get you through

Any definitive treatment that follows (a filling, a root canal, an extraction, a new crown) is charged separately at our standard fees. We’ll always tell you the cost before doing anything beyond the emergency appointment.

If the bill is bigger than you can manage in one go, Chrysalis Finance lets you spread anything from £350 to £25,000 over up to 12 months at 0% APR (subject to status). You can sort that out in the same visit.

The £90 covers any same-day appointment during our normal opening hours — Monday to Friday 9 to 5:30 (closed 1–2 pm for lunch), Saturday by appointment. Out-of-hours emergency call-outs (evenings, Sundays and bank holidays) are £300 plus the cost of any treatment, reflecting the on-call clinician time.

When we’re closed

If we’re shut and you can’t wait until the morning:

• Call us first on 020 3971 2000. Even when the practice is closed, the voicemail gives you a direct out-of-hours number for urgent dental issues — usually faster than 111 for anything that’s actually a dental problem.
• If you can’t reach us, or you’d rather — call NHS 111. They’ll direct you to the nearest out-of-hours dental service.
• For uncontrolled bleeding, breathing or swallowing difficulty, rapidly spreading facial swelling, or major trauma — call 999 or go to A&E. These are rare but they are 999 situations, not 111 situations.

A word for anxious patients

If you’re reading this with a racing pulse because the dentist makes you anxious before anything has even happened — we know. A lot of our patients tell us the same thing. Calling us first is fine. Coming in with a friend or family member is fine. Telling us at the door that you’re terrified is fine. We will not rush you. We will explain everything before we do anything.

If you’d like a friend or relative to ring on your behalf, that works too.

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Whatever’s happened, you don’t have to figure it out alone. 020 3971 2000. We’ll take it from there.

— Dr Jacqueline Jacobs