When to Visit the Dentist (cont.)

View Cosmetic Dentistry: Before and After Slideshow Pictures

Medical Author:

Scott D Fell, DO, FAAEM

Coauthor:

Christina L Kukula, DO

Medical Editor:

Joseph A Salomone III, MD

Medical Editor:

Francisco Talavera, PharmD, PhD

Medical Editor:

Steven L Bernstein, MD

Urgent Dental Problems

Traumatic: The following problems require urgent attention by a dentist or a hospital’s Emergency Department:
- Tooth knocked out
  - Any permanent tooth loss requires urgent evaluation because these teeth may be re-implanted.
  - If you recover a lost tooth, touch or hold it by the crown (chewing edge) and not the root.
  - If the tooth has become dirty, gently rinse it in tap water, but do not scrub it.
  - You should keep the tooth moist. The best way to do this is to place it back in the socket or the location from where it was knocked out.
  - Another option is to place it between your cheek and gum and continue to keep it moistened with saliva.
  - A third option is to place the lost tooth in milk.
- Broken or chipped tooth
  - You should arrange to see your dentist as soon as possible.
  - The chipped or broken piece should be placed in a cool moist cloth.
  - Chips or breaks can vary in degree. The extent of the chipping will determine how your dentist will treat it.
- Tooth knocked out of position or alignment (subluxation)
  - Try to push the tooth or teeth back into their proper position with very light pressure. Do not force it.
  - Bite down on the tooth to keep it in position and then seek immediate dental care.
  - Your dentist may splint the tooth so it can heal.
- Lacerations
  - Cuts or lacerations to your cheeks, gums, or tongue can occur as a result of direct trauma to the mouth area, such as a blow or falling and biting your tongue or cheek.
  - Any cut requires immediate medical attention in the emergency department or by your dentist.
  - Applying direct pressure to the cut can help control bleeding.
  - Some lacerations inside the mouth may be stitched. Others may be allowed to heal on their own. Some of these injuries will also be treated with antibiotics.
Nontraumatic tooth problems
- Toothache or tooth pain: You may have a cavity or dental abscess (pocket of infection) in or around a tooth. You should have the tooth evaluated by a dentist or the emergency department if any of the following occur:
  - The pain is severe. (Pain related to a cavity worsens with exposure to heat or cold or with pressure on the tooth such as chewing.)
  - You have a fever.
  - The gum around the painful tooth swells significantly.
  - Pus or other fluid drains from around the painful area.
  - Swelling occurs in your cheek, chin, face, or neck. (Never place an aspirin or any other pain medication against the gums near the affected tooth because it may burn the gum.)
  - Your gum, cheek, or face surrounding the involved tooth exhibits redness.
  - You have any uncertainty regarding the cause of the pain.
- Gum swelling or redness
  - Redness or swelling over a large area of the gums or skin inside your mouth requires evaluation by your dentist. Redness may suggest gingivitis, a dental abscess or infection, or other dental or gum disease.
  - This rarely requires urgent care, but you should see your dentist as soon as an appointment can be arranged.
- Jaw pain
  - Pain in your jaw, called temporomandibular joint syndrome, can occur because of inflammation or degeneration of the joint.
  - This can be identified as pain near your ear or a clicking or popping sensation when your jaw opens or closes. (The popping may or may not be painful.)
  - Your dentist may fit you for a mouth guard or treat you with anti-inflammatory medications. This is not an emergency and does not require urgent evaluation. More severe cases, however, do require advanced treatment.