Dental Emergency First Aid Guide

Dental emergencies are common, often unexpected, and frequently frightening. The first few minutes of your response can significantly affect the outcome -- especially for traumatic injuries. This guide walks through the most common dental emergencies and what to do before you reach our office. Keep it accessible -- post it on your refrigerator, save it to your phone, or print it and keep it with your medical records.

Knocked-Out Permanent Tooth (Avulsion)

• Pick up the tooth by the crown -- never by the root. The root surface contains periodontal ligament cells that are essential for reimplantation success. Touching, scrubbing, or drying the root destroys these cells. Handle the tooth by the white crown portion only.
• If the tooth is dirty, rinse it gently with milk or your own saliva -- not water, not soap, not antiseptic. A brief, gentle rinse only. Do not scrub.
• Attempt to replant the tooth immediately if you can. Hold it by the crown and push it firmly but gently back into the socket in the correct orientation. Bite down on a cloth or gauze to hold it in place. If you can replant the tooth within 5 minutes, the chance of successful long-term retention is excellent.
• If you cannot replant it, store it in milk. Milk is the ideal transport medium -- it preserves the ligament cells on the root surface. If milk is not available, keep the tooth moist in your own saliva (tuck it between your cheek and gum). Do not let the root dry out. Do not put it in water -- water is not an acceptable storage medium.
• Call us and come immediately. Reimplantation within 30 minutes gives the best outcome. After 60 minutes outside the mouth, long-term success drops significantly. Call (480) 530-3663 on your way -- we will meet you as quickly as possible.
• Important: this applies to permanent teeth only. Do not attempt to replant a baby (primary) tooth -- this can damage the developing permanent tooth underneath. Call us for guidance.

Broken or Chipped Tooth

• Rinse your mouth gently with warm water. If there is bleeding from the gum tissue, apply gentle pressure with a clean cloth or gauze.
• Save any large fragments in a small container with water or milk, and bring them to your appointment. In some cases, a large fragment can be bonded back.
• Cover sharp edges with dental wax (available at pharmacies) to protect your tongue and cheek from cuts. Sugarless chewing gum can also temporarily smooth a rough edge in a pinch.
• Avoid temperature extremes -- very hot or very cold food and beverages may cause intense sensitivity if the inner pulp is exposed.
• Call our office and schedule within 24 to 48 hours. A broken tooth without pain or sensitivity can generally wait until the next business day. A broken tooth with exposed nerve, severe pain, or loose fragments needs same-day evaluation.

Lost Crown or Bridge

• Keep the crown -- do not throw it away. Bring it to your appointment. In many cases, the crown can be re-cemented if it is undamaged.
• Inspect the crown and the prepared tooth. If the tooth underneath is fractured or significantly decayed, the crown may not be salvageable. Do not try to force a damaged crown back onto a damaged tooth.
• If the prepared tooth is painful or sensitive, you can apply a small amount of clove oil (eugenol) to the exposed tooth surface using a cotton swab for temporary relief. Clove oil is available at pharmacies and has a mild numbing effect. Do not apply it to your gum tissue.
• Temporary dental cement (Dentemp or similar, available at pharmacies) can be used to seat the crown temporarily while you wait for your appointment. Clean any old cement from inside the crown and the tooth surface, dry both, apply a small amount of temporary cement inside the crown, and press it firmly onto the tooth. Bite gently to seat it. This is a bridge to your appointment -- not a permanent fix.
• Call us within 24 hours. An unprotected prepared tooth can shift, become sensitive, or fracture. Do not leave it unprotected for more than a day or two.

Dental Abscess

• A dental abscess is a bacterial infection that can spread beyond the mouth. It requires professional treatment -- antibiotics alone, without addressing the source, provide only temporary control. Do not delay seeing a dentist.
• Signs of abscess: throbbing or persistent toothache; swelling of the gum, cheek, or jaw; a pimple-like bump on the gum near a tooth; bad taste or pus in the mouth; fever; or a tooth that is extremely tender to even the lightest touch.
• Call 9-1-1 or go to an emergency room immediately if you have swelling that affects your ability to open your mouth, swallow, or breathe. A dental abscess can spread to the airway (Ludwig's angina) -- this is a life-threatening condition that requires emergency medical care, not a dental office.
• For abscesses without spreading symptoms, call our office first thing in the morning. We prioritize patients in pain. While waiting, ibuprofen and acetaminophen together (not simultaneously) provide better pain control than either alone. Rinsing with warm salt water can provide mild relief.
• Do not lance or pop the abscess yourself. Releasing a dental abscess without proper drainage setup spreads the infection into the surrounding tissue. This is one situation where attempting to help can make things significantly worse.

Severe Toothache

• Rinse with warm salt water to clear debris from around the tooth. Use dental floss to gently remove any food that may be wedged in the gum -- this is occasionally all that is causing the pain.
• Do not put aspirin directly on the tooth or gum. This is a persistent myth -- applying aspirin to a tooth does not relieve dental pain and can cause chemical burns to the gum tissue.
• Over-the-counter pain relief: Ibuprofen 400 to 600 mg and acetaminophen 500 mg taken at alternating intervals provide the best coverage for dental pain. Benzocaine gels (Orajel) provide short-term topical relief.
• Call our office promptly. Severe or persistent toothache is almost always a sign of an underlying problem -- decay reaching the nerve, a cracked tooth, or early infection -- that requires professional diagnosis and treatment. Pain medication manages the symptom but not the cause.

Soft Tissue Injuries (Lips, Cheeks, Tongue)

• Control bleeding with clean gauze or cloth and firm pressure held for 10 to 15 minutes. Soft tissue in the mouth heals remarkably quickly due to its rich blood supply -- most minor cuts stop bleeding within 15 minutes.
• Apply ice or a cold compress to the outside of the cheek or lip to reduce swelling.
• Seek emergency room care for: lacerations that are deep, gaping, or will not stop bleeding after 15 to 20 minutes of pressure; injuries from significant force (car accident, fall from height); any injury that also involved the neck or head.
• Small lacerations inside the mouth often do not require sutures and heal on their own. Rinse with warm salt water several times daily to keep the area clean. Follow up with our office if healing seems slow or the area looks infected after 48 hours.

In any dental emergency during office hours, call Smile Science Dental Spa at (480) 530-3663. We prioritize same-day or next-day evaluation for patients in pain. 20118 N 67th Ave Ste 308, Glendale, AZ 85308.