The short version
- A knocked-out tooth: hold it by the crown, keep it in milk or saliva, and come within the hour.
- Facial or neck swelling with fever or difficulty breathing is an emergency — go immediately.
- Never hold aspirin against the gum; it burns the tissue.
In a dental emergency, what you do in the first hour frequently determines the outcome. This is worth reading before you need it, because nobody researches calmly while holding a tooth.
A knocked-out permanent tooth
This is the one true race against the clock. A tooth replanted within an hour has a good chance of surviving; after a few hours, the odds drop sharply.
Find the tooth and pick it up by the crown — the white chewing part — never the root. The root surface carries delicate cells that must stay alive for the tooth to reattach, and wiping them away is what usually loses the tooth.
Do not scrub it, do not use soap or antiseptic, and do not store it in plain water, which destroys those cells. If it is visibly dirty, rinse briefly in milk or saline. The best storage is milk; the patient’s own saliva works too. If the patient is calm and old enough, the tooth can be gently repositioned in its socket and held in place while travelling.
Then get to a clinic immediately, calling on the way. One important exception: do not replant a knocked-out baby tooth, as it can damage the developing permanent tooth underneath.
Facial or neck swelling
This is the emergency people underestimate most. An infection that starts in a tooth can spread into the tissue spaces of the face and neck, and in the wrong direction it threatens the airway.
Treat it as urgent if swelling is spreading quickly, sits under the jaw or in the neck, comes with fever, or makes swallowing difficult. If there is any difficulty breathing, go to a hospital emergency department immediately rather than a dental clinic.
Antibiotics alone rarely solve this. The source usually has to be drained and the responsible tooth treated.
A broken or chipped tooth
Rinse gently with warm water and save any fragments in milk or saline — a clean break can sometimes be bonded back. Apply a cold compress to the outside of the cheek and avoid chewing on that side.
If you can see a pink or red dot in the middle of the break, the nerve is exposed. That needs same-day attention.
Bleeding after an extraction
Some ooze for a few hours is normal. Roll clean gauze or a cotton handkerchief into a firm pad, place it over the socket and bite down steadily for a full twenty minutes without lifting it to check — repeatedly checking is the commonest reason bleeding continues, because it breaks the clot each time.
Stay upright, avoid rinsing, spitting, smoking, straws and hot drinks for the rest of the day. Call the clinic if heavy bleeding continues past thirty minutes of firm pressure.
Severe toothache
Take your usual painkiller at the normal dose and rinse with warm salt water. Sleeping propped up slightly often helps, since lying flat increases pressure in the tooth.
Never hold an aspirin against the gum. It does not work that way and it chemically burns the tissue — we still see the ulcers it causes.
The one habit worth having
Save the clinic number in your phone now, before anything happens. In an emergency, call first rather than simply arriving; being told what to do on the way is often the part that saves the tooth.
Worried about any of this?
An article cannot examine your mouth. Call and describe the problem — we will tell you honestly whether you need to be seen urgently or whether it can wait.
