Dental Emergency Help

Who Should You Call First?

A&E departments aren't equipped to treat teeth. There's no dental chair, and the staff usually can't repair a broken tooth or settle a toothache. For nearly every problem in the mouth, painful or not, the person you need is a dentist. Hospital comes first only when your breathing is at risk, you're losing a lot of blood, or the face or jaw itself has been hurt.

Not sure which applies to you? Phone us while we're open and tell us what happened. You'll get a straight answer on whether it's one for us, for your GP or for the hospital.

When an Adult Tooth Is Knocked Out

Time matters more here than in any other dental emergency. A tooth that goes back into its socket within roughly an hour has a genuine chance of reattaching. Leave it longer and the living cells on the surface of the root start dying off.

1. Handle the tooth only by the part you'd normally see when you smile, and keep your fingers off the root
2. If there's dirt on it, dip it in milk for a few seconds, or hold it under a cold tap if you have no milk. Never scrub or wipe it clean
3. Push it gently back into the gap, the same way round as the teeth next to it, and keep it there by biting on a folded handkerchief
4. If it won't go back, put it in a cup of milk. An adult can keep it tucked inside the cheek instead, provided there's no danger of swallowing it
5. Ring us at once, or NHS 24 on 111 when we're closed, and explain that a tooth has been knocked out

Teeth that have been knocked sideways, pushed up into the gum or left wobbly need urgent attention as well. We can guide them back into position and splint them to the teeth either side while the gum settles. Baby teeth are handled quite differently, as the section on children further down explains.

Broken Teeth and Missing Fillings

Keep any pieces you find in a clean pot or bag, since a sizeable fragment can sometimes be bonded back onto the tooth. Rinse your mouth with lukewarm water, and if the gum is bleeding, hold a clean cloth against it. A sharp edge rubbing your tongue can be covered with a little sugar-free chewing gum, or with dental wax from the chemist.

Chew on the opposite side until we see you, and keep away from sweets and very cold drinks, as an exposed tooth reacts sharply to both. Small chips on front teeth can normally be rebuilt in one appointment with tooth-coloured composite. For a larger break, or the cavity left behind by a lost filling, we may put in a temporary dressing first, £70, and let the tooth calm down before the permanent repair. ¹

A break that reaches the nerve often shows as a pink or red spot in the centre of the tooth and is very tender to touch. Saving that tooth may mean root canal treatment. Our guide to choosing a crown, onlay or filling explains how the final repair is decided.

A Loose or Lost Crown or Bridge

Put it in a small box or a sealed bag so it doesn't go missing, and bring it with you. Don't be tempted by superglue or any other glue from around the house. It harms the crown and the tooth beneath, and a crown fixed back on slightly crooked can split the root.

Temporary dental cement from a pharmacy will hold a crown for a day or two if you follow the leaflet carefully, though you don't have to use it. If the bare tooth is sensitive to cold, rub a little sensitive toothpaste onto it. Where the crown and the tooth are both in good shape, we clean them up and fix the crown back on, £70. If the tooth underneath has decayed or broken, you'll need a new crown, and we'll go through the choices and costs with you before starting anything. ¹

Toothache That Won't Let Up

Start with an over-the-counter painkiller from the pharmacy, at exactly the dose printed on the pack. Never press a tablet against the gum; it burns the tissue and does nothing for the tooth. At night, sleep with an extra pillow under your head, keep very hot or cold food off the painful side, and rinse with warm, salty water.

Pain that throbs, stops you sleeping or hangs on after a hot drink usually means the nerve inside the tooth is inflamed or infected, and it won't get better without treatment. At the emergency visit we'll track down the cause, normally with an X-ray, and try to relieve the pain at that same appointment. Often that means taking out the inflamed nerve tissue, which is the first stage of root canal treatment, £110. ¹

Antibiotics won't fix toothache. They're only worth prescribing if an infection is spreading or you feel unwell in yourself, and even then the tooth still has to be treated. If the pain strikes overnight or at a weekend, our out-of-hours toothache guide will help.

Abscesses and Facial Swelling

A swollen cheek, a lump on the gum, or a spot on the gum that weeps salty fluid usually points to an abscess, which is a collection of infection at the end of a root or in the gum. You should see a dentist that day, but an abscess by itself isn't a reason to dial 999. Hold a cold pack wrapped in a tea towel against the cheek, keep your head up, and don't try to burst or drain it.

Some signs change that. Go to A&E if the swelling is shutting your eye, spreading beneath your jaw or into your neck, or making it difficult to swallow or breathe, or if you have a high temperature and feel very ill. Now and then a dental infection tracks into the deeper spaces of the face and neck, and that needs urgent treatment in hospital. You can read how abscesses are dealt with on our dental abscess page.

Bleeding, and Children's Knocked Teeth

Some oozing for the rest of the day after a tooth is taken out is normal. If it's heavier than that, fold a clean, damp piece of gauze or a handkerchief into a pad, lay it over the socket, sit up and bite down firmly for a full 20 minutes. Resist the urge to peek, rinse or spit, as all three disturb the clot. If two rounds of pressure haven't stopped it, ring us, or NHS 24 when we're closed. A lip or tongue cut in a fall will normally stop with pressure too, but a gaping cut, or one that keeps bleeding, may need stitching at A&E.

If a young child knocks out a baby tooth, don't put it back. Doing that can harm the adult tooth forming in the gum above. Bring your child in that same day anyway, so we can check the gum and the developing adult tooth. There's more on this in our guide to children's dentistry in Lanark.

Booking an Emergency Appointment

Call 01555 662441 as soon after we open as you can. On every day we're open, some appointments are kept back for emergencies, and they're there for our registered patients and for people we've never met. The visit is £85, with no charge if you belong to one of our dental plans. If you need more than first aid, such as a dressing or removal of the nerve, we'll tell you the fee before we go ahead. ¹

We're open Monday to Thursday, 9am to 5.30pm, and Friday, 9am to 5pm. Closed at weekends. Whenever we're closed, ring NHS 24 on 111. They'll give you advice and, if it's needed, arrange urgent dental care. If you're in pain or have swelling, please phone rather than emailing, because emails are only read while we're open. For something minor, such as a small chip, mention it when you call so we can book enough time.

Emergency patients are usually seen by Dr Akça, Dr Flessas or Dr Gray, and whichever of them sees you can go on to do the permanent repair once the immediate problem has settled. We see patients from Lanark and right across Clydesdale, including Carluke, Lesmahagow and Biggar.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.