Dental problems have a strange way of only happening at the worst times—late at night, on a holiday, or right before an important meeting. If a sudden pain or injury occurs, your first reaction may be panic, followed by a difficult question: Does this require an emergency trip to the dentist right now, or can it wait until the office opens in the morning? It’s important to know the difference between a routine dental issue and a true clinical emergency for the sake of both your oral health and your peace of mind. Although patients’ comfort level is different, there are clinical signs that determine when a tooth absolutely must be treated immediately to prevent extraction or to stop the spread of a serious infection.
The Severe and Throbbing Toothache
Not all toothaches are created equal. A sensitivity to cold or a mild ache that comes and goes could signal a small cavity or worn-down enamel. That usually warrants a future appointment, but does not necessitate an emergency. The real thing is a “throbbing” toothache that can keep you up at night and won’t subside with an over-the-counter pain reliever. If the pain is accompanied by swollen gums that you can visibly see, a bad taste that won’t go away, or fever, you may have a dental abscess. It’s a bacterial infection at the end of the root that can spread to the jawbone or even elsewhere in the body if it’s not taken care of. In that case, waiting even twenty-four hours can be risky, and you should seek professional care immediately.
Distinguishing Between Chips and Fractures
When it comes to damaged teeth, the level of urgency is often determined by the depth of the break. Chipping of the enamel, although extremely upsetting to look at in the mirror, and even the very tip feels sharp to your tongue, is not likely to be an emergency. In the absence of pain or bleeding, most of these can be smoothed down or bonded over during normal business hours. A major fracture with a large chunk missing is another story, though. If you can see a black spot or a pink spot in the centre of the broken area, the nerve of the tooth may be exposed. This can be extremely painful and leaves the tooth vulnerable to quick infection, so you will need to visit us promptly to protect the inner pulp and possibly prevent the need for a root canal.
The Critical Window for Dental Trauma
Traumatic injuries, whether from a fall or a sports accident, often result in the most time-critical emergencies. When a permanent tooth is completely knocked out, it is a high-priority emergency where every minute counts. Dentists refer to this as the “Golden Hour”, as the success rate of replantation decreases significantly after thirty to sixty minutes have passed since the injury occurred. If this happens, it’s important to handle the tooth only by its crown and avoid touching the sensitive root fibres. If possible, it can be gently placed back into the socket or placed into a container of milk or saliva to keep it moist while rushing to the clinic. In the case of a tooth being pushed out of alignment or a tooth being loosened to a significant degree, it is also time-critical to stabilise the tooth so that the surrounding ligaments can heal properly.
Lost Restorations and Soft Tissue Injuries
It’s quite normal for an older filling or crown to loosen while you’re eating. Although this will feel odd and leave the underlying tooth sensitive to air or temperature, it’s usually not a big deal unless it’s associated with severe pain or sharp edges that are cutting your cheek. Most drug stores will have a brand of temporary dental cement that can seal things off for a day or two until you can get in. That said, injuries to the soft tissues in the mouth, like deep cuts to the tongue, lips or cheeks, are a different story. If you have a laceration that will not stop bleeding after fifteen minutes of firm pressure, it’s time to either visit the emergency room or your dentist right away. Stitches are often necessary to close the wound and allow it to heal properly.
When in Doubt, Always Call
The number one rule of thumb is that you should never have to guess about your health on your own. Even if you’re not sure if your situation is a “real” emergency, our Emergency dentists in cheadle is trained to triage these phone calls. We would much rather you call 0161 768 2028 and describe your symptoms to us and be told you can wait until the morning than for you to suffer through a night of avoidable pain or face a permanent loss of a tooth. If you’re experiencing worrisome symptoms, a call to your dental professional is always the right first step towards a solution.