Dental Emergencies: First Steps
First-hour advice for the dental accidents and infections we see most, how to judge whether it's a hospital matter or one for the dentist, and how to be seen by us the same day.
I Have a Dental Emergency in Broughty Ferry. What Are My Options?
Ring Ferry Smile Studios on 01382 477350, as near to opening time as you can manage. Each day we're open we set aside same-day emergency appointments for anyone in pain, whether you're a patient of ours or not; the fee is £70, and dental plan members pay nothing. Outside our hours, including evenings and weekends, NHS 24 on 111 is the number to call. Go to A&E when a swelling makes breathing or swallowing difficult, when pressure won't stop bleeding, or following a serious facial injury.
A&E, the Dentist or NHS 24?
However painful it is, almost every dental problem is something a dentist should deal with. The emergency department at the hospital has no dental chair and can rarely repair a tooth, so it's the right choice only when the threat is to your breathing, from blood loss, or to the structures of your face.
| Situation | Where to go |
|---|---|
| A swelling that interferes with breathing or swallowing, or that is rapidly moving up towards the eye or down into the neck | A&E, or dial 999 |
| Bleeding that persists despite 20 minutes of steady pressure | A&E |
| A hard knock to the jaw or face, a jaw that may be fractured, or any period of unconsciousness | A&E |
| A knocked-out adult tooth, a fractured tooth, a lost crown or filling, toothache, or a gum swelling that is staying put | Phone 01382 477350 during our opening hours |
| The same problems when we're shut | NHS 24 on 111 |
If you're unsure, phone us during opening hours and tell us what's happened. We'll give you a straight answer on whether it's us, your GP or the hospital you need.
An Adult Tooth That's Been Knocked Out
Of everything in dentistry, this is the one where minutes genuinely count. Replaced in its socket within roughly an hour, a tooth stands a good chance of knitting back in. Beyond that, the cells on the root surface begin to die off.
- Locate the tooth and hold it by the crown, the end you chew with. Avoid handling the root
- If it's dirty, give it a quick swirl in milk, or hold it under cold running water if milk isn't to hand. Never scrub or wipe it
- Push it gently back into the socket the right way round, matching the teeth next to it, and bite on a folded hanky to hold it still
- If it won't go back, a cup of milk is the next best place for it. Adults can tuck it inside the cheek instead, so long as there's no chance of it being swallowed
- Call us immediately, or, if we're closed, NHS 24 on 111, and explain that a tooth has come out
A tooth that's been knocked sideways, driven upwards or loosened also needs urgent attention. We can guide it back into position and splint it to the neighbouring teeth while the gum recovers. Children's teeth follow different rules, covered in the section on knocks further down.
Need an Appointment Today?
Ring us as soon as we open and we'll fit you in the same day.
Broken Teeth and Fillings That Have Fallen Out
Keep any broken pieces in a clean pot, since a large fragment can occasionally be bonded back in place. Rinse gently with lukewarm water; should the gum be bleeding, hold a clean cloth against it. If a sharp edge is scraping your tongue, a blob of sugar-free chewing gum or a little dental wax from the pharmacy will take the edge off.
Until we see you, chew on the opposite side and avoid ice-cold drinks and sugary foods, both of which an exposed tooth will react to sharply. A minor chip on a front tooth is normally rebuilt in composite in a single appointment. A larger fracture, or a cavity left where a filling used to be, may be given a temporary dressing first, at £70, to let the tooth settle before the permanent repair. 1
Where the break reaches the nerve, you might spot a pink or red speck in the centre of the tooth, and it will be extremely sensitive. Root canal treatment may be what saves that tooth. The way we pick the final restoration is explained in crown, onlay or filling.
A Crown or Bridge That Has Fallen Out
Put it somewhere safe, a small box or a sandwich bag will do, and bring it with you. Whatever you do, don't reach for superglue or any other household adhesive. It harms the crown and the tooth under it alike, and a crown fixed on at even a slight angle can split the root.
Chemists stock temporary dental cement, good for keeping a crown on for a day or so provided the instructions are followed to the letter, although you don't have to use it. A smear of sensitive toothpaste over the bare tooth eases any cold sensitivity. Provided the crown is intact and so is the tooth under it, we can clean them up and cement the crown back on for £70. If the tooth inside has decayed or fractured, a replacement crown will be needed, and we'll set out the choices and fees before doing anything. 1
Toothache That Won't Ease
Begin with ordinary painkillers from the chemist, taken strictly as directed on the packet. Never rest a tablet against the gum: the tissue gets burned and the tooth is no better for it. Sleep with an extra pillow, avoid very hot or very cold food on the painful side, and use a warm salt-water rinse.
A throbbing ache, one that wakes you at night or carries on long after a hot drink, generally points to an inflamed or infected nerve inside the tooth. It won't settle on its own. At your emergency appointment the cause gets tracked down, normally with the help of an X-ray, and we aim to relieve the pain on the spot, frequently by taking out the inflamed nerve tissue as the first step of root canal treatment, at £110. 1
Antibiotics are not a cure for toothache. They have a place only where infection is spreading or you feel unwell generally, and the tooth will still need treating afterwards. For toothache at night or over the weekend, read our guide to out-of-hours toothache.
A Swollen Face or a Dental Abscess
A bump on the gum, a spot that oozes with a salty taste, or a puffy cheek usually signals an abscess: a collection of infection at a tooth's root or within the gum. It should be seen by a dentist that day, though by itself it doesn't justify calling 999. Press a cold compress, wrapped in a tea towel, to the cheek, keep your head propped up, and don't try to squeeze or burst it.
Certain signs change the picture. If the swelling is closing an eye, tracking under the jaw or into the neck, interfering with swallowing or breathing, or you have a fever and feel really ill, go to A&E. Now and again a dental infection tracks into the deeper tissues of the face or neck, and that calls for hospital treatment without delay. How an abscess is treated is described on our dental abscess page.
Bleeding, and Knocks to Children's Teeth
It's normal for a socket to ooze a little for the remainder of the day after an extraction. Anything heavier: fold up a clean, damp handkerchief or piece of gauze, position it over the socket and bite firmly for a full 20 minutes while sitting upright. Peeking, rinsing and spitting all disturb the clot, so resist the urge. If it's still bleeding after a second 20 minutes of pressure, phone us, or NHS 24 if we're closed. A cut to the lip or tongue from a fall usually settles with pressure; a wound that gapes open or won't stop bleeding may need stitches at A&E.
For young children, a knocked-out baby tooth stays out. Replacing it risks harming the adult tooth forming above. Even so, your child should be seen the same day for a check on the gum and on the adult tooth developing beneath it. Our children's dentist guide has more on this.
How to Get a Same-Day Appointment
Phone 01382 477350 as soon after opening as you can. Same-day emergency appointments are held back on every day we're open, and they're available both to our registered patients and to people who've never set foot in the practice. An emergency visit costs £70, or nothing at all for anyone on a dental plan with us. Any treatment beyond first aid, such as a dressing or removing a nerve, is quoted for before we go ahead. 1
Our opening hours are Monday to Friday 8.30am to 5pm. Closed at weekends. When we're closed, in the evening or at the weekend, ring NHS 24 on 111 for advice and, if needed, urgent dental care. Anyone in pain or with a swollen face should phone rather than message us, since WhatsApp is only checked while we're open. For something that isn't urgent, a small chip for example, a WhatsApp photo is useful because it lets us book an appointment of the right length.
Your emergency appointment will be with one of our dentists, who can then go on to carry out the permanent repair once the immediate problem is under control.
Questions
This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.