Dental problems can develop after an accident, when a restoration breaks or because of infection, decay or gum disease. Some require immediate medical attention, while others can be managed temporarily until a dentist is available.
Knowing the difference can help you seek the appropriate level of care.
Call 000 or go to an emergency department when necessary
Some mouth and facial problems are medical emergencies rather than matters to manage solely at a dental practice.
Call triple zero (000) or go to the nearest emergency department if you have:
- Difficulty breathing
- Difficulty talking or swallowing
- Significant swelling of the tongue, mouth, throat or neck
- Rapidly increasing facial swelling
- A large amount of blood going down the throat
- Heavy bleeding that cannot be controlled with pressure
- A serious facial or jaw injury
- Loss of consciousness or signs of a head injury
- Severe allergic-reaction symptoms
- Collapse, confusion or significant difficulty staying awake
Do not wait for a dental practice to open when breathing, swallowing, consciousness or uncontrolled bleeding is involved.
When should you seek same-day dental care?
Contact a dentist urgently if you have:
- A knocked-out adult tooth
- A permanent tooth that has been displaced or made very loose by trauma
- Severe or increasing tooth pain
- Facial or gum swelling
- Suspected dental infection or abscess
- Fever with dental pain or swelling
- Pus or a persistent unpleasant taste
- A broken tooth with significant pain or internal tissue visible
- Bleeding that continues after dental treatment
- Dental trauma affecting several teeth
- Severe pain following a recent extraction
- A crown or filling loss accompanied by significant pain
Tell the receptionist what happened, when it occurred and whether you have swelling, fever, bleeding, breathing difficulty or a knocked-out tooth. This helps the practice determine the urgency.
Toothache
Toothache can be caused by:
- Tooth decay
- A cracked tooth
- An inflamed or infected dental pulp
- A dental abscess
- Gum disease
- Food trapped between teeth
- A damaged filling or crown
- Grinding or clenching
- Referred pain from another area
Dental pain does not always worsen, but the cause generally requires assessment. It should not be assumed that the problem will resolve permanently because the pain temporarily subsides.
Seek prompt care if the pain:
- Is severe or increasing
- Wakes you from sleep
- Makes eating difficult
- Occurs with swelling or fever
- Is triggered by biting
- Continues after hot or cold exposure
- Develops after trauma
- Returns repeatedly
Until you are assessed, rinse gently with water and clean carefully around the area. Ask a pharmacist which pain-relief medicine is suitable for you and follow the labelled dose.
Do not place aspirin, crushed tablets, essential oils or caustic substances directly against the tooth or gum. These may injure the soft tissues.
Dental abscess and facial swelling
A dental abscess is an infection that can develop within a tooth, around its root or in the surrounding gum.
Possible signs include:
- Persistent or throbbing pain
- Swelling of the gum, face or jaw
- Pain when biting
- Fever
- A bad taste
- Pus
- Tender glands in the neck
- Difficulty opening the mouth
A dental abscess does not normally resolve without treatment. Antibiotics may be appropriate in selected circumstances, but they do not necessarily remove the source of infection. Treatment may involve drainage, root canal treatment, periodontal treatment or tooth removal.
Increasing swelling, difficulty breathing or swallowing, tongue or neck swelling, or significant illness requires emergency medical care.
Do not apply heat to facial swelling. A cold compress wrapped in a cloth may help reduce discomfort while you arrange assessment.
Knocked-out adult tooth
A knocked-out adult tooth is time-critical. It is best to reach a dentist within approximately 30 minutes.
If an adult tooth is knocked out:
- Find the tooth and hold it by the crown—the part normally visible in the mouth.
- Do not touch or scrape the root.
- If dirty, rinse it briefly and gently in milk or sterile saline. Do not scrub it.
- If you are confident it is an adult tooth, place it back into the socket in the correct orientation.
- Ask the person to bite gently on clean gauze or a soft cloth to hold it in position.
- Go immediately to a dentist or emergency department.
If the tooth cannot be reinserted, place it in a clean container covered with milk or the injured person’s saliva. Do not store it in plain water and do not allow it to dry out.
Storing a tooth inside the cheek can create a swallowing or choking risk and is unsuitable for young children, unconscious people or anyone unable to hold it safely.
Replanting the tooth does not guarantee that it will survive. Further treatment, including root canal treatment, may be required.
Knocked-out baby tooth
Do not place a knocked-out baby tooth back into its socket. Replanting it may damage the developing adult tooth underneath.
Find the tooth, manage any bleeding with gentle pressure and arrange a dental assessment. Take the tooth with you if possible.
If you are uncertain whether it is a baby or adult tooth, store it in milk or saliva and seek urgent dental advice.
Chipped, cracked or broken tooth
A small painless chip may not require treatment on the same day, but it should still be assessed. A crack may extend further than can be seen.
Seek urgent care if:
- The tooth is very painful
- The tooth has split
- The centre of the tooth is visible
- The tooth is loose or displaced
- The injury has caused significant bleeding
- Your bite feels different
- The damage followed a substantial impact
- The edge is cutting your tongue or cheek
If you find a broken fragment, place it in milk or sterile saline and bring it to the appointment. In some cases, the fragment may be suitable for reattachment.
Avoid chewing on the affected side. Do not apply household glue or attempt to repair the tooth yourself.
Treatment may involve smoothing, bonding, a filling, crown, root canal treatment or removal. A crown is not automatically required, and the appropriate option depends on the extent and location of the damage.
Loose or displaced permanent tooth
A permanent tooth that becomes loose after an accident should be assessed urgently, even if it has not fallen out.
Do not repeatedly move or test it. Avoid biting with the tooth and eat soft foods until assessed.
A dentist may reposition and stabilise the tooth with a temporary splint. Follow-up is usually required because damage to the pulp, root or surrounding bone may not be immediately apparent.
An adult tooth that gradually becomes loose without trauma may indicate gum disease, bone loss, grinding or another dental problem and should also be assessed promptly.
Lost filling
A lost filling can expose sensitive tooth structure and allow further damage.
Until you can see a dentist:
- Keep the area clean
- Avoid chewing hard or sticky foods on that side
- Avoid extreme temperatures if the tooth is sensitive
- Do not place household adhesives or unsuitable materials in the cavity
A lost filling is not always a same-day emergency, but prompt assessment is advisable—particularly if there is pain, a sharp edge or a large amount of missing tooth structure.
Lost or loose crown
If a crown comes off:
- Keep it in a clean container
- Do not force it back onto the tooth
- Do not use superglue or household adhesive
- Avoid chewing on the affected tooth
- Arrange a dental appointment
A dentist needs to determine why the crown came off and whether there is decay, fracture or loss of cement.
Seek more urgent care if the underlying tooth is painful, fractured or extremely sensitive, or if the crown is attached to an implant and feels loose.
Bleeding from the mouth
Bleeding may follow trauma, dental treatment or tooth removal.
To control bleeding:
- Place slightly dampened clean gauze or cloth directly over the area.
- Apply firm, continuous pressure.
- Keep it in place for approximately 30 minutes without repeatedly removing it to check.
- If bleeding continues, replace it with clean gauze and seek dental or medical advice.
Avoid vigorous rinsing, spitting, smoking, strenuous exercise, hot drinks and hard foods while the area is bleeding.
Call 000 if bleeding is heavy, cannot be controlled, is flowing down the throat or is affecting breathing.
Tell the treating practitioner if you take anticoagulant or antiplatelet medication. Do not stop prescribed medication without medical advice.
Cuts to the lips, tongue or cheeks
Apply firm pressure using clean gauze or cloth. A cold compress outside the mouth may help with swelling.
Seek urgent assessment for:
- A deep or gaping wound
- Bleeding that does not stop
- A wound extending through the lip
- Embedded dirt, tooth fragments or other material
- A possible jaw fracture
- Difficulty opening or closing the mouth
- Altered sensation
- A bite that no longer fits normally
Some soft-tissue injuries require cleaning, stitches or medical treatment.
Pain after a tooth extraction
Some discomfort after an extraction can be expected. Contact the treating dentist if:
- Pain becomes more severe after initially improving
- Bleeding does not settle with pressure
- Swelling continues to increase
- You develop fever, pus or an unpleasant taste
- You have difficulty swallowing or breathing
- Pain is not controlled by the recommended medication
Increasing pain several days after an extraction may indicate dry socket or infection and should be assessed.
Broken braces, aligners or retainers
A broken orthodontic appliance is not usually life-threatening but may require prompt advice.
Contact the treating dentist or orthodontist if:
- A wire is cutting the cheek or gum
- A bracket becomes loose
- An aligner develops a sharp crack
- A retainer no longer fits
- A fixed retainer breaks
- A tooth becomes unusually mobile or painful
Orthodontic wax may temporarily cover an irritating wire. Do not cut or modify an appliance unless instructed by the treating practitioner.
If part of an appliance has been inhaled and the person is choking or struggling to breathe, call 000.
Dental anxiety during an emergency
Tell the practice if you experience dental anxiety, have a history of trauma or are worried about pain.
The dental team can explain the immediate priorities, discuss local anaesthetic and agree on communication or stop signals. Sedation may be considered in selected cases after appropriate assessment, but it may not be available or suitable during every emergency.
Anxiety should be taken seriously, but urgent infection, trauma or airway symptoms should not be left untreated because of it.
When can a dental problem wait for a standard appointment?
Problems that may not require same-day care include:
- A small painless chip
- Mild intermittent sensitivity
- Minor staining
- A slightly rough restoration without pain
- A denture requiring routine adjustment
- Mild gum bleeding without swelling or significant pain
These symptoms still warrant assessment if they persist, recur or worsen. Gum bleeding, for example, can indicate inflammation or gum disease even when it is not an emergency.
Prepare for unexpected dental injuries
It can help to keep the following information available:
- Your dentist’s telephone number
- After-hours dental service details
- Your current medication list
- Relevant allergies and medical conditions
- The Healthdirect number: 1800 022 222
- Emergency number: 000
A properly fitted mouthguard may reduce the severity of dental injuries during contact or collision sports.
Seek help for a dental emergency in Perth
If you have tooth pain, swelling, a broken tooth or another urgent dental concern, contact Smile Design Studio in Mosman Park, Perth, on (08) 9468 3322 and describe your symptoms.
If you cannot reach a dentist and have breathing or swallowing difficulty, severe swelling, serious facial trauma or uncontrolled bleeding, call 000 or attend an emergency department.
You can also contact Healthdirect on 1800 022 222 for health advice and assistance locating an appropriate service.
This information is general first-aid guidance and does not replace an individual dental or medical assessment. Call 000 for potentially life-threatening symptoms.
