Dental mishaps and emergencies happen every day.
It is important you contact your dentist immediately if you have sudden severe pain, a swollen face, swollen gums, a loose tooth, or tender gums. Because these are all signs of infection or an acute abscess.
But what if it’s on a weekend?
Or it happens when you’re out of town?
Or when your dentist is unreachable?
Has something like this ever happened to you?
Scene l – You Are Halted Mid-Chew
It’s Saturday night and you’re at a restaurant with friends. Or perhaps on a date.
Suddenly, you bite into something that’s unexpectedly hard – like an olive pit in your salad. You are jolted by a sharp wince of pain that halts you in mid-chew.
The pain continues with waves of aftershocks. It’s kind of like if you stubbed your bare toe on a block of concrete. Finally, the pain retreats.
But you realize your tooth just broke and you have no idea what to do when a tooth cracks.
Scene 2 – You Lose a Crown or Filling
You’re on vacation with your family. You’re in an old-fashioned candy when you spy some candy you haven’t seen since childhood – Charleston Chews! You can’t resist and you buy a bag.
You take one bite and feel the warm embrace of gooey chocolate taffy.
Uh-Oh! A crown has just been pulled off your tooth. Or…one of your large fillings just abandoned your molar.
What do you do?
Here are…
5 Common Dental Emergencies & What To Do Until You Can See A Dentist
1. A Chipped Tooth
- If there’s no pain: A chipped tooth usually will have jagged, sharp edges that love to grab your lip, cheek, or tongue. Use an emery board to gently smooth out the rough edges of your tooth until you can see a dentist.
- If the tooth is sensitive to cold, sugar, or heat: When a tooth first chips or breaks, it’s very sensitive to touch and temperature. This usually fades over time, but frequently applying Sensodyne toothpaste to the affected area can bring you some relief until you can see a dentist.
2. Your Tooth Cracks Or You Lose A Filling
Many products are available in the dental aisles of your local pharmacy that can help:
- DentTemp: Whether you use the premixed or powder version, place it in the void and pat it with water to harden the material. Then bite into it while it’s still soft. Scrape away any excess material with a toothpick.
- Dent’s Toothache Gum: Soften the gum in your mouth and place it on your affected tooth. If you can’t find Dent’s gum or can’t get to a pharmacy, you can use sugarless chewing gum, preferably sweetened with xylitol, instead. Mold it into the sensitive area to protect it. (A softened piece of household candle wax can also be hand-molded and pressed into place.)
- Sensodyne or Fluoridated Toothpaste: Coat your tooth with the toothpaste. Then cover the area with sugarless chewing gum or softened candle wax.
- If A Significant Portion Of Your Tooth Broke Off: If a significant portion of your tooth broke off and if the tooth has a large filling, there’s a good chance your filling is secure. This is even more serious than if your tooth cracks. If the tooth fragment has broken off completely, once the initial pain fades, you can continue your meal. But avoid cold, sweets, and extreme heat. If your tooth breaks and is dangling from your gum, go to the restroom with a glass of ice water. Place a piece of ice against your gum where the tooth is loose for 30 seconds. Be careful not to put the ice directly on the tooth. Your gum will get numb enough that you will be able to gently and painlessly remove the loose, broken piece of tooth. If the gum bleeds a bit, bite on a tissue or paper towel for a few minutes, and it should stop.
3. A Dislodged Cap Or Crown
- First, clean and dry both your tooth and the cap or crown. Place a dab of Fixodent or Polygrip into it and put it back in place. Then, tap your teeth together. If you can get to the store, make a loose slurry of flour and water and use it the same way. The cap or crown will only stay in place temporarily – so it is important to see your dentist as soon as possible.
4. A Dislodged Porcelain Veneer
- Try placing the veneer back on your tooth in the proper position. When you’ve got the hang of it, carefully place a dab of Krazy Glue inside and push it into place. Wipe away excess cement with nail polish remover. Remember, just a little dab will do ya!
5. Irritated, Tender Gums, Canker Sores or Inflamed Wisdom Teeth
- Rinse your mouth with Listerine or with a warm salt-water rinse. Swish vigorously. (Do not gargle). An anesthetic salve like Ambesol can also be applied for quick relief.
Remember, all the solutions above offer only temporary relief. If your tooth cracks or you lose a crown or you experience any of the dental emergencies above, please see a dentist right away.
If you’re one of my patients, you can always reach me by calling 212-685-3040. If the office is closed, listen to the message and you will be given my cell number.
Related Reading:
- What To Do When You Have A Dental Problem & Your Dentist’s Office Is Closed
- Chipped Front Tooth? You May Have Bruxism
DISCLAIMER: The advice I offer in response to your questions is intended to be informational only and generic in nature. Namely, I am in no way offering a definitive diagnosis or specific treatment recommendations for your particular situation. My intent is solely educational and my responses to your actual questions serve as a springboard for discussion of a variety of dental topics that come up in day-to-day dental practice. Any advice offered is no substitute for proper evaluation and care by a qualified dentist.
259 Responses
Thankyou very much for your quick response, I will try to find a dentist.
Can you please advise me doc, two days ago my crown broke off completely taking the nerve(stump) with it. I now have a bit of nerve at my gumline base. There is no sensitivity whatsoever. I have no dentist and am worried about possible infection. Will this need to be removed? could it serve for a implant denture?
Dear Bruce,
That you have no pain makes me think that what you refer to as the exposed nerve (stump remnant) might actually be a portion of a root canal filling. Generally speaking, if the nerve were visibly exposed you would be much more distressed. Namely, your tooth would be extremely sensitive
So assuming your did have root canal, I am less concerned about your developing an infection in the near term. It is possible that your tooth can be saved with a post and core buildup and a new crown- that’s assuming there is adequate tooth structure. If not, certainly an implant is an option. You need to see a dentist for an evaluation. In the meantime, enjoy the holiday weekend and be ready to make some calls first thing Monday morning. Based on your description, I think you will be fine for the next few days. If your condition changes (pain or swelling), you will need to seek out emergency care. Good luck.
Dr. Sinkin
Thank you!
Hey there! So I’m very sorry to bother you so late. I was just eating steak leftovers and my crown came clean off. It is a temporary crown that was put in a week ago (while I wait for the permanent one). My actual tooth wasn’t damaged as far as I can tell, thank goodness! I also cleaned cleaned the temporary crown. Here’s my question for you.. When I brush my teeth, should I brush the stump that my crown fell off of? Will I still be able to eat until I see the dentist in a few days? I’m pretty freaked out over the whole thing. Any advice would certainly be much appreciated. Thank you!!
-Kate
Hi Kate.
Chewy steak can do it. Definitely brush the stump…use warm water and toothpaste. Don’t freak out as all seems fine and no damage apparently done to your tooth. Call your dentist and see if you can go in earlier to have the temporary re-cemented.
Dr Sinkin
Hi my tooth just fell out (it was a baby tooth) I can’t be sure but from memory I had the replacement adult fang removed about 10yrs ago because it grew through top of my gum I can’t get to dentis for another five days I’m hoping there is no risk off infection. It didn’t hurt wen it came out but it dosent look like all the root came out. Thanks
Hi Mary,
Not to worry. Baby teeth generally fall out in a more timely fashion relative to permanent tooth development. Over retained baby teeth are common in adults and sometimes last a lifetime. More ofter they go the way yours just did…they fall out. Risk of infection is unlikely. The lack of root is expected as baby teeth near the end of their functional life time, the roots resorb making way for the permanent successor. In your case, it sounds to me that you are a likely candidate for a dental implant.
Dr. Sinkin
Hello,
Whilst eating an apple tonight a tooth that had a failed root canal a while ago snapped completely on one side. I can move it inwards and it feels hollow on the other, (I assume the crown has now completely gone) but a slim part of my actual tooth is still attached to something on the other side. I have been wondering whether to: a) twist it off myself b) leave it and wait until I can go after being paid next Monday. Is waiting a silly thing to do? Is there anything I can do to protect it in some way until Monday or do I have to go straight away. Btw there is no pain, nerve not exposed.
Thanks
Female, 37
You have given me quite a bit of information about your poor tooth. You mentioned a failed root canal (how do you know it failed?) And a lost crown? Then what you have left is a shell of a tooth that once supported the missing restoration and that remaining tooth is broken. No acute pain and no nerve because you had root canal. No gum swelling? I am guessing that it’s your back tooth; otherwise the cosmetic defect would have probably driven you to the dentist. I think that the loose fragment could probably be removed without too much distress but seeing your dentist is a must ASAP. You don’t want to develop an abcess. From your description, I fear you will probably lose the tooth. Keep the area clean and rinse with Listerine for added disinfection. Good luck. FYI…I really can only speculate on the situation based on your description. Get a professional evaluation.
Michael
Hi Doctor,
7 days back my lower jaw molar teeth broke around 25% of the teeth. 75℅ is still intact. For initial 3-4 days I got some pain and slight fever and took pain killers and antibiotic. Now pain is not there as you suggested I have put sensodyne tooth paste to my teeth,it gave me some relief. Now I don’t have pain but whenever I drink cold water I feel the pain.
Currently I’m abroad and having no dental insurence,I will be going back to my country in 3-4 months,Is it fine to wait till that time.I have some Temperory filling with shall I use it for now?
Is there any chance of infection ?
Thanks
Giri
I tried the garlic powder, the vanilla extract, the Red Cross remedy eugenal or whatever, nothing compares to the relief I got
From Makers Mark Bourbon and some
Cheap cooking whiskey I had on hand. Wish I would have tried it to sleepless nights ago. Unbelievable the difference whiskey
Makes
Hi Ben,
Just curious, did you swallow the bourbon? Because that’s when you maximize the anesthetic effects of alcohol. But seriously, alcohol, as in ethyl alcohol not isopropyl (rubbing) alcohol, is an astringent. It desciates (super dries) the adjacent gum and tooth structure. The alcohol irritates the gum and “distracts” the pain center in the brain from the broken exposed tooth pain (Gate Theory of Pain).
Alcohol also dries the tooth surface which can draw fluids out of the dentin channels that interact with the nerve endings inside your tooth (dental pulp).
I hope you have since been to a dentist and had your dental problem addressed. Thanks for your input.
Dr. Sinkin
Hi Dr. Sinkin,
My tooth #3 had a large amalgam filling for 15+ years. It was found to have had some decay under that filling so three weeks ago it was redrilled and replaced with a composite filling.
About a week after the new filling being placed, I bit down on a piece of hard candy and began to feel bite sensitivity along with sensitivity to cold & hot. I returned to my dentist thinking maybe the filling had cracked.
Upon X-rays and an exam, the dentist found that the tooth was cracked on the lingual side. However the pain was transient (not lingering, only with stimulus) and the dentist did not believe I would need a root canal and that the nerve pain could calm down. We did opt to restore the tooth with a porcelain crown. I have a temporary currently on the tooth while we await the permanent to come in.
Since the crown prep 4 days ago, the temperature sensitivity is completely gone but I still can not bite down on the tooth without bite sensitivity. Especially if the piece of food is on the edge of the tooth closest to the tongue where the crack was/is.
Is this normal to still have bite sensitivity with a cracked tooth covered by a temporary? I am purposely not eating on that side of my mouth so as to let the tooth “settle,” but I am wondering if the permanent crown will get rid of the bite sensitivity, too. Thanks in advance.
Dear Chris.
The sensitivity you are experiencing in the aftermath of your recent dental odyssey. …namely replacing a large amalgam filling of 15 years duration in a molar with recurrent decay, is not surprising. Clearly the hard candy cracked your tooth, but to what extent the damage is to the remaining tooth or nerve remains undetermined. It is possible that the trauma of 2 successive dental interventions as well as the candy injury has “excited” the nerve. Time may allow the inflammation to dissipate; however, there is a pretty good chance that your tooth will require further treatment. Root canal is certainly a distinct possibility. My suggestion is that when the permanent crown is ready have your dentist place it with temporary cement and take it for a test drive for several weeks or longer. If your tooth remains sensitive, root canal is the next step. I never permanently cement a crown on a symptomatic tooth. If the crown is truly all ceramic or porcelain and it remains sensitive, root canal through it will probably necessitate a new crown to be made. Because of the history of large fillings and the subsequent crack, crown preparation and sensitivity, I suspect root canal is in your future. (Not to worry…see my blog about painless root canal.) Good luck.
Hi, How difficult is it to replace a crown on a root canaled tooth? The situation is that my wife chipped a crown on one of her upper front teeth and is needing to have it replaced. In fact both of her upper front teeth have crowns and both had root canals (with posts) 25 years ago. The dentist says that she needs to have both crowns replaced as they were connected in the back during the procedure 25 years ago. We worry that during the procedure to remove the old crowns the root canals will be damaged as we’ve read that teeth that have had root canals are very fragile. Thank you in advance.
Hi Dave.
I understand your concerns but they are largely based on common misperceptions. While it is true that teeth that have had root canal treatment are more prone to fracture than teeth that have not been so treated, this does not mean that they are weak. That your wife’s front teeth have been fine for the past quarter of a century since being “root canaled” speaks volumes. The fragility of endodontically treated teeth has more to do with the consequences of not properly restoring them after root canal is completed. Generally teeth requiring root canal have lost much of their structural integrity because of the presence of large cavities, big fillings or trauma (which is why the nerve can become inflamed in the first place.) Root canal in itself does not necessarily weaken the tooth. If teeth with root canal are restored properly they can last a lifetime. However, that doesn’t mean that the crowns placed will last forever. Crown replacement is a common occurrence for any one of a number of reasons including porcelain fracture, gum recession, decay and poor esthetics. All things being equal, replacement of your wife’s crowns should be a straightforward experience leaving your wife with even prettier front teeth. (Porcelain cosmetics have vastly improved improved over the last 25 years.)
I’m going to put myself out on a limb and conjecture that your wife’s original treatment was the result of trauma; hence, 2 crowns splinted together on teeth with root canal and posts. Assuming no other underlying problems besides chipped porcelain, your wife will not have the same dental experience that might be indelibly inscribed in her memory when she first broke her teeth. Removing crowns is an easy procedure. They are cut off, not pulled off. Tell her not to worry and let me know how it all works out.
Dr. Sinkin
Hi Doctor,
While eating groundnut,I have broken my bottom jaw teeth vertically,It may be around 25℅ or quarter of the teeth is broken and the broken part is very slightly movable but its intact due to support of next teeth. I have sensitivity feeling when I drink hot or cold liquid. As temperory measure by putting filling powder from local pharmacy shop will fix the problem ? because once I go back to India after 3 month I will fix the teeth.I don’t have dental insurance here.Currently pain is not there, only while I’m eating I’m getting the pain,Is my teeth is exposed to nerve ? Kindly advice.
Badari
Hi Girish,
I can visualize the problem as you so well describe. You are in quite the predicament in that 3 months is a long time to try and nurse the problem and your tooth and underlying nerve are oblivious to your insurance status. The loose fragment will most assuredly become dislodged leaving vital and sensitive tooth uncovered. If the nerve is exposed you will have no choice but to see a dentist ASAP. If the nerve is not exposed, the sensitivity may subside as the tooth surface is covered with salivary proteins. Your tooth powder or Sensodyne toothpaste can help by applying it to the tooth. I recommend that you find a dentist to evaluate your tooth. You may just need a simple bonding procedure to correct the the damage. In any event, you don’t want to be in the situation where you have a full blown toothache. Get yee to a dentist and good luck.
I’ve had a cavity in one of my bottom right bicuspids. I could see the black spot(cavity) getting worse but didn’t have dental insurance until recently. Tonight I bit into a hard cracker and almost half of the tooth on the tongue side broke completely off. There’s no pain or swelling, but the soonest appointment I could get with a dentist is five days from now. Will I be alright until then? Will I have to have the entire tooth removed??
Dear LeAnn,
I can’t begin to tell you how common your predicament is. Sight unseen, I can’t make a diagnosis, but I Would venture an educated guess that you will be okay for the next 5 days. From what you describe, assuming that the remaining tooth structure is intact, I do not think you will need the tooth extracted. Most likely you will need a crown and possibly root canal. If the tooth has extensive decay below the gum, you may need what called a crown lengthening procedure ( a type of gum surgery). If the tooth is beyond restoration, a dental implant should be considered but I’m jumping the gun. By the way, your decision to avoid care because of your lack of insurance will end up costing you more out of pocket dollars and more time in the dental chair. Good luck.
Hi. I was eating and out of no where a piece of my back tooth-which I think is a molar-came off. It was quite a big piece. I can feel a sharp bit when I brush my tongue over the tooth. The worst thing is I’m on vacation in a remote part of Asia and can’t get to a dentist for nearly 2 weeks. I’m freaking out a bit as I don’t want to get an infection etc. do you have any suggestions? Also should I brush the tooth?
Dear Rani,
These sort of dental mishaps always seem to occur at the most inconvenient time. RELAX! From what you describe, including the lack of pain or swelling, you are probably at very low risk of infection, unless you break your tooth even more which speaks to the importance of avoiding eating on this side. You probably had a large filling or restoration that weakened the remaining tooth and you just happened to bite on it in such that a piece broken off. I don’t believe you will have any problems while you are away. Brush as normal, use warm water if sensitive, and don’t floss so as not to dislodge anymore tooth or filling. A piece of sugarless gum placed against the tooth may spare your tongue from additional insult if it’s getting sore. Enjoy your trip.
Dr Michael Sinkin
Thank you, Dr. Sinkin! You are very right….he is not in pain and says it is “starting to feel just like the other teeth” to avoid a trip to the dentist ;), but I have contacted his pediatric dental team and we are now on the “wait list”. They expressed that this not an emergency per se, but something they want to look at pretty soon. I’m sure we’ll get in later this week.
What a nice service you offer….thanks again!
Of all the days for a major dental issue…Sunday afternoon as I prepare to start a new job tomorrow!!! My 8 yr old son has had silver crowns on some of his back teeth since was 4 years old. Just now, he came in and told met the “silver top” came off one of them, and he has it in-hand. It happens to be a tooth closer to the front teeth on the bottom row. I don’t think it is time for it to “fall out”, but considering I just ate and am very queasy otherwise regarding teeth (sorry!), I cannot look at it, without risking fainting!! I did look from afar and he says the tooth is smaller than the others (from the crown I’m assuming) and that it does not hurt. I’m planning to save the crown and perhaps try to get him in for repairs tomorrow afternoon or later this week. My question is: will this exposed nubbin cause pain (my mouth is throbbing just thinking about it)?? Is there some other consequence if I don’t take him first thing tomorrow morning, and wait later in the week when I can somewhat safely ask to leave work early?? Insurance is not an issue, timing is!! Thank you in advance, Doctor!!
Dear Vanessa,
Based solely on what you just told me including the most important fact that your son is not in distress, I think he’ll be just fine until you can get him to the dentist. He has a stainless steel crown on his baby tooth and may very well have had a “baby tooth root canal.” I can’t diagnose by email but I think you can take yourself out of panic mode and make an appointment as soon as you can arrange it. I suggest you call his dentist of record for further reassurance. Good luck with the job.
I lost a crown on a tooth that had a root canal. My dentist said that the tooth had cracked below my gumline, and recommended that I have the tooth extracted, then get an implant or bridge. I made an appointment with an oral surgeon for the extraction, but it’s not for another 3 weeks. Is it OK to wait that long? What precautions can I take to keep the root clean and to prevent infection?
Dear Sherri,
No worries. Just keep the area clean. Your tooth had root canal so sensitivity won’t be an issue. If you develop any swelling, call your dentist. Rinsing with Listerine is an added measure to prevent bacterial build-up.
i have a crown on my lower incisor with another crown second molar back and a bridge between. About three weeks ago I started having tooth pain in that area, that continued to worsen to the point of going to the ER. Was prescribed something for the pain and amoxicillan 875 bid. Three days ago while eating pound cake of all things, my crowns/bridge fell out. I no longer have dental insurance, live in a different state than before, am in severe pain and my jaw is swelling. Dont know what to do. feels like a nerve is exposed. The ground down teeth are both black in color. Is that the way they were prepared before crowning? HELP
Dear Tammy,
Not having dental insurance doesn’t change your dental state-you must see a dentist.( I suggest you read my recent post about the negative impact the economy has had on dental care…l share some helpful insights about your financial concerns.)
If your dental description is accurate, you need to see a dentist for immediate care. There are many ways to address your obvious lack of teeth (some quite affordable) after the more immediate crisis is stabilized. From what you described, your previous bridged was destined to fail (an incisor and a molar as sole supports for such a large span bridge is not well engineered.) Do some homework, ask for recommendations and find a caring dentist who can help you.
Sorry, realised I wrote bottom in last question, the tooth is missing from the TOP left hand side, 3 from the back.
Jg
I am on a 6 week holiday in usa ( i live in britain). My bottom left hand molar (3 from the back) which has had root canal, the crown (and pin) came off and I swallowed the tooth. There is no pain.
1) is it ok to leave the gap for 5 1/2 weeks until I get home to my dentist, or do I need to do something
2) will the teeth either side move in the 5 1/2 weeks until I get home
3) if i went or emergency dental treatment ( i think i have insurance) what could the dentist do??
Thanks for your advice
Jg
Juliet,
I’m more concerned about the swallowed crown than I am about your tooth. Generally crowns will pass through your GI system uneventfully and come out in your stool. You want to make sure it passes. (That’s right, you’re on poop patrol.) Especially since the post went down the tube with the crown.
Healthy people as well as people with a variety of gastrointestinal conditions; diverticulosis, Crohn’s syndrome, colitis, to name a few, may run into a problem with a wayward post and crown. Don’t panic, just watchfully wait.
As far as your tooth is concerned, don’t worry. You will need a new crown when you return to the United Kingdom. You had root canal so you won’t have tooth pain. Be mindful for swelling of the gums but, otherwise, brush your “tooth” and enjoy your vacation. If any abdominal distress occurs, seek medical care.