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
I had a root canal a year ago and had a crown placed on my front tooth, while eating today i broke my crown and the tooth which it was placed on has been halved , I am nervous please tell me what to do
Dear Arun,
I understand your concern. There isn’t much I can offer you in the way of advice except the obvious….you need to see your dentist right away. If you broke the crown without damaging the tooth, a new crown can be made. If the tooth did not have a post placed, and the remaining tooth structure is sound, it is entirely possible that the broken tooth can be restored. If the tooth is split too far below the gum or the root is fractured, other options exist including a dental implant. But don’t get too far ahead of yourself. See your dentist and get the facts. Good luck.
Dr. Sinkin
Hi, I hope you can help me. The tooth next to my Eye tooth was surpise to have a root canal diwn kast summer, but I didn’t have the funds. Now I’ve waited to long and it’s to late. The temp filling is gone and the toith is exposed. Yesterday I was eating some hard bacon and the tooth fills loose. Im surpose to get the tooth extracted in two weeks. Should I go right away or can I wait. For the last two weeks the gum around it feels puffy and sore.
Dear Chery,
I suggest you go sooner rather than later. You certainly don’t want to develop an infection.
Good luck and have a happy Thanksgiving.
Dr. Sinkin
I am such a chicken, I was supposed to get a root canal this morning but I was too scared. I had cold sensitivity on another tooth that I asked her to look at and she said that one needed a root canal as well. I hi-tailed it out of there, terrified. I immediately went to my regular dentist (I was at the endo this morning) and he said it was probably just sensitivity and put some stuff on it. So here I am sitting at home feeling sorry for myself and mad at myself. I have only been to this endo one time for an evaluation. I’m so scared, I really don’t like the dentist and I am really scared of pain. Help Me….
Dear Sandi,
Your reaction to the prospect of having root canal treatment is not uncommon. We have been indoctrinated and influenced by the hype and terror that has been ascribed to root canal therapy. Movies, books, television all have used dental humor and root canal in particular as a focal point of unpleasantry. But much of this is based on archaic notions from decades ago when root canal was not as refined a procedure as it is now. In fact, many of my patients find it boring and some even nod-off!
Please read my previous blog: Painless Root Canal, An Oxymoron? https://michaelsinkindds.com/blog/painless-root-canal-treatment-an-oxymoron/
It will amuse and educate you. Good luck!
Dr. Sinkin
Dear Dr., I was just at my dentist this morning complaining of pain in my left upper back molar. It hurts if I drink anything cold or move my tongue to far to the right side of my mouth. When I feel with my finger it feels as though my gum is split and it really hurts to touch it. My dentist checked it and took x-rays; he says he doesn’t see anything that could be causing my pain, just a little irritation. He did fix a chipped filling I had on the same side. and put some desentizing goop on the tooth that was bothering me. but now it’s been almost an hour since I was there and it’s starting to hurt again. He told me to put warm compresses on my cheek and take ibuprofen for the pain and it should subside in a few days. But I’m worried there is something else going on although he said there is nothing in the x-rays. He told me to continue wearing my mouth guard because he thinks that’s why it’s hurting because of my grinding. I don’t know what to do, I don’t think I can handle this until I go back in January. My insurance is used up for this year.
Sandi
Dear Sandi,
Sometimes diagnosing the cause of someone’s tooth pain can be an elusive endeavor. When clinical findings, such as xrays, temperature and bite testing are all negative, a bit more of the art of diagnosis is called upon. I think time will reveal the culprit. The root cause of the dental malady may not at first be evident, but clearly you need to see the dentist again, regardless of your insurance.
Good Luck.
Dr. Sinkin
I had a 2 temporary crowns put on 3 days ago (they are connected, so one big crown) and now it’s Saturday night. I ate a handful of Reese Pieces and the area that that the temps are on was aching. I went to go brush my teeth and floss on the front and back of the crown. On the back side when I pulled the floss out the crown popped up. Not off, but I pushed it back down and bit down to make sure it lined up still and it does. But it is still aching. I am not sure why and I left a voice mail for the dentist so I am sure I can get in Monday morning. But in the mean time should I do anything, or not do anything, other than no sticky or sweet foods? I don’t know if something got under it making it ache or what? Any help would be so very much appreciated.
Hi Aice,
Your temporary crowns have become dislodged and the cement seal holding your temporarily splinted (attached) crowns have become “unglued”. The intense sugary sweet candy caused an assault on your teeth’s nerve endings. Rinse with warm salt water to neutralize the irritation. Don’t floss. Use SENSODYNE toothpaste. During this time avoid sweets.
Get in to see your dentist ASAP.
Good luck!
Dr. Sinkin
My #3 tooth was in extreme pain and my endodontist found a crack that ran through the root. He removed the “angry” nerve and tissue and packed the tooth with meds and a temp filling. I’m scheduled for the tooth to be extracted, but my tooth feels great now. No pain and no sensitivity to cold. Do I still need to follow through with the extraction? Since my tooth feels much better now, can’t I just put a crown over the temp filling? I really don’t want to pull my tooth out!
Dear Benjamin,
In a word……no.
Your endodontist did “too good” a job making you comfortable in an emergency situation. Believe me, most endodontists would prefer to save the tooth, complete the root canal and place a nice crown. But, your tooth is cracked and it’s just a matter of time before you likely will have more problems, including a possible infection.
You can’t place a crown on a tooth without finishing a root canal, and you can’t finish a root canal if a tooth is split. My advice: follow your endodontist’s
recommendation.
Best of luck,
Dr Sinkin
Dr. Sinkin, I recently had a tooth repaired with a I guess a bonding. My molar had broken and my dentist repaired it with a filling of sorts. My problem is that I am afraid to eat on that side of my mouth in case it breaks again. I do grind my teeth at night and I have a hard mouthguard and I am scared to sleep because I’m afraid I will bite down to hard and break the tooth again. I don’t know what to do, I’m driving myself nuts worrying about this.
Thanks Sandi
Dear Sandi,
Bonding a broken tooth is a common procedure that can serve as the definitive restoration/filling for years to come. Or it can be a quasi-temporary repair that can tide you over until a more durable solution can be offered, such as a crown. Did your dentist explain your particular situation?
In the long run, a crown could be a better and less costly option because repeated repairs can add-up. And the fact that you wear a night guard indicates that your teeth get a “work-out” every night. But I’m sure that your dentist has a good handle on your situation. You may just need him or her to explain a little more to you about the procedure and what to expect.
So, call the dentist for some guidance. Also, if you feel that your night guard puts extra pressure on the affected tooth either by way of the fit or the bite, it may need to be adjusted.
You need a little more explanation, but don’t let it keep you up at night. Just keep wearing your night guard.
Best,
Dr.Sinkin
Thank you Dr.Sinkin for the quick response. I feel more at ease just knowing that I am doing what I can to not further the damage. Thanks again for helping me get a better perspective on the situation!
You are very welcome.
Dr.Sinkin,
I had a terrible fall last thursday and lost a huge piece of my right front tooth. Thankfully my dentist was able to see me, perform a root canal and put a temporary cap on it. I have an appointment with him in two weeks to get a permanent crown made for it. My doctor mentioned that my left front tooth was cracked and although the x-rays didn’t show that I needed work done on it, I could still possibly lose it. He told me to look out for browning, near by pimples on the gum line and burning sensitivity of the tooth as indicators that it also will need a root canal and crown. Well it’s almost a week later and although the sensitivity of my left front tooth has gone down, I have noticed more cracks on the front than I’d previously thought. The bottom edge of the tooth also is starting to show a maybe brownish/yellow/translucent tint.
Would putting sensodyne gently on the surface of my front left tooth where the cracks are help the enamel regenerate?
Is it possible for the cracks to heal?
I will see my dentist in a couple weeks but I’m wondering if there is anything I can do to avoid losing this tooth as well?
I am trying to stay on a liquid and soft foods only diet but sometimes my bottom tooth underneath will tap my front left tooth when I’m talking and I get a sharp pain.
Thank you so much for the help!
Dear Kelsey,
So sorry to hear of your dental trauma.
As far as your soon-to-be crowned tooth goes, it sounds like you received timely and thorough care. As for your other front tooth, there is really no way to refortify your tooth as in remineralizing those cracks. It appears that the fall targeted your teeth, but luckily no further harm came to you. I do not view restoring your tooth or teeth with beautiful crowns, even if root canal is needed, as losing one’s teeth. They are being saved- meaning they are not being extracted. And with the proper care, your teeth should look as good and perhaps even better then before, though, admittedly, breaking one’s front teeth is very traumatic…physically as well as emotionally.
Wishing you the best,
Dr. Sinkin
Thank you Dr Sinkin for the prompt response and help.
It’s always worrying to experience dental problems whilst on holiday so it’s good to hear your advice.
Thanks again, Bruce
Hi Dr Sinkin,
I wonder if you can please help me with a query about my half crown which which fell out a few weeks ago – this tooth has had root canal work about 5 years ago. I had the crown glued back on by my dentist but this fell off after a couple of weeks. After returning to the dentist 5 days later, he put in a temporarily (soft) filling as I was shortly to go on holiday. His intention is to replace the half crown with a full crown on my return – none of this preparation work has been done. However whilst on holiday the soft filling has come out and fallen down the sink hole. I have still a week on holiday in Tenerife (I live in the UK) and not in any pain. Can you please advise whether I need immediate treatment (filling) on my tooth? Any advice would be greatly appreciated.
Thanks Bruce
Dear Bruce,
You will likely be able to manage the problem until you get home. Most important: Chew on the other side and don’t forget. If you bite on it you could do some real damage. Brush the tooth as normal; be diligent about keeping it clean but not overly agressive. If you can get to a pharmacy you may be able to find temporary filling material; if so, you can use it to plug up the root canal access hole until you get home.
Best wishes,
Dr. Sinkin
Hi, this is about my 7 yr old son , one of his teeth has been loose for about 2-3 weeks now except now it’s pretty much dangling the thing I’m worried about is his gums although they’re not swollen it’s very purple just the part of his gums where the loose tooth is . It’s i think what you call a lateral incisor maybe it’s the tooth next to his two front top teeth. It has a cap/crown on it and it’s a baby tooth. Will his gums be ok? I’m not so much worried about the tooth because he’s already lost several of his baby teeth the only thing I worried about is his gum being purplish where the tooth is coming out. Is this something to be worried about??
Dear Georgette,
That the gum being purple is usually consistent with inflammation associated with a loose baby tooth. That said, the tooth has a crown and there is no way to determine if it’s the tooth that is loose or the crown itself. I suggest you call your dentist and have it looked at. Better safe than sorry.
Dr. Sinkin
My last molar on the top, #15, is largely a filling that has been there for a number of years. There is no problem with the filling. However, there is a small cavity on that tooth on the part of it that is next to the next tooth. The dentist wants to do a crown. He doesn’t think that a filling will hold. Why wouldn’t it hold? I would prefer a filling if possible.
Dear April,
Of course you would prefer a filling as opposed to a crown…who wouldn’t? A filling is done in one visit, is less “invasive,” and less costly. But less treatment is not necessarily more conservative treatment if one considers the long-term prognosis of a tooth. And less treatment can be tantamount to “patch” work that may ultimately fail.
You have a second molar (#15) that has a large filling. More specifically, in your own words, it is largely filling. Now you have a cavity on the part of the tooth that is filling-free. Placing a filling in this situation can compromise the integrity of the existing restoration and could weaken the entire tooth. What you are hoping is that the patch will cure the problem, but in fact it could lead to your second molar breaking and needing a crown, anyway. Additionally, because #15 is subjected to much biting force, your tooth could break below the gum or through the nerve and that would lead to more costly and involved treatment.
What it may boil down to is this: a “patch” could save you time and money now but it may cost you much more in the future, be it in 2 months or two years from now. It’s certainly something to think about. You might want to ask your dentist to show you a photograph of the tooth. That might give you a clearer view of the situation and make you feel better about the crown.
Good luck!
Dr Sinkin
I had a root canal done about seven years ago but didn’t get the crown. The tooth broke off at the gum line about five or six years ago and has never caused a problem. Last week I felt a fragment of tooth come loose and a some sliver came out. Now this week, another piece of tooth is protruding, loose, but I can’t get it out. My gum is now sore and swollen. My pain is increasing and my gum is turning black.
Dear Debra,
I am truly sorry for your dental tribulations. Unfortunately, your story is all too common. The number one reason that teeth treated with root canal therapy are lost is that they were not properly restored and protected with a crown. I have received scores of emails describing your very predicament and have seen far too many emergencies stemming from a broken endodontically treated tooth (root canal) that was broken beyond repair because of a failure to place a proper restoration.
The rhetorical question that I frequently ask myself when I encounter this situation is why invest the time, effort and money trying to save a tooth with root canal only to see the tooth extracted because of a failure to complete the needed treatment? Of course, I know that finances play a big part in this frequent conundrum. Root canal is the first step when a painful tooth requires the removal of an infected or irreversibly inflamed nerve and pain is a big motivator to seeking dental treatment. But it’s just the first step in the successful treatment of a tooth at risk.
Root canal, post and core and crowns usually go hand in hand and this triumvirate of care can involve a significant financial investment. Of course, both patient and dentist desire seeing the completion of such care, but oftentimes when the pain is gone, the cost weighs in heavy and the restorative phase of treatment is often delayed for months, for years, or even forever…until disaster strikes.
Debra, without seeing your tooth, your description leads me to surmise that your tooth may need to be extracted. The gum is clearly inflamed, quite possibly infected. You need to see a dentist ASAP.
In the meantime, use warm salt water rinses and analgesic pain medication. Don’t procrastinate any longer lest your problem gets even worse. Best of luck.
Dr. Sinkin
I have a crown over a root canaled molar. The crown just came off while I was eating some nuts. I read through your q and a’s and think I have it handled. But I just want to thank you for providing this blog to those of us who have these dental emergencies. This is Friday night, going into a weekend, and here in Florida, we are expecting a tropical storm or hurricane by late Sunday into Monday. My dentist has no emergency line, so I’ll have to wait until Monday to call and hope we have electricity by then. So, I have no pain, and I believe I should be saving the crown, brushing the tooth stump, and not eating on that side. I think I prefer to skip temporarily gluing it back in, unless it’s necessary to do so. Thanks a million!
Dear Amy,
It sounds like you have the situation well under control. Put your crown in a safe place. I can’t tell you how many times patients wrap their displaced restorations in a tissue only to then throw it in the garbage! I hope the storm fizzles out and sun comes out with no harm done. Good tidings.
Dr Sinkin
So, I have no clue how this happened, but my back tooth on my upper jaw is either chipped or cracked (I can’t really tell which), but I think its a slight chip or crack. I’m not feeling any pain right now, but I’m scared! I don’t ever recall having any problems with my teeth, and I don’t know what to do. I’m already planning on staying away from coffee for awhile until I know exactly what’s going on. I have a huge fear of seeing dentists since I was 12 (I’m 18, now), and if seeing a dentist means having a needle stuck in me (I have an even bigger fear of needles)….I just don’t know what to do right now, and I’m scared. Please help!
Dear Mika,
For your own sake, please try to calm down. You are getting way too ahead of yourself and will make yourself sick with worry for perhaps no reason at all. If you chipped your tooth, you might only need to have the area polished. Or you could possibly have the chipped area bonded and might not need any anesthetic. If an old filling came out and there’s no decay, bonding without drilling or anesthetic is entirely possible. Obviously you need to see a dentist. Dental fear can be crippling and quite dreadful. You need to calmly share your feelings with both the receptionist and the dentist. Make an appointment for an emergency examination and explain that you do not expect/wish to be treated during this first encounter. You need to prepare yourself and understand the recommended treatment. This way you can have your tooth evaluated with the peace of mind that the dentist will just be looking. Once you know what’s needed you can discuss strategies to help you deal with your fear.
You mentioned that it’s an upper back tooth – the easiest area to give a nearly painless injection, IF you need anesthetic. Nitrous oxide and/or a mild sedative may be helpful, but in truth, nothing trumps compassionate care.
One step at a time. Don’t torment yourself needlessly, find out what the problem is and take it from there. Dentistry has come a long way and so have you….you’re older and wiser!
Good luck and let me know how it goes.
Dr Sinkin
Dr Sinkin I recently had a tooth extracted(crowned 10 years ago) I experienced intermittent pain from that tooth affecting other teeth (all upper right side)off and on visited several dentists nothing could be found to cause this no cracks, nothing. This past winter this worsened I visited another dentist and he found a split root only option extraction. We are in the process of a bridge and another tooth in its place (I sustained extensive bone loss)
My dentist,MD injected something (900.00) to promote some sort of graft (if I’m saying this right, so he has something to be able to attach a new tooth to. It’s been 6 weeks since the extraction and the pain is back just like it was before extraction. How can this be? I’m confused and I’m wondering if this caused this pain or is it something else. Should I seek a 2nd opinion?
Dear Patricia,
Dental pain intensity can range from background annoyance to all-consuming. I never think that a second opinion is a bad way to go. In fact I encourage it. But before you running to other offices, what has your dentist told you? By your description, I’m not exactly sure what’s going on with your post extraction experience. Are you having a bridge or an implant? Did you have a bone graft where your tooth was extracted and are you going to have an implant? Was an implant considered? The bone loss on the tooth that might be supporting the bridge – was that the area that you had the graft? Is the tooth strong enough to support a bridge. Where is your pain coming from? Referred from, another tooth in the area? Extraction/graft related?
I suggest that you have an evaluation by a Board Certified Oral Surgeon and/or a Periodontist to get another point of view and I would include your dentist in the process. I’m sure he’d be more than willing to recommend some specialists for you. What you need is more information before taking the next step or having more treatment. Be well.
Dr Sinkin
I am on vacation and my back molar which had a crown has broken off at the gum line. I am not in pain. Do I need to see if I can get in to a dentist today (Friday) while I am out of town, or could this wait until I return home next Thursday? Thank you for your response.
Jean,
Experience tells me that you most likely will be fine until you return home. Either you already had root canal treatment or the nerve is no longer vital. Since you are not in distress or feeling discomfort, you will probably be ok not to seek care from an out of town dentist. But you will need to have the tooth fully evaluated and there is a good change you will need a new crown and a post placed which will require multiple visits. Meanwhile, keep the stump clean, it’s usually OK to brush in these situations. Set up an appointment as soon as you return home. Have fun!
Dr. Sinkin
Dear Dr. Sinkin, thank you for hosting this wonderful website. I am astonished at the level of detail in your responses.
We are in Fort Lauderdale, about to embark on a three week anniversary cruise (a gift from our children). I have had extensive dental restoration done the past 18 months. The last quadrant is not complete. Gum tissue still healing, etc.
#8 – #15 are my own teeth. My dentist back in Chicago used a type of dental material to form teeth #9 and #10 as a single temporary unit. Part of my own tooth #10 is the anchor for the unit. He made a second prosthetic unit to stand in for #11 and #12 That unit was fixed in place with two wires embedded in the units.
This morning, a large visible part of the first unit (#9) broke off in pieces. The upper part is still all there, but the portion below is broken in a jagged way. It looks dreadful. An hour later the entire second unit (11 and 12) fell out, wires and all. When I picked it up it fell apart in my hands. No pain at all.
I am heartbroken and frantic. Our cruise departs tomorrow morning!
The only hope is that I watched my dentist make these prosthetics with his fingers, like shaping pottery. Is it possible I could attempt to make another? Or fix the broken area on the front of #9? I don’t know what the material is, though, and his office is closed for 2 weeks.
Please tell me what do.
Dear Katherine,
Bad timing, as if there was ever a good time for a dental disaster. Hopefully there is a dentist available on board. I’m so sorry for your troubles.
Bonus voyage.
Dr. Sinkin