Is a Toothache a Dental Emergency? When to Call and What to Do

A toothache rarely picks a convenient moment. It starts on a Sunday evening, or in the middle of a week that’s already full of work, school runs and everything else. So most of us do the same thing: take a painkiller, chew on the other side and hope it settles down.

Sometimes that’s fine. Often it isn’t, because a toothache is usually a sign of a problem that keeps progressing whether or not it keeps hurting. This guide covers how to tell whether yours can wait, what you can safely do at home in the meantime, and when a toothache means the emergency room rather than the dentist.

Is a toothache a dental emergency?

Sometimes. A mild ache that comes and goes can usually wait for a regular appointment, although it still needs to be looked at. A toothache needs prompt attention when the pain is severe or won’t let up, or when it comes with swelling or a fever. And if swelling is affecting your breathing or swallowing, that’s a medical emergency: go to the emergency room.

If you’re not sure which of those describes you, call us at (480) 581-7681 and tell us what’s going on. We’d rather tell you it can wait than have you sit at home in pain.

Signs your toothache needs prompt attention

Call the office as soon as you can if you notice any of these:

• Severe or persistent pain. Pain that doesn’t ease, or that’s strong enough to keep you awake at night.
• Swelling. A toothache together with swelling in the gum, face or jaw usually means infection, and an infection in the jaw doesn’t stay put.
• Fever. A fever alongside tooth pain is another sign that an infection may be involved.
• Pain after an injury. A knock to the mouth, or a tooth that has cracked or broken, is worth a call even if it doesn’t look like much.

Other symptoms are less urgent but shouldn’t be left for months: sensitivity to hot or cold that lingers, pain when you bite down, or a tooth that has darkened. They’re common signs that the inside of a tooth is in trouble, and they’re easier to deal with sooner than later.

When to go to the emergency room instead

For most dental problems, a dentist is better equipped than a hospital. Go to an emergency room for:

• Swelling that is affecting your breathing or swallowing
• Bleeding that won’t stop
• Facial trauma or a suspected broken jaw

An emergency room can help with pain and infection, but it generally can’t repair the tooth itself, so you’ll still need to see a dentist afterwards. If our office is closed and your situation can’t wait, go to your nearest emergency center.

What to do for a toothache until you’re seen

These steps can make the wait more comfortable. They ease the symptoms, though; they don’t treat whatever is causing them.

• Call first. We can tell you over the phone what to do in the meantime, and we’ll know what to expect when you arrive.
• Rinse gently with warm salt water.
• Floss gently around the sore tooth. Food trapped between teeth is sometimes the whole problem.
• Use a cold compress on the outside of your face if there’s swelling.
• Take over-the-counter pain relief as directed on the label. Never place aspirin directly against the gum; it burns the tissue.
• Chew on the other side until the tooth has been looked at.

If it’s your child who is in pain, the same steps apply, with pain relief that’s appropriate for their age. Our guide to children’s dental emergencies has more.

If the pain stops on its own

It’s tempting to treat that as good news and cancel the appointment. Unfortunately, pain that disappears suddenly can mean the nerve inside the tooth has died, while the infection that caused the pain is still there and still spreading. It’s worth having the tooth checked even if it has stopped hurting.

What waiting can cost you

Painkillers quiet a toothache; they don’t treat it. While the pain is being managed, whatever is causing it carries on, and the treatment tends to get bigger the longer it’s left:

• A filling can become a root canal. Decay caught early is often a simple filling. The same decay left until it reaches the nerve can mean a root canal and a crown.
• An infection can spread. An untreated infected tooth can develop an abscess and spread into the surrounding bone and soft tissue. At that point it’s a serious problem, not just a painful one.
• A tooth that could have been saved can be lost. Replacing a missing tooth is more involved, and more expensive, than keeping the original.

None of this happens overnight, and none of it is inevitable. It’s simply the reason a toothache that has lasted more than a day or two deserves a phone call rather than another week of waiting.

What might be causing your toothache

Tooth pain has a number of possible causes, and they don’t all feel different from the inside. Common ones include decay that has reached the nerve, a cracked tooth, a lost filling or crown, an infection at the root, gum problems, grinding your teeth at night, and wisdom teeth coming through.

Symptoms alone can’t tell you which one you have. That takes an exam and, usually, an X-ray. What the tooth needs depends on what we find:

• A cavity caught early is often a simple filling.
• An infection inside the tooth usually calls for a root canal, which relieves the pain rather than causing it. The tooth is usually protected with a crown afterwards.
• An extraction is a last resort, for a tooth that can’t be saved.

Whatever the answer, we explain what we’ve found in plain language and go through your options with you before anything is done.

Other dental problems worth a call

Not every dental emergency is a toothache. Call us about any of these too:

• A knocked-out permanent tooth. This is the most time-sensitive situation in dentistry. Pick the tooth up by the crown, not the root, rinse it briefly without scrubbing, and either place it back in the socket or keep it in milk. Don’t let it dry out, and call immediately. A knocked-out baby tooth is different: don’t try to put it back, and call us for advice.
• A cracked or broken tooth. Keep any fragments and bring them with you.
• A lost crown or filling. Keep the piece if you have it and avoid chewing on that side. It usually isn’t an after-hours emergency unless there’s significant pain, but call during business hours, because an exposed tooth is vulnerable.

Our emergency dental care page goes through each of these in more detail.

What happens when you come in

Relieving your pain and getting any infection under control come first. Longer-term repair is planned once you’re comfortable.

If cost is part of what’s keeping you from calling, you’ll know where you stand before treatment is scheduled: after an exam, we explain what’s recommended and what it will cost. We accept most PPO insurance plans, and there are payment and financing options if you need them.

Being in pain and being afraid of the dentist at the same time is common, and it’s exactly the situation we want to help with. Tell us when you call. Sedation options are available, and Dr. Gifford has particular experience caring for highly anxious patients. Our post on making a dental visit easier when you’re nervous explains how it works.

Toothache in San Tan Valley or Queen Creek?

Call Flossed Family Dentistry at (480) 581-7681, or request an appointment if it isn’t urgent. Our office is on Hunt Highway in San Tan Valley, and we see patients from Queen Creek and the surrounding communities. Tooth pain rarely resolves on its own, and it’s usually easier to treat sooner.