Emergencies: What to Do
What to do in the first hour for the most common dental accidents and infections, how to tell a hospital emergency from a dental one, and how to get a same-day appointment with us.
What Should I Do in a Dental Emergency in Hamilton?
Phone Hamilton Smile Studios on 01698 767220, ideally soon after we open. We hold back same-day emergency appointments during opening hours for anyone in pain, registered with us or not, at £70, and free for dental plan members. When we're closed, in the evenings and at weekends, call NHS 24 on 111. A&E is the place for a swelling that's making it hard to breathe or swallow, bleeding that pressure can't stop, or a serious facial injury.
Hospital, Dentist or NHS 24?
Most dental problems, however sore, are a job for a dentist. A hospital emergency department has no dental chair and usually can't fix the tooth, so it's the right place only when the danger is to your airway, your blood loss or the rest of your face.
| Situation | Where to go |
|---|---|
| Swelling that makes breathing or swallowing difficult, or is spreading fast towards the eye or neck | A&E, or call 999 |
| Bleeding still going after 20 minutes of firm pressure | A&E |
| A heavy blow to the face or jaw, a possible broken jaw, or any loss of consciousness | A&E |
| Knocked-out adult tooth, broken tooth, lost crown or filling, toothache, gum swelling that's not spreading | Call us on 01698 767220 during opening hours |
| Any of the above when we're closed | NHS 24 on 111 |
If you can't decide, ring us during opening hours and describe what's happened. We'll tell you honestly whether you need us, your GP or the hospital.
A Knocked-Out Adult Tooth
This is the one true race against the clock in dentistry. A tooth put back into its socket within about an hour has a real chance of reattaching. After that, the cells on the root start to die.
- Find the tooth and pick it up by the biting end. Try not to touch the root
- If it's dirty, swish it in milk for a few seconds, or under cold running water if there's no milk. Don't scrub or wipe it
- Slide it back into the gap, facing the same way as the teeth beside it, then bite on a folded handkerchief to keep it there
- If you can't get it back in, drop it into a cup of milk. An adult can hold it inside the cheek instead, as long as there's no risk of swallowing it
- Phone us straight away, or NHS 24 on 111 if we're closed, and say a tooth has been knocked out
A tooth that has been shoved sideways, pushed up or loosened needs seeing urgently too. We can ease it back into place and splint it to its neighbours while the gum heals. For children, the rules differ: see the section on knocks below.
Need to Be Seen Today?
Phone us first thing and we'll find you a same-day slot.
Chipped Teeth and Lost Fillings
Save any fragments in a clean container, because a large piece can sometimes be bonded back on. Rinse with lukewarm water and, if the gum is bleeding, press a clean cloth against it. A jagged edge that's catching your tongue can be softened with a pellet of sugar-free gum or some dental wax from a chemist.
Until you're seen, chew on the other side and steer clear of ice-cold drinks and sweets, which an exposed tooth will feel sharply. A small chip on a front tooth is usually rebuilt with tooth-coloured composite in one visit. A bigger break, or a hole where a filling used to be, may get a temporary dressing first, £70, so the tooth calms down before it's properly restored. 1
If the break goes into the nerve, you may see a pink or red dot in the middle of the tooth, and it'll be very tender. That tooth may need root canal treatment to keep it. How we choose the final repair is set out in crown, onlay or filling.
A Crown or Bridge That's Come Off
Keep it somewhere safe, such as a small box or a sandwich bag, and bring it to your appointment. Please resist using superglue or any household adhesive. It damages both the crown and the tooth, and a crown stuck on at a slight angle can crack the root.
Pharmacies sell temporary dental cement, which can hold a crown in place for a day or two if you follow the instructions exactly, though it isn't essential. A dab of sensitive toothpaste on the exposed tooth helps with cold sensitivity. If the crown and the tooth underneath are both sound, we can clean them and re-cement it, £70. If the tooth has decayed or snapped inside the crown, a new one will be needed, and you'll get the options and fees before anything is done. 1
Severe Toothache
Ordinary painkillers from a pharmacy, taken exactly as the packet says, are the first step. Don't hold a tablet against the gum: it causes a chemical burn without helping the tooth. Prop yourself up on an extra pillow at night, keep hot and cold food away from the sore side, and rinse with warm salty water.
A toothache that throbs, keeps you awake or lingers after a hot drink usually means the nerve inside the tooth is inflamed or infected. It won't heal by itself. At your emergency appointment we'll find the cause, usually with an X-ray, and aim to settle the pain there and then, often by removing the inflamed nerve tissue as the first stage of root canal treatment, £110. 1
Antibiotics don't cure toothache. They're only useful when an infection is spreading or you feel generally unwell, and the tooth still needs treating afterwards. For pain at night or over a weekend, see our guide to out-of-hours toothache.
Swelling or a Dental Abscess
A lump on the gum, a pimple that leaks a salty taste, or a swollen cheek usually means an abscess: a pocket of infection at the root of a tooth or in the gum. It needs a dentist the same day, but on its own it isn't a 999 call. Hold something cold, wrapped in a tea towel, against your cheek, keep your head raised and don't squeeze or lance it yourself.
The warning signs are different. If the swelling is closing your eye, spreading under your jaw or down your neck, making it hard to swallow or breathe, or you've a high temperature and feel very unwell, go to A&E. Dental infections occasionally spread into the spaces of the face and neck, and those need hospital care quickly. Our dental abscess page explains how an abscess is treated.
Bleeding and Knocks to Children's Teeth
After an extraction, a little oozing for the rest of the day is expected. If it's more than that, roll up a clean, damp gauze or handkerchief, place it over the socket and bite down hard for a solid 20 minutes, sitting upright. Don't keep checking it, rinsing or spitting, because that disturbs the clot. If bleeding carries on after two rounds of pressure, phone us, or NHS 24 out of hours. A cut lip or tongue from a fall usually stops with pressure; one that gapes or won't stop may need stitches at A&E.
With young children, baby teeth that are knocked out should be left out. Putting them back can damage the adult tooth growing above. Your child should still be seen that day, so we can look at the gum and the adult tooth developing above it. Our children's dentist guide covers this in more detail.
Getting an Appointment with Us
Ring 01698 767220 as close to opening time as you can. We keep same-day emergency appointments every weekday, and both registered patients and people who've never been to us before can have one. The emergency appointment is £70, or free if you're on one of our dental plans. Anything beyond first aid, a dressing or nerve removal for instance, is priced for you before we start. 1
Our opening hours are Monday to Friday 9am to 5.30pm, and until 7.30pm on Thursdays. Closed at weekends. In the evenings and at weekends, call NHS 24 on 111, who can give advice and arrange urgent dental care if you need it. If you're in pain or swollen, please phone rather than WhatsApp us, as messages are read during opening hours. A photo by WhatsApp is handy for something non-urgent, like a small chip, so we can book the right length of appointment.
Emergency appointments are usually with Dr Lee Min Ning or Dr Karanveer Singh, and either can carry on with the permanent repair once the 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.