Toothache Out of Hours

Signs You Need A&E Tonight

Most toothache, however miserable, is safe to manage at home until a dentist can see you. A few situations aren't, and you shouldn't sit on them until Monday:

• A swollen face or jaw that's making breathing, swallowing or opening your mouth difficult
• Swelling that's growing quickly, closing an eye or spreading down into your neck
• A high temperature and feeling properly unwell alongside a swollen face
• Bleeding from the mouth that's still going after 20 minutes of firm, steady pressure
• A heavy knock to the face or jaw, especially if you blacked out or your bite suddenly feels wrong

For any of these, go to A&E or call 999. Hospital teams can drain a spreading infection, give antibiotics into a vein and deal with fractures, none of which a dental surgery can do.

Who to Phone When We're Closed

Our hours are Monday to Friday 9am to 5.30pm, and until 7.30pm on Thursdays. Closed at weekends. Outside those times:

• NHS 24 on 111. Free from landlines and mobiles, day and night. Tell them it's dental pain. A clinician will talk it through and, where needed, arrange an urgent NHS dental appointment
• A local pharmacy. Pharmacists can recommend painkillers that are safe alongside your other medicines, and many open on Saturdays
• Dental plan members get out-of-hours cover as part of membership, set out on our dental plans page

You don't need to be registered with any dentist to use NHS 24. If you're unsure whether the pain counts as urgent, they'll make that call with you. Please don't rely on a WhatsApp message to us at night, because it won't be read until we're next open.

Easing the Pain Until Morning

1. Take an ordinary painkiller, following the dose on the box. Paracetamol or ibuprofen are the usual choices. If you're pregnant, take other medication or have asthma, stomach or kidney problems, check with a pharmacist or NHS 24 which is safe
2. Sleep propped up on an extra pillow, which lowers the pressure in the tooth
3. Rinse a few times with warm water and a teaspoon of salt, swishing gently
4. Clean round the sore tooth softly with a brush and floss. Trapped food often makes things worse
5. Hold a cold pack wrapped in a towel against your cheek, ten minutes on and ten off, if there's swelling
6. Chew on the other side, and avoid very hot, very cold and sugary food and drink

If a filling or crown has fallen out and left a sharp edge, a small ball of sugar-free gum pressed over it will protect your tongue overnight.

Things That Make It Worse

• Putting aspirin, or any tablet, directly on the tooth or gum. It burns the gum and does nothing for the nerve
• Taking more than the stated dose, or doubling up on two products that contain the same drug. Ask a pharmacist or NHS 24 instead
• Drinking alcohol to dull it, particularly on top of painkillers
• Squeezing or pricking a gum swelling
• Trying to pull out a loose tooth or a broken piece
• Fixing a crown back on with superglue
• Leaving antibiotics from an old prescription to do the job. Leftover tablets are rarely the right drug or dose

Why It's Worse When You Lie Down

When you lie flat, more blood flows to your head, and an inflamed nerve sealed inside a tooth has nowhere to swell into. The extra pressure is what turns a daytime ache into a throb at 2am. With no distractions, you notice it more as well.

Pain that keeps you up, or starts by itself without anything hot, cold or sweet setting it off, usually means the pulp in the middle of the tooth is inflamed or infected. Painkillers can take the edge off, but that kind of toothache rarely settles for good on its own. The tooth needs treatment, often a dressing or removal of the nerve tissue, which our root canal guide explains.

One thing to watch: if a tooth that has hurt badly for days suddenly stops, the nerve may have died. The infection is still there and can form an abscess, so book in anyway.

Being Seen by Us on a Weekday

Phone 01698 767220 as soon as we open. We set aside emergency appointments every weekday, and you don't have to be one of our patients to have one. It costs £70, with no charge for dental plan members. ¹ If you're new to us, you can also book an emergency slot online.

If Monday morning is a long way off, it may help to know that on Thursdays we're open until 7.30pm, so pain that starts on a Thursday may still be seen that day. If you're travelling in from Bothwell, Motherwell or Wishaw, our getting here page has directions to 20–22 Brandon Street.

What We Do at the Appointment

Your dentist, usually Dr Lee Min Ning or Dr Karanveer Singh, will ask where and when it hurts, test the tooth and take an X-ray if one is needed. Our aim is for you to leave in less pain than you came in with.

You'll get the fee before any treatment starts, and a written plan for the permanent repair to think over at home. ¹ For broken and knocked-out teeth, see our dental emergencies guide.

Questions

This guide is general information, not a diagnosis. A dentist needs to examine you to say what is right for your teeth.