Should I Go to a Hospital or a Dentist for My Dental Emergency?

A dental emergency is one that needs immediate attention. As straightforward as that may seem, it can be difficult to know when you may need emergency care at a hospital or can reasonably wait until your dental office next opens.

You may also need to determine if the problem can be treated by a general dentist (such as for a cracked or chipped tooth) or if the injury is severe enough to require an oral maxillofacial surgeon (such as for a broken jaw).

This article helps you choose the appropriate course of action for a dental emergency, whether it be at a dentist's office or the nearest emergency room. It also offers tips on how to manage a dental emergency until a provider is available to treat you.

What Is a Dental Emergency?

A dental emergency is one that involves the oral cavity, including the teeth, gums, and mouth. It may be caused by a traumatic injury, such as a blow to the face, or an underlying condition, such as gum disease or an infection, that causes unbearable pain.

Examples of a dental emergency include:

• A severe toothache
• A cracked or chipped tooth
• A partially dislodged tooth
• A knocked-out tooth
• A tooth abscess
• A lost or damaged dental restoration (such as a crown, bridge, veneer, or filling)
• A severe soft tissue injury (like a busted lip or lacerated gum)
  

In the context of dentistry, an "emergency" may be something you can live for a short time (such as a lost filling) or a true emergency for which treatment cannot be delayed.

What to Do in a Dental Emergency

Because the definition of a dental emergency is so far-ranging, it is best to call your dentist first. They should also be able to tell you if your injury is something they can deal with or one that needs to be seen at an emergency room.

If it is outside of your dentist's business hours, they may have an on-call service that will leave a message with your dentist. There are also sometimes 24-hour dental emergency facilities you can turn to, particularly in larger cities. However, check if they accept your insurance as this could cost a lot of money if they don't. Even if they do, many dental plans have exclusions or limitations that may not cover your specific injury.

If you sustain a severe injury, it may be in your best interest to go to your nearest emergency room or urgent care facility. Cost may still be an issue, but they are more likely to accept major insurance, including Medicare. Moreover, you would be billed through your medical insurance (where emergency coverage tends to be broader) rather than your dental insurance.

When to See a Dentist

As a general rule, it is best to see if a dentist if the "emergency" falls under the following categories:

• A cosmetic issue, such as a lost crown or broken veneer that is not causing any pain
• A toothache that you can manage with an ice pack and/or over-the-counter painkillers
• A cracked or chipped tooth that is not causing significant pain

In such instances, you can generally wait until your dentist has a slot in their appointment schedule.

There are also "borderline" situations when you either need to see a dentist as a matter of urgency or seek an alternative if your dentist's office is closed. These include:

• A severe toothache
• A severe cut in your mouth or on your lip
• A partially dislodged tooth (whether there is pain or not)
• A knocked-out tooth
• A broken crown or bridge that displaces the underlying jaw implant (the screw-like “post”  in your jaw), causing it to become loose and painful
  

When to Go to the Hospital

In the event of a genuine medical emergency, it is important to not wait and seek immediate care at a hospital. Some conditions cannot be adequately treated by a general dentist and may require the care of an oral maxillofacial surgeon who treats conditions affecting the head, neck, mouth, jaw, and face.

People sometimes avoid going to a hospital for a dental emergency because they think it is "overkill" or will cost too much. But there are situations in which an emergency room visit is not only reasonable but essential.

Dental injuries requiring emergency care include:

• A knocked-out tooth caused by a blow to the face (to check that the jaw is not broken or dislocated)
• A tooth abscess that causes high fever with chills, unrelenting pain, a pus-like discharge, and difficulty breathing or swallowing (indicating a severe infection)
• A severe laceration of the mouth that causes uncontrollable bleeding
• Any traumatic injury that affects how your jaw works
• Any dental injury that causes unbearable pain

What to Do When Waiting for a Dental Appointment

If a dental emergency is not life-threatening, you may need to manage the condition until a dentist or other healthcare provider can see you.

There are several measures and safeguards you can take in the meantime:

• For a toothache: Apply a cold compress to your cheek for 10 to 15 minutes several times a day. Take over-the-counter (OTC) painkillers like Tylenol (acetaminophen) or nonsteroidal anti-inflammatory drugs (NSAIDs) like Aleve (naproxen) or Advil (ibuprofen).
• For a badly cracked or partially dislodged tooth: Save any tooth fragment. If the tooth is partially dislodged, try to ease it back in place unless there is a risk of it falling out entirely. Manage pain with a cold compress and an OTC painkiller until a dentist can see you.
• For a knocked-out tooth: Rinse the tooth under cold water, holding it by the crown (the part of the tooth furthest from the root). Do not touch or remove any tissues. Try to replace the tooth in the socket. If you can't, place the tooth in a jar of milk or a commercial solution called Save-a-Tooth and rush to your dentist.
• For a broken veneer, crown, or filling: You can use an OTC dental cement like Recap-It to temporarily hold a broken veneer or crown in place. (Do not use superglue!) If a filling has fallen out, you can fill the hole with sugar-free gum (not regular gum) until you see a dentist.
• For a mouth cut or laceration: Rinse your mouth with saltwater. Hold a piece of gauze or a caffeinated tea bag over the wound for 10 to 20 minutes. (Caffeine narrows blood vessels.) Use a cold compress and Tylenol to ease pain, but avoid NSAIDs which can promote bleeding.

Summary

Many dental emergencies can wait until a dentist can see you. These include a cracked or chipped tooth, a toothache, or a broken or lost dental crown, bridge, veneer, or filling. Other dental emergencies need to be seen immediately, such as a partially dislodged or knocked-out tooth.

True emergencies—such as a severe mouth laceration, a traumatic facial injury, or a complicated tooth abscess—should be treated at a hospital.