Dental emergencies can be painful and upsetting. Unlike other health crises, dental emergencies are typically not life-threatening, but they can be excruciating and demand immediate attention. One of the most common questions people ask about dental emergencies is when to go to the doctor for an emergency tooth extraction?
How to Determine if You Need a Tooth Extraction?
In many circumstances, having a tooth extracted can be scheduled as a routine dental procedure. However, there are some situations in which tooth extraction needs to be a top-level priority, raising it to the level of an emergency.
Typically, a dentist will attempt to preserve a natural tooth if it is at all possible, but if a tooth is heavily decayed or diseased, tooth extraction may be necessary. But how can you tell when the need for tooth extraction has turned into a full-fledged emergency?
Symptoms that May Require a Tooth Extraction
Your symptoms determine whether or not you need tooth extraction. Their severity indicates if that tooth extraction is an emergency situation.
The following are situations and symptoms that require an emergency tooth extraction:
- Moderate to severe pain
- Heavy bleeding from the gums or area around a tooth, or bleeding that won’t stop
- A knocked-out or loose permanent tooth
- Damage to a jaw or jaws
- Severe toothache, toothaches that don’t get better after taking over-the-counter medication, or increasing swell of the gums or oral tissues
- Swollen gums or an abscess
- Pus leaking from the gums around a tooth
- Broken or fractured tooth or teeth
Of these situations, a loosened or knocked out tooth is the most time-critical dental emergency. If you have a tooth that has been knocked out, avoid handling the root. Gently wash the tooth carefully with plain water and try to place it back into the socket. If it will not go in, place it in a glass of milk until you can see your dentist.
What Makes It an Emergency?
Any injury to the teeth, oral cavity, and/or gum tissue that may cause you to permanently lose a tooth is an emergency. Injuries in which a tooth is loosened, dislodged, or displaced from its socket are serious, time-sensitive situations that need immediate professional help. That’s because when a tooth is knocked out, a dentist or oral surgeon can oftentimes place the tooth back into its socket, saving the tooth and preserving its normal functioning. The longer it takes to have the tooth surgically re-implanted increases your chances of the tooth being permanently lost.
Cracked or broken teeth can also be dental emergencies, as the damage to cracked or broken natural teeth can lead to tooth loss. As well, any health condition that poses a threat to your overall general health, such as heavy bleeding from the mouth or oral tissues is an emergency.
Dentists will preserve the natural tooth if possible, but some conditions require an emergency tooth extraction. However, the following are common situations that do not require an emergency tooth extraction or an emergency visit to your dentist:
- Lost crowns or fillings. Although missing crowns and fillings can cause some discomfort, they are not dental emergencies and may be treated by making an appointment with your dentist.
- A chipped tooth. If you have a slightly chipped tooth that is not causing pain, repairs to that tooth damage can be scheduled. If you’re having a lot of moderate or severe pain that cannot be controlled with over-the-counter pain relievers, contact your dentist immediately.
- Minor toothache. A mildly painful toothache can typically be treated with over the counter pain relievers until you can arrange a visit to your doctor on a non-emergency basis. If the pain becomes severe, it’s time to seek an emergency dental visit.
- Lost or damaged dental appliances. Lost or damaged mouthguards or dentures can be replaced on a non-emergency basis.
- Loose or missing veneers. As is the case with lost or missing dental appliances, loose or lost veneers are not dental emergencies.
These home remedies are not permanent solutions to tooth pain but may temporarily provide a person with some mild relief while arranging to see a dentist. Of course, over-the-counter pain relievers such as ibuprofen and acetaminophen are good places to start when attempting to alleviate tooth pain. Note that ibuprofen will reduce inflammation and relieve pain. Acetaminophen will also alleviate pain, but it does not fight inflammation.
Other ways to alleviate tooth pain at home include:
- Salt-water rinses. Place one-half teaspoon of salt into 8 ounces of warm water and stir until it’s thoroughly dissolved. Gently swish sips of the salty water in your mouth until your tooth pain is alleviated, then spit.
- Ice packs or warm compresses. An ice pack placed on the side of your face can help ease dental pain. A warm (not hot) compress may also be useful for alleviating tooth pain.
- Topical anesthetics. Over-the-counter home remedies that contain benzocaine can provide temporary relief of tooth pain.
- Clove oil. Clove oil contains a compound called eugenol, which has numbing and antiseptic properties. Diluted clove oil placed onto cotton gauze and held beside the tooth may relieve pain, although it’s important not to swallow clove oil, as it is very powerful. Many over the counter preparations for tooth pain contain eugenol.
- Flossing. Food debris can cause tooth pain if it becomes trapped between a tooth and gum tissue. Gentle flossing can help dislodge that debris and alleviate the pain.
Most of the time, dental emergencies don’t call for a trip to the emergency room. If you have tooth damage or oral pain from facial trauma—that is, you’ve been struck in the face, jaw, or mouth—you should go to the emergency room. As well, if you’re experiencing severe intense pain, have facial swelling or swelling in the gums, or are bleeding from the gums or mouth, seek help at the emergency room.
If you have a toothache and a fever higher than 101 degrees, it’s time for you to go to the emergency room.
No, in most circumstances, a hospital emergency room will not perform an emergency tooth extraction. If you’ve suffered facial trauma, heavy bleeding from the mouth, have a cracked or broken jaw, or been in a serious accident that may have damaged the bones of your face, then a trip to the ER is definitely called for. However, hospitals typically do not perform emergency extractions.
At the ER, you will be prescribed antibiotics and pain medication, as well as instructions to visit a dentist or oral surgeon.
Tooth extractions are a routine part of dentistry, and any dentist can perform an emergency extraction of a damaged or diseased tooth. Although dentists will try to preserve a person’s natural teeth, sometimes it’s better for the health of surrounding teeth for a damaged or infected tooth to be pulled and replaced by a dental implant.
When a tooth is completely visible above the gumline, most of the time a dentist can remove it. However, some tooth extractions are more complex and should be performed by an oral surgeon.
Cases like these include:
- Impacted wisdom teeth. Impacted wisdom teeth may fracture upon removal or may be at risk of damaging other teeth. Wisdom teeth may also have large roots that crowd the roots of other teeth or may be fused into the jawbone.
- Fractured teeth. Removing cracked or fractured teeth is a surgical procedure due to the complexity of removing a tooth or teeth in segments.
- Fused teeth. When teeth are fused into the jawbone, an oral surgeon will be required, as surgery on the jawbone will be necessary.
- When there is severe abscess, swelling, pain, restricted mouth opening, and the need for IV sedation anesthesia
Unlike dentists, oral surgeons, also called oral and maxillofacial surgeons, undergo a four to six year long surgical residency. They are trained specifically to treat complex conditions that affect the jaws, mouth, and face. Oral surgeons are also trained in administering IV sedation.
What to Expect During an Emergency Tooth Extraction
First, the doctor will inspect your mouth and teeth to determine what the situation calls for. Your doctor will also take x-rays or other scans to see what’s going on beneath the surface of your gums and oral tissues, which is especially critical if the jawbones are involved.
Some people may need IV sedation to stay comfortable during an emergency tooth extraction, which makes it a good idea to have someone accompany you; if you have IV sedation, you will be unable to drive yourself home.
Leave the gauze pads in place for up to 4 hours and only drink cool or warm liquids for the first 24 hours after your procedure.
There are some steps you can take that will help you heal faster. Naturally, the degree to which you’ll need to change your routine depends on the severity and complexity of your unique situation. If you’ve had several teeth extracted, you will need to be even more attentive to your healing process.
These are some of the most important things you can do to ensure your healing from an emergency tooth reaction is as thorough and rapid as possible:
- Rest. You’ll need to rest for the first 24 hours after your extraction and take it easy for the next day or two. Avoid any exertion and avoid heavy lifting.
- Use ice packs to reduce swelling at the surgical site—20 minutes on and 20 minutes off.
- Manage bleeding. After a tooth has been extracted, you can expect some minor bleeding. You will go home with gauze pads to place on the incision site to help control bleeding and drainage but remember that minor bleeding after having one of your teeth extracted is normal and helpful. Bleeding will produce blood clots that will protect the surgical site from infection.
- Avoid smoking or using straws for at least 48 hours post-surgery. Using straws or smoking creates suction, which can dislodge the protective blood clots on the surgical site or tooth socket. It is best to avoid smoking during the entire healing process, as smoking irritates healing tissues.
- Don’t rinse or spit during the first 3 days after the extraction, and do not rinse vigorously for a week.
- Eat soft foods. Avoid hard, crunchy, or chewy foods for the first 48 to 72 hours after emergency tooth extraction. When you’re on the mend from an emergency tooth extraction, avoid very hot or cold liquids and stick to soft foods like scrambled eggs, soups, smoothies, and meal replacement drinks.
While some dental emergencies require tooth extraction, there are a number of other dental emergencies that may not require tooth extraction but deserves immediate attention:
A damaged or loose dental implant needs immediate attention. Dental implants are small titanium rods placed into holes drilled into the jawbone. In a process called osseointegration, bone fuses to these rods, making it unlikely for them to come out without significant facial trauma. However, osseointegration takes from 4 to 6 months, and during that window, dental implants might become dislodged.
Even small shifts in a dental implant’s position is enough to warrant an emergency visit.
These types of injuries not only dislodge teeth from their sockets, but they may also loosen tooth roots or crack teeth. When a tooth feels loose or shifts in its sockets, call your dentist immediately.
Sudden pain, swelling, pus, or blood from the gums
Pain, swelling, and pus from the gumline are signs of periodontal disease. When an infection reaches a tooth’s nerves, the pain can become intense.