When to Visit the Dentist

  • Medical Author: Scott D Fell, DO, FAAEM
  • Coauthor: Christina L Kukula, DO
  • Medical Editor: Joseph A Salomone III, MD
  • Medical Editor: Francisco Talavera, PharmD, PhD
  • Medical Editor: Steven L Bernstein, MD

When to Visit the Dentist - Introduction

  • Most symptoms and problems that occur with your mouth, teeth, and gums are not emergencies and usually can wait for an appointment with your dentist.
  • The information here is to help you identify problems or symptoms that require immediate medical or dental attention.

Urgent Dental Problems

  • Traumatic: The following problems require urgent attention by a dentist or a hospital’s Emergency Department:
    • Tooth knocked out
      • Any permanent tooth loss requires urgent evaluation because these teeth may be re-implanted.
      • If you recover a lost tooth, touch or hold it by the crown (chewing edge) and not the root.
      • If the tooth has become dirty, gently rinse it in tap water, but do not scrub it.
      • You should keep the tooth moist. The best way to do this is to place it back in the socket or the location from where it was knocked out.
      • Another option is to place it between your cheek and gum and continue to keep it moistened with saliva.
      • A third option is to place the lost tooth in milk.
    • Broken or chipped tooth
      • You should arrange to see your dentist as soon as possible.
      • The chipped or broken piece should be placed in a cool moist cloth.
      • Chips or breaks can vary in degree. The extent of the chipping will determine how your dentist will treat it.
    • Tooth knocked out of position or alignment (subluxation)
      • Try to push the tooth or teeth back into their proper position with very light pressure. Do not force it.
      • Bite down on the tooth to keep it in position and then seek immediate dental care.
      • Your dentist may splint the tooth so it can heal.
    • Lacerations
      • Cuts or lacerations to your cheeks, gums, or tongue can occur as a result of direct trauma to the mouth area, such as a blow or falling and biting your tongue or cheek.
      • Any cut requires immediate medical attention in the emergency department or by your dentist.
      • Applying direct pressure to the cut can help control bleeding.
      • Some lacerations inside the mouth may be stitched. Others may be allowed to heal on their own. Some of these injuries will also be treated with antibiotics.
  • Nontraumatic tooth problems
    • Toothache or tooth pain: You may have a cavity or dental abscess (pocket of infection) in or around a tooth. You should have the tooth evaluated by a dentist or the emergency department if any of the following occur:
      • The pain is severe. (Pain related to a cavity worsens with exposure to heat or cold or with pressure on the tooth such as chewing.)
      • You have a fever.
      • The gum around the painful tooth swells significantly.
      • Pus or other fluid drains from around the painful area.
      • Swelling occurs in your cheek, chin, face, or neck. (Never place an aspirin or any other pain medication against the gums near the affected tooth because it may burn the gum.)
      • Your gum, cheek, or face surrounding the involved tooth exhibits redness.
      • You have any uncertainty regarding the cause of the pain.
    • Gum swelling or redness
      • Redness or swelling over a large area of the gums or skin inside your mouth requires evaluation by your dentist. Redness may suggest gingivitis, a dental abscess or infection, or other dental or gum disease.
      • This rarely requires urgent care, but you should see your dentist as soon as an appointment can be arranged.
    • Jaw pain
      • Pain in your jaw, called temporomandibular joint syndrome, can occur because of inflammation or degeneration of the joint.
      • This can be identified as pain near your ear or a clicking or popping sensation when your jaw opens or closes. (The popping may or may not be painful.)
      • Your dentist may fit you for a mouth guard or treat you with anti-inflammatory medications. This is not an emergency and does not require urgent evaluation. More severe cases, however, do require advanced treatment.

Routine Dental Care

Good dental care is the best way to prevent nontraumatic problems with your teeth.

  • Brush your teeth at least twice a day with a fluoride toothpaste and floss at least once a day.
  • Frequent cleaning of your teeth and check-ups every 6 months with your dentist or dental hygienist are also important.
  • Prepare for dental emergencies if you experience one by having an established relationship with a dentist. That way, you are more likely to get quick and proper treatment when needed.

Pictures of Tooth Problems

This tooth chipped while the person was eating nacho chips.
This tooth chipped while the person was eating nacho chips.Click to view larger image.

Notice the chipped tooth with the yellow appearance. The yellow area is dentin - the inside portion of the tooth that became exposed after the tooth cracked.
Notice the chipped tooth with the yellow appearance. The yellow area is dentin - the inside portion of the tooth that became exposed after the tooth cracked. Click to view larger image.

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References
Medically reveiwed by Kenneth Rotskoff, MD, DDS; Board Certified Dentistry, Oral/Maxillofacial Surgery

REFERENCES:

1. Camp JH. Diagnosis and management of sports-related injuries to the teeth. Dent Clin North Am. Oct 1991;35(4):733-56. [Medline].
2. McTigue DJ. Diagnosis and management of dental injuries in children. Pediatr Clin North Am. Oct 2000;47(5):1067-84. [Medline].
3. Nelson LP, Shusterman S. Emergency management of oral trauma in children. Curr Opin Pediatr. Jun 1997;9(3):242-5. [Medline].
4. Waldrop RD, Ho B, Reed S. Increasing frequency of dental patients in the urban ED. Am J Emerg Med. Oct 2000;18(6):687-9. [Medline].