When something goes wrong with a tooth, it is hard to know whether to drop everything or wait until Monday. Some dental problems genuinely need same-day care, and a few need a hospital. Others can safely wait a few days. Here is how to tell them apart, and what to do in the moment.
Emergency, or can it wait?
As a rough guide, treat it as urgent if there is significant pain, swelling, bleeding that will not stop, or a tooth that has been knocked out or badly broken. These are the situations where acting quickly changes the outcome, whether that means saving a tooth or stopping an infection before it spreads.
Things that are annoying but usually able to wait a few days include a small chip with no pain, a lost filling or crown that is not sore, mild sensitivity, or a dull ache that comes and goes and settles with ordinary pain relief. Uncomfortable, yes, but not an emergency, and worth booking as a normal appointment.
When you are not sure which box you are in, ring us and describe what is happening. We would far rather you called and got a straight answer than sat at home worrying, or ignored something that turns out to matter. We hold same-day slots every clinic day for exactly this.
Toothache
A mild, occasional ache that eases with pain relief can usually wait for a regular appointment, though it is still telling you something is up. Pain that lingers after hot or cold, throbs, keeps you awake, or is bad enough to stop you concentrating should be seen promptly, because that pattern often means the nerve inside the tooth is involved and it tends to get worse rather than better.
In the meantime, over-the-counter pain relief taken as directed usually helps, and keeping your head propped up rather than lying flat can ease the throbbing at night. A cold compress on the outside of the cheek can take the edge off. Avoid putting aspirin directly on the gum, which is an old remedy that just burns the tissue.
If a toothache is severe or has kept you up overnight, ring us on 09 964 0508 as early in the day as you can and we will do all we can to see you before closing.
Swelling
Swelling is the one to take seriously. A swollen gum, cheek or jaw, often with a bad taste or a pimple-like spot on the gum, usually means an infection that is spreading beyond the tooth. This needs same-day dental care, so ring us and say the word swelling so we prioritise you.
There is a line where swelling stops being a dental problem and becomes a medical emergency. If swelling spreads towards the eye or down the neck, or if it starts to affect your breathing or swallowing, do not wait for a dentist. Go straight to the emergency department, and if it is severe, call 111. Airway swelling is rare, but it is dangerous and time-critical.
While you wait to be seen, keep taking pain relief as directed and stay upright. Do not try to burst any swelling yourself, and resist the urge to press or squeeze it.
A broken or chipped tooth
A small chip with no pain is not an emergency. Keep the area clean, avoid biting on that side, and book a normal appointment to have it smoothed or repaired. If a sharp edge is cutting your tongue or cheek, a little dental wax from the pharmacy, or even a piece of sugar-free gum pressed over it, can tide you over.
A larger break is more pressing, especially if the tooth is painful, sensitive to air, or you can see a pinkish spot in the middle, which is the nerve. That should be seen soon to give the tooth the strongest chance. If you have the broken piece, pop it in a container and bring it with you, as it can sometimes be reattached.
Either way, rinse gently with warm water, use pain relief if you need it, and avoid very hot, cold or hard foods on that tooth until we have had a look.
A knocked-out tooth
A knocked-out adult tooth is one of the true emergencies where minutes matter. Pick the tooth up by the crown, the white part you chew with, and never touch the root. If it is dirty, rinse it briefly in milk or saline, do not scrub it, then if you can, push it gently back into the socket and bite on a clean cloth to hold it. If you cannot, keep it in a cup of milk or tucked inside the cheek, and get to us straight away, ideally within the hour.
Do not try to re-implant a child's baby tooth, as pushing it back can damage the adult tooth forming underneath. Still bring your child in promptly so we can check for other injuries, but skip the re-implant step for little ones.
Ring us on 09 964 0508 while you are on the way. If the injury came from an accident, ACC usually helps cover the treatment, and we lodge the claim with you at the visit so it is one less thing to think about.
A lost filling or crown
A filling or crown that comes out but leaves you comfortable is usually not an emergency. Keep the area clean, avoid chewing on it, and book in within a few days. If you still have the crown, keep it safe and bring it along, because it can often be recemented rather than remade.
If the exposed tooth is sharp or sensitive, a pharmacy has temporary dental cement that can cover it for a day or two until you are seen. That is a stopgap, not a repair, so still get it looked at rather than leaving it, since an exposed tooth is more vulnerable to decay and breakage.
If losing the filling or crown has left you in real pain, that shifts it up the list, so treat it like a toothache and ring us so we can fit you in.
When to ring Healthline or go to ED
For dental problems in normal hours, ring us first on 09 964 0508. We are at the Airport Shopping Centre with free parking at the door, and we keep same-day slots for people in pain. Describe what is happening and we will tell you honestly whether you need to come in now or whether it can wait.
After hours, or if you are simply not sure how serious something is, you can ring Healthline free on 0800 611 116 any time, day or night, for advice from a nurse. It is a good port of call when you cannot reach a dentist and want to know what to do next.
Go straight to a hospital emergency department, and call 111 if it is severe, when there is swelling affecting your breathing or swallowing, uncontrolled bleeding, or a facial injury from a significant accident, such as a suspected broken jaw. Those are medical emergencies first and dental ones second, and the hospital is the right place to start.
Quick questions
- Is a lost filling or crown a dental emergency?
- Usually not, if you are comfortable. Keep the area clean, avoid chewing on it, and book within a few days. Keep the crown if you have it, as it can often be recemented. If it has left you in real pain, treat it like a toothache and ring us.
- When should I go to the emergency department instead of the dentist?
- Go to ED, and call 111 if severe, when swelling affects your breathing or swallowing, there is uncontrolled bleeding, or a facial injury from a significant accident such as a suspected broken jaw. Those are medical emergencies the hospital should handle first.
- What do I do with a knocked-out tooth?
- For an adult tooth, hold it by the crown, rinse briefly in milk if dirty, and gently push it back into the socket, or keep it in milk. Get to us within the hour and ring 09 964 0508 on the way. Do not re-implant a child's baby tooth.
- Can I ring someone after hours for dental advice?
- Yes. Healthline is free on 0800 611 116, any time of day or night, for advice from a nurse. In normal hours, ring us first on 09 964 0508 and we will tell you whether you need to be seen today.
Sources: New Zealand Dental Association, patient guidance on dental emergencies · Healthline New Zealand (0800 611 116), after-hours health advice · ACC New Zealand, dental injury cover. This article is general information, not a substitute for an examination and personal advice from a dentist. If you're in pain or unsure, book a visit or call 09 964 0508.
