Originally published October 7, 2016. Updated August 12, 2026.
It is 8:40 on a Friday night. A soccer ball has just met your daughter’s front tooth, and now there is blood, panic, and a small white tooth in your hand. Or maybe it is quieter: a dull ache that has been building all week and has turned into a throb that keeps you up. Either way, you are facing a dental emergency, and you need to decide what to do in the next few minutes.
This guide explains what counts as a dental emergency, what to do for a knocked-out tooth, a broken tooth, and a severe toothache, and when the emergency room is the right call instead of the dentist.
Why does fast action matter in a dental emergency?
Some dental problems are on a clock. A knocked-out adult tooth has the best chance of being saved when it is replanted quickly, and an infection that is left alone can spread beyond the tooth. Other problems, like a small chip that does not hurt, can usually wait for a regular appointment. Knowing the difference saves teeth, and it also saves you from a panicked night in the wrong waiting room.
What counts as a dental emergency?
Call a dentist right away if you have any of the following:
- A knocked-out adult tooth
- A severe toothache that will not settle
- A broken or cracked tooth with pain, bleeding, or sharp edges
- Swelling in the gums or face, or a pimple-like bump on the gum
- A lost filling or crown that leaves the tooth painful or exposed
- Bleeding from the mouth that does not stop
A chipped tooth that feels fine, a small lost filling with no pain, or mild sensitivity to cold can usually wait for the next available appointment. When you are unsure, call and describe what happened. Our team can tell you whether it needs care now. You can read more about how we handle these visits on our emergency dental care page.
What should you do if an adult tooth is knocked out?
A knocked-out tooth is the most time-sensitive dental emergency. The American Association of Endodontists (AAE) says there is a chance to save the tooth when treatment happens preferably within 30 minutes. The international dental trauma guidelines treat replanting within 60 minutes as “immediate,” and a 2023 follow-up study of replanted teeth found that most of the teeth that were eventually lost had been outside the mouth for more than an hour. In short, speed matters more than anything else you do.
Step by step for a permanent tooth
- Pick the tooth up by the crown, the chewing surface, and avoid touching the root.
- Rinse it gently with plain water if it is dirty. Do not scrub it, and do not use soap, alcohol, or peroxide.
- Try to place it back in the socket if you can, and have the person bite gently on gauze or a clean cloth to hold it there. The American Dental Association (ADA) recommends this if it can be done without touching the root.
- If it will not go back in, keep it moist. Store it in milk, between the cheek and gum, or in a tooth preservation product with the ADA Seal of Acceptance. Never let it dry out.
- Get to a dentist immediately. Call us on the way at (804) 261-1970 (Parham Road) or (804) 372-4420 (Brook Road).
At the office, the tooth is usually placed back in its socket and held in place with a splint for several weeks. The AAE notes that a replanted tooth often needs a root canal a week or two later, and MedlinePlus says the same. Your dentist will also check the neighboring teeth, because injuries there are easy to miss.
What about a knocked-out baby tooth?
Baby teeth are handled differently. The American Academy of Pediatric Dentistry (AAPD) endorses international guidelines that advise against replanting a baby tooth, because doing so can damage the permanent tooth growing beneath it. Even so, call your child’s dentist after any blow to the mouth. If the tooth was not already loose, the fall may have hurt more than one tooth. Our pediatric dentistry team can check for hidden damage and put your child at ease.
How do you handle a broken, chipped, or cracked tooth?
Rinse your mouth with warm water to clean the area, and hold a cold compress against your cheek or lips to control swelling. If you can find the broken piece, bring it with you in a small container of milk. Do not ignore a crack just because the pain is mild. A small break can give bacteria a way into the tooth, and the AAE explains that a crack reaching the inner pulp usually needs a root canal and a crown to protect the tooth.
Depending on the damage, a dentist may reattach the fragment, place a tooth-colored filling, or cover the tooth with a crown. If a tooth is too damaged to save, we can talk through replacement options such as dental implants.
One more warning: if you cannot close your upper and lower teeth together after an injury, the jaw may be broken. MedlinePlus advises getting emergency medical care at a hospital in that case.
What can you do about a toothache until you see the dentist?
A toothache is your body’s way of saying something needs attention. Tooth decay is the most common cause, but the ache can also come from an abscess, a cracked tooth, gum disease, teeth grinding, or even a sinus infection. You can read how sugary and acidic drinks contribute to decay in our post on the worst drinks for your teeth.
Safe steps at home
- Rinse with warm water and gently floss to remove any food trapped around the tooth.
- Use a cold compress on the outside of your cheek to reduce swelling and ease the ache.
- Take an over-the-counter pain reliever as directed on the label if you cannot see a dentist right away. MedlinePlus lists this as a reasonable stopgap.
What to avoid
- Do not place aspirin on the tooth or gum. Both the ADA and the AAE advise against it.
- Skip topical numbing gels on the injured area. The AAE advises against them for traumatic injuries.
- Do not poke at a stuck object with pins or other sharp tools. Use floss, and call us if it will not come out.
Home care only buys you time. If a toothache lasts longer than a day or two, MedlinePlus recommends contacting a dentist. Persistent pain often means a cavity or infection that needs a filling or a root canal, and both are far simpler when caught early.
When is a toothache an ER emergency?
A tooth abscess is a pocket of infection, and it does not go away without treatment. The Cleveland Clinic notes that pain may stop if the infection kills the tooth’s nerve, but the bacteria can continue to spread. Mayo Clinic makes the same point about a ruptured abscess: relief does not mean the problem is solved.
Go to the emergency room, or call 911, if a toothache comes with any of these:
- Fever of 100.4°F (38°C) or higher
- Swelling in your face, jaw, or neck
- Trouble swallowing or breathing
- Confusion or a racing heart
Also keep in mind that jaw or tooth pain can occasionally come from the heart. If the pain arrives with chest pressure or shortness of breath, call 911 rather than a dentist.
How can you prepare for a dental emergency before one happens?
A little planning takes most of the panic out of the moment:
- Have a dental home. Patients who already know their dentist and office can get advice faster. If you are looking for one, our new patient page explains how to get started.
- Save the numbers. Put both office numbers in your phone: Parham Road and Brook Road.
- Build a small kit. Keep gauze, a small lidded container, a cold pack, and an ADA-accepted tooth preservation product in your first-aid kit or sports bag.
- Protect teeth in sports. A properly fitted mouthguard is one of the easiest ways to prevent a knocked-out tooth.
- Keep up with checkups. Regular exams catch cavities and cracks before they become painful. See how often you should visit the dentist.
Frequently asked questions about dental emergencies
What is considered a dental emergency?
A dental emergency is any tooth or mouth problem that needs care right away to save a tooth, stop bleeding, or control pain or infection. Common examples are a knocked-out adult tooth, a broken tooth with pain or bleeding, severe toothache, and facial swelling. Call a dentist immediately for any of these.
How long can a knocked-out tooth stay out of the mouth?
Sooner is always better. The American Association of Endodontists says there is a chance to save the tooth if treatment happens within about 30 minutes, and the international dental trauma guidelines treat replanting within 60 minutes as immediate. Keep the tooth moist and get to a dentist right away.
Should I put a knocked-out tooth in water or milk?
If you cannot place the tooth back in its socket, store it in milk or against the inside of your cheek. Do not store it dry, and do not scrub it or clean it with soap, alcohol, or peroxide. A brief rinse with plain water is acceptable if the tooth is dirty.
Can a toothache go away on its own?
The pain sometimes fades, but the cause usually does not. MedlinePlus advises seeing a dentist if a toothache lasts longer than a day or two. An abscess may stop hurting if the nerve dies, yet the infection can keep spreading.
Do dentists reattach knocked-out baby teeth?
No. Dentists generally do not replant baby teeth because it can harm the permanent tooth developing underneath. Call your dentist anyway after a fall or blow to the mouth, because the injury can involve more than the one tooth.
Need help with a dental emergency now?
If you are dealing with a knocked-out tooth, a broken tooth, or a toothache that will not quit, call us. Describe what happened, and we will give you first-aid guidance over the phone and work to see you as quickly as we can.
- Parham Road: 2314 E Parham Rd, Henrico, VA 23228, (804) 261-1970
- Brook Road: 9007 Brook Rd, Glen Allen, VA 23060, (804) 372-4420
Not in pain right now? Contact us to book a checkup so a small problem never becomes an emergency.
Quick takeaways
- A knocked-out adult tooth is a true emergency. Act within minutes, ideally within 30 to 60 minutes.
- Handle the tooth by the crown, keep it moist in milk or the socket, and never scrub it.
- Baby teeth are usually not replanted, but call your dentist after any injury.
- Rinse with warm water, use a cold compress, and avoid putting aspirin or numbing gel on the gum.
- A toothache that lasts more than a day or two needs a dentist, even if it eases.
- Fever, facial swelling, or trouble breathing or swallowing means the ER.
- Save both office numbers and keep a small dental first-aid kit ready.
Sources
- American Dental Association. Dental Emergencies. MouthHealthy.org.
- American Association of Endodontists. Traumatic Dental Injuries FAQ.
- Fouad AF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2020.
- Roskamp L, et al. Retrospective analysis of survival of avulsed and replanted permanent teeth according to 2012 or 2020 IADT Guidelines. Brazilian Dental Journal. 2023.
- American Academy of Pediatric Dentistry. IADT Guidelines for the Management of Traumatic Dental Injuries: Injuries in the Primary Dentition.
- MedlinePlus, National Library of Medicine. Broken or knocked-out tooth and Toothache. Reviewed February 2026.
- Cleveland Clinic. Tooth Abscess.
- Mayo Clinic. Tooth abscess: Symptoms and causes.
