Dental Emergencies: What to Do Before You Can Reach Us
Updated: 2 days ago
Most dental emergencies come down to four situations: a knocked-out tooth, a broken tooth, serious pain, or swelling. Each has a few things you can do in the first hour that protect the tooth. Call or text 425.643.5778, and if swelling is spreading or you have trouble breathing or swallowing, go to the ER first.
If you need to be seen today, the emergency dentistry page explains how same-day visits work here and how to reach me after hours.
What counts as a dental emergency, and what can wait until morning?
The hardest part of a dental problem is often not knowing how worried to be. So let me sort it into two groups, because once you know which group you are in, most of the panic goes away.
Call right away, any time of day, for these: a knocked-out adult tooth, a tooth pushed out of position, facial swelling, bleeding that will not stop with steady pressure, pain that over-the-counter medication does not touch, or a jaw injury. These are the situations where the clock matters, either for saving the tooth or for keeping an infection from getting ahead of us.
Usually fine to call in the morning: a chipped tooth that does not hurt, a filling or crown that came out without pain, a dull ache that comes and goes, a broken brace wire you have covered with wax, or mild sensitivity to cold. These deserve attention, but you can sleep tonight and call when we open. If you are not sure which group you are in, call or text anyway.
What should I do if a tooth gets knocked out?
This is the one where the first few minutes matter most.
If it is an adult tooth, find it. Pick it up by the crown, the white part you normally see, and avoid touching the root. The root is covered in delicate cells we need alive for the tooth to reattach, and scrubbing damages them. If the tooth is dirty, rinse it briefly with milk, saline, or water, nothing more.
Now try to place it back in the socket, facing the right way, and bite gently on gauze or a clean cloth to hold it there. The socket is the best possible place for that tooth to wait. If it will not go back in, put it in a small cup of milk. An adult who will not swallow it can also tuck it inside the cheek. Not in water, and not in a dry tissue, because the root needs to stay moist in something close to the body's own chemistry.
The best chance of saving the tooth is within 30 to 60 minutes, so call or text 425.643.5778 while you are on your way. If more time has passed, come in anyway. The odds change, but they do not drop to zero.
If it is a baby tooth, do not put it back, because that can damage the permanent tooth developing underneath. Hold a clean cloth on the area and call us so we can check that the adult tooth below is safe.
What if a tooth breaks or chips?
Rinse with warm water and save any pieces you can find, since sometimes I can bond one back on. A cold compress on the cheek helps with swelling. Cover a sharp edge with dental wax or sugar-free gum, and chew on the other side until we see you.
A small chip can often be smoothed or bonded in one short visit. A bigger break, where a cusp sheared off or a large filling went with it, needs more coverage. Often I can place an onlay instead of a full crown, which rebuilds the broken part and leaves the healthy part alone. Either way, our same-day CEREC crowns mean we can usually design, mill, and cement the final piece in one appointment.
The detail to pay attention to is whether the tooth hurts with air or cold. A chip that is purely cosmetic can wait until morning. A tooth that zings when you breathe in may have the nerve exposed, and that one gets a call the same day, because the longer the nerve sits open, the more likely it is to become infected.
What helps a bad toothache tonight?
A toothache at 11 p.m. is miserable, and a few things help while you wait for us.
Start with a warm salt water rinse, then floss gently around the sore tooth. A surprising number of bad toothaches are something packed between two teeth pressing on the gum, and clearing it brings relief in seconds. An over-the-counter pain reliever, taken as directed on the label, is fine. A cold compress on the outside of the cheek helps with throbbing. When you lie down, keep your head elevated, because lying flat makes the pulsing worse.
Two things to avoid. No heat on the face, since warmth can increase swelling. And never place aspirin directly on the gum, because it chemically burns the tissue.
The signal that matters: pain that wakes you up at night, or that lingers after something cold, usually means the nerve itself is inflamed or infected. A filling will not calm that down, and a root canal is how we save the tooth. That phrase makes people nervous, so I wrote about whether a root canal actually hurts and about how I decide whether you truly need one. The short version is that the procedure relieves the pain rather than causing it.
When is swelling an ER situation?
Most dental swelling is a localized abscess I can drain and treat in the office. But some swelling means an infection is spreading into the spaces around the jaw and neck, and that can become dangerous quickly.
Go to the ER if swelling is spreading toward your eye, under your jaw, or down your neck. Go if you have a fever along with the swelling. Go if you have any trouble swallowing, breathing, or opening your mouth. And go if there is any chance the jaw is broken or you have taken a serious blow to the face.
The ER can give you antibiotics, manage the pain, and image the jaw. What it cannot do is fix the tooth. So once you are stable, the next call is to us, so the source of the infection gets handled and it does not come back.
What if a crown or filling comes out?
This one feels alarming, especially mid-meal, but it is rarely a true emergency. It is also not something to leave for months.
If a crown comes off, keep it and rinse it clean. You can pick up temporary dental cement at any pharmacy and reseat it to protect the tooth until we see you. Never use household glue, which is toxic to the tooth and nearly impossible to remove later. Avoid chewing on that side, and expect some sensitivity to cold, which is normal.
Call within a few days. A tooth without its crown can drift, and exposed tooth structure decays faster than enamel. The sooner we recement it, the more likely the original crown goes back on unchanged.
A lost filling is almost always a simple redo with a bonded composite filling that matches your tooth.
What happens when you get to our office?
Comfort first. If you are in pain, we numb the area before anything else, because you cannot think clearly about options while you hurt.
Then we look. Usually that means a digital x-ray. When I need to see a root fracture or an infection in three dimensions, we take a CBCT scan here in the office, so nobody is sent across Bellevue to an imaging center and left waiting on results.
Then we talk about what I found, in plain language. Conservative dentistry does not change on a bad day. If a tooth needs a bonded filling, that is what we do. If it needs a crown, we can often finish it the same visit. If the nerve is involved, a root canal saves the tooth, and I do those here. Only if a tooth truly cannot be saved do we talk about replacing it, and that conversation can wait for a calmer appointment. An emergency visit is for fixing what is actually broken, not for handing you a treatment plan.
If you are a nervous patient, say so. We build in extra time, and I wrote about how we approach dental anxiety so you know what to expect. And if you have not seen a dentist in years and this is what finally brought you in, you are welcome here, no lecture. I wrote about what that first visit back looks like too.
How do I reach you, and what if it is after hours?
During office hours, call or text 425.643.5778. We work emergencies in as early as the schedule allows, and the sooner you reach us, the more room we have to do that.
Evenings and weekends, call or text the same number and follow the instructions in the greeting.
If you are not a current patient, call anyway and we will do our best to get you in. Our office is in the Factoria neighborhood of Bellevue, right off I-90 and I-405, a quick drive from most of the Eastside.
And one more time, because it matters: if swelling is spreading, or you have trouble breathing or swallowing, go to the emergency room first and call us after.
Dental Emergency FAQ
Do you see dental emergencies for new patients?
Call and we will do our best to get you in. Emergencies do not wait for you to have an established dentist, and plenty of our long-term patients first came to us on a bad day. Call or text 425.643.5778 and tell us what is going on.
Should I go to the ER for a toothache?
For pain alone, no. The ER can prescribe medication but cannot treat the tooth, so you will still need to see us, and you will have spent hours waiting. Go to the ER if the toothache comes with spreading swelling, fever, or any trouble breathing or swallowing. Otherwise, call us first.
How fast does a knocked-out tooth need to go back in?
The best outcomes happen within 30 to 60 minutes. Put the tooth back in the socket if you can, or keep it in milk, and call us while you are on your way. Even past that window, bring the tooth in, because there is still a chance.
Can a cracked tooth wait until my next cleaning?
A chip that does not hurt can usually wait a week or two, but not months, because cracks tend to spread under chewing pressure. A cracked tooth that hurts with cold or when you bite down should be seen within a few days. Waiting too long can turn a simple onlay into a root canal or a lost tooth.
What should I keep at home for dental emergencies?
A small kit covers almost everything: gauze, dental wax, temporary dental cement from the pharmacy, a cold pack, salt for rinses, and an over-the-counter pain reliever. Add our number to your phone so you are not searching for it in the moment. Milk in the fridge covers the knocked-out tooth scenario.
If something is wrong right now, call or text 425.643.5778. If it is after hours, call or text the same number and follow the instructions in the greeting. If swelling is spreading or you have trouble breathing or swallowing, go to the ER first and call us after. For anything that can wait until morning, you can also request an appointment and we will call you back.
Reviewed by Dr. Victor Bauer, DDS. Last updated October 2026.
Dr. Victor Bauer, DDS is a general dentist and the owner of Family Dental Care of Bellevue, located in the Factoria neighborhood of Bellevue, WA. He provides comprehensive family care including dental implants, Invisalign, and same-day CEREC crowns. Questions about your smile? Call 425.643.5778 or request an appointment.
