What are the immediate steps to take for a toothache emergency?

Immediate Steps for Toothache Emergency

For a toothache emergency, immediate referral to a dentist is the most appropriate action, especially if there is severe pain, swelling, or signs of infection.

Assessment and Initial Management

• First, determine if the toothache is accompanied by facial swelling, fever, or difficulty breathing, which may indicate a spreading infection requiring immediate dental or emergency medical attention 1.

• For pain management until dental care can be accessed:

  • Over-the-counter pain medications like ibuprofen or acetaminophen can provide temporary relief 2.
  • Avoid placing aspirin directly on the gum or tooth as this can cause tissue damage 2.

• If there is visible swelling, applying a cold compress to the outside of the cheek for 20 minutes may help reduce inflammation 2.

When to Seek Immediate Dental Care

• Immediate dental referral is necessary for:
  • Severe pain that is not relieved by over-the-counter pain medications 1, 2.
  • Facial swelling or swelling of the gums (parulis or gingival abscess) 1.
  • Signs of infection including fever, malaise, or lymphadenopathy 2.
  • Trauma to the tooth with mobility, displacement, or avulsion 1.

Specific Scenarios Requiring Emergency Care

• For tooth trauma:

  • If a permanent tooth is avulsed (knocked out completely), it should be handled by the crown only, briefly rinsed if dirty, and reimplanted immediately if possible 1.
  • If reimplantation is not possible, store the tooth in cold milk, balanced salt solution, or saliva (never water) and seek immediate dental care 1.
  • Note that primary (baby) teeth should NOT be reimplanted if avulsed 1.

• For fractures:

  • Crown fractures exposing the pulp (nerve) require immediate dental attention to preserve tooth vitality 1.
  • Uncomplicated fractures (not exposing the pulp) should be seen by a dentist within a few days 1.

Recognizing Non-Odontogenic Toothache

• Be aware that some toothaches may not be of dental origin. Signs suggesting non-odontogenic pain include:
  • Pain that is burning or stimulating rather than pulsatile 3.
  • Constant, unremitting pain without variation 3.
  • Pain that persists despite local anesthetic block of the tooth 3.
  • Multiple spontaneous toothaches without clear dental cause 3.

Prevention of Future Emergencies

• Regular dental check-ups can help identify and address potential issues before they become emergencies 2.

• Good oral hygiene practices including brushing twice daily, flossing, and using antimicrobial mouthwash can help prevent dental caries that often lead to toothaches 2.

• For those participating in contact sports, wearing appropriate protective gear such as mouthguards can minimize the risk of dental trauma 2.