A toothache can range from a mild annoyance to excruciating pain. But how do you know when it's time to seek emergency medical care?

In this article, we will explore the signs that indicate your toothache requires immediate attention — and whether a trip to the emergency room (ER) is necessary.

Quick Answer: Should I Go to the ER for a Toothache?

If you are experiencing severe, unbearable pain, uncontrolled bleeding, difficulty breathing or swallowing, or any other symptoms that may indicate a dental emergency, it's crucial to seek immediate medical attention. In such situations, a trip to the emergency room may be necessary.

However, if your toothache is mild to moderate and there are no other alarming symptoms, it's best to schedule an appointment with your dentist during regular office hours.

  • The emergency room will almost never treat a tooth directly — so don’t expect to get an extraction or root canal from the hospital.

  • However, if the underlying dental issue has caused a severe or life-threatening systemic issue (such as an uncontrolled infection, debilitating pain, or uncontrolled bleeding), the emergency room will usually provide palliative treatment to temporarily minimize pain or reduce suffering.

When to Consider the Emergency Room for Dental Pain

It's important to understand that not all toothaches require a visit to the emergency room. In fact, most dental issues can be addressed by a dentist during regular office hours.

However, there are certain situations when immediate medical attention is needed.

If you experience any of the following symptoms, it may be time to consider heading to the ER:

  • Severe, unbearable pain that is not alleviated by over-the-counter pain relievers

  • * Swelling in your face or jaw that is rapidly increasing

  • * Bleeding that won't stop

  • *** Difficulty breathing or swallowing

  • High fever accompanied by a toothache

If you are unsure about the severity of your symptoms, it's best to err on the side of caution and seek immediate medical attention. Delaying treatment could lead to more serious complications.

Toothaches can stem from various issues such as cavities, gum disease, abscesses, or even more serious (and rare) conditions like oral cancer. Identifying the cause of your pain is helpful in determining the most effective treatment plan.

Signs Your Toothache Requires Prompt Attention from a Dentist

While the severity of tooth pain can vary, there are specific signs that indicate the need for prompt care.

Pay attention to these red flags — in most cases, dealing with the issue promptly can avoid the need for a last-minute trip to the emergency room:

  • Persistent pain that lasts longer than 48 hours

  • Pain that worsens with chewing or biting down

  • Visible abscess or fluid-filled swelling around the tooth

  • Broken or fractured tooth

  • Loose tooth

These symptoms could indicate a serious dental problem that requires immediate attention. Ignoring them can lead to further complications, such as infection or even tooth loss.

How to Tell If Your Toothache Is an Emergency

Distinguishing between a regular toothache and a dental emergency can be challenging. Here are some factors to consider:

  • Intensity of pain: Is it severe and unbearable?

  • Other symptoms: Severe swelling, bleeding, or difficulty breathing?

  • Duration of pain: Has it lasted longer than 48 hours?

  • Impact on daily activities: Does the pain interfere with eating or sleeping?

Some swelling does not constitute an emergency — nor does some pain. However, swelling that is spreading uncontrollably is generally considered a true medical emergency, particularly if it interferes with swallowing or breathing.

The Role of the Emergency Room in Dental Emergencies

When faced with a dental emergency, the emergency room may not be the first place that comes to mind. However, ERs have a role in managing severe dental pain and other dental emergencies.

Emergency room doctors can provide temporary relief for dental pain, prescribe antibiotics for infections, and address other urgent dental issues such as draining abscesses.

However, it's important to note that emergency rooms are not equipped to provide definitive dental care. Therefore, it is imperative to follow up with a dentist as soon as possible to address the underlying cause of the toothache.

Emergency Room or Emergency Dentist?

When faced with a toothache, deciding where to seek help can be challenging.

While the emergency room (ER) can offer immediate assistance for various health concerns, it's not always the best option for non-life-threatening dental issues. Here's why choosing an emergency dentist might be more beneficial than heading to the ER for a toothache:

  • Specialized Care: Emergency dentists are equipped to handle dental issues more effectively than the ER. They have the specific tools, equipment, and expertise needed to diagnose and treat dental problems directly, from toothaches and abscesses to broken teeth. In contrast, the ER is designed to address a wide range of general health emergencies and may not have a dental professional on staff.

  • Appropriate Treatment: An emergency dentist can provide the exact treatment required for dental issues, such as root canals, extractions, or filling replacements, which are beyond the scope of care typically available in the ER. The ER can offer pain relief and antibiotics if necessary, but for definitive dental treatment, you'll need to see a dentist eventually.

For non-life-threatening dental situations, seeking out an emergency dentist is usually the better choice. They can offer immediate, specialized care tailored to your dental needs, ensuring you receive the most appropriate treatment without the additional step of visiting the ER.

However, in cases of severe infection, significant facial swelling, or uncontrolled bleeding, going to the ER is necessary to address any potential life-threatening conditions before seeing a dentist.

Steps to Take Before Deciding to Visit the ER for a Toothache

Before rushing to the emergency room for a toothache, there are a few steps you can take to alleviate your symptoms and determine the best course of action:

  1. Rinse with warm saltwater: Gently swishing warm saltwater around your mouth can help reduce inflammation and ease some of the pain.

  2. Apply a cold compress: Placing a cold compress or ice pack on the affected area can help numb the pain and reduce swelling.

  3. Take over-the-counter pain relievers: Non-prescription pain medications, such as ibuprofen or acetaminophen, can provide temporary relief.

  4. Contact your dentist: Call your dentist's office and explain your symptoms. They can help guide you on whether you should visit the emergency room or wait for an appointment during regular office hours.

  5. ***See an after-hours/emergency dentist: If your area has an emergency dentist that provides after-hours treatment, this should be your first step. Many times, this will be more helpful and less expensive than the ER, and allow you to skip the ER trip. In a worst-case scenario, an emergency dentist can still evaluate the situation and determine whether or not you need to visit the emergency room.

By taking these steps, you can ease your discomfort while getting professional advice on how to proceed with your toothache.

Common Causes of Severe Tooth Pain

Understanding the potential causes of severe tooth pain can help you better assess the urgency of your situation. Some common culprits include:

  • Dental abscess: An infection that forms a pus-filled pocket around the tooth. If the infection is localized to a single tooth or small area of the mouth, you should schedule an appointment promptly with your dentist, but shouldn’t need to visit the ER.

  • Tooth decay: Cavities that have reached the inner layers of the tooth.

  • Cracked or fractured tooth: Damage that exposes the sensitive inner layers of the tooth.

  • Gum disease: Inflammation and infection of the gums.

  • Impacted wisdom tooth: A wisdom tooth that grows at an angle and presses against nearby teeth.

If you suspect any of these conditions may be causing your toothache, it is important to seek prompt dental care to prevent further complications. For most of these situations, the ER will only be able to prescribe antibiotics and pain medication, rather than actually addressing the problematic tooth.

Final Thoughts

Dealing with a toothache can be an uncomfortable and distressing experience. While most dental issues can be addressed during regular office hours, there are situations where immediate medical attention is necessary.

Uncontrollable bleeding or swelling, especially swelling that affects the back of the mouth or throat, necessitates a prompt trip to the emergency room. When in doubt, use your best judgment — a dental emergency can turn into a systemic emergency quite quickly!

Understanding the signs that indicate a dental emergency and knowing how to alleviate your symptoms can help you make an informed decision about whether a trip to the emergency room is required. Remember, if in doubt, it's always best to consult a dental professional to ensure the health and well-being of your teeth.

FAQs

What will the ER do for tooth pain?

The ER can provide temporary relief for tooth pain, typically through prescription pain relievers and antibiotics to address infection. However, they are generally not equipped to handle dental procedures such as extractions. They'll likely recommend seeing a dentist as soon as possible for definitive treatment. If your town has an emergency dentist, this may be a good option.

Can the ER pull an infected tooth?

No, the ER generally cannot pull an infected tooth. Emergency rooms do not have dental professionals on staff and are not equipped for dental procedures. They can often only offer pain and infection management until you can visit a dentist.

How do you know if a toothache is serious?

A toothache is serious if it's severe, lasts more than a couple of days, and is accompanied by symptoms such as fever, swelling, pain when biting, a foul taste in the mouth, or persistent bad breath. These symptoms could indicate an infection that requires prompt dental treatment.

When should you go to the hospital for dental pain?

You should consider going to the hospital for dental pain if you experience severe swelling that affects your eyes or breathing, a high fever, severe pain that isn't relieved by over-the-counter medications, or if you suspect you have an abscess that is spreading uncontrollably. In such cases, immediate medical attention can prevent serious complications.

How do you know if a tooth infection is spread?

Signs that a tooth infection has spread include fever, swelling in the face or cheek, increased pain, presence of pus or a foul taste, and swollen lymph nodes under your jaw or in your neck. Severe infections may lead to general fatigue or even illness.

How do you know if your tooth is infected?

An infected tooth often presents with throbbing pain, sensitivity to hot or cold, swelling in the gum around the tooth, a bad taste in the mouth, fever, and possibly a visible discharge or pus. You may also notice swollen glands or discomfort in the area.

Can the ER help with severe tooth pain?

Yes, the ER can help manage severe tooth pain by providing pain relief and antibiotics if an infection is suspected. However, they will not address the root cause of the dental issue and will recommend follow-up care with a dentist.

Will the ER pop a tooth abscess?

The ER typically does not perform procedures to drain or "pop" a tooth abscess unless it is severe or life-threatening. Their approach is to manage the symptoms and possibly prescribe antibiotics to tackle the infection. Dental intervention is necessary for a permanent solution, such as draining the abscess or performing a root canal.

* Though the author of this post is a licensed dentist in the state of Kansas, this information is provided for informational and educational purposes only. Please use your best judgment and contact emergency medical services in the event of an emergency.