Short answer
Go to a hospital emergency department immediately for facial swelling spreading towards the eye or neck, difficulty breathing or swallowing, high fever, bleeding that will not stop, or a jaw injury. For a knocked-out adult tooth, hold it by the crown, rinse briefly, put it back in or store it in milk, and see a dentist within the hour.
Dental emergencies rarely happen at a convenient time. Knowing what to do in the first few minutes can save a tooth, and recognising the warning signs of a serious infection can protect your health. This page explains how to tell a hospital emergency from an urgent dental problem, gives first-aid steps for the most common situations, and explains what to do while you arrange care.
Go to a hospital emergency department immediately if you have
Some dental problems become medical emergencies. Do not wait for a dental appointment if you have any of the following. Go to the nearest hospital emergency department, or call an ambulance (123 in Egypt):
- Facial swelling that is spreading, especially towards the eye, causing the eye to close, or down into the neck or under the jaw.
- Difficulty breathing or swallowing, or being unable to swallow your saliva.
- High fever with a dental swelling, or feeling very unwell, drowsy or confused.
- Bleeding that will not stop after 15 to 20 minutes of firm pressure, for example after an extraction or injury.
- Jaw trauma: a blow to the face with suspected broken jaw, teeth that no longer meet properly, inability to open or close the mouth, or numbness of the lip or chin after injury.
- Any head injury with loss of consciousness, vomiting, severe headache or confusion, even if a tooth is also damaged.
Spreading dental infections can, in rare cases, threaten the airway. Hospital teams can give intravenous antibiotics, imaging and surgical drainage if needed. The dental cause can be treated once you are safe.
Knocked-out tooth: first aid that can save it
A knocked-out adult tooth is one of the few true dental emergencies where minutes matter. The chance of saving the tooth is highest when it is put back in its socket as soon as possible, ideally within the first 15 to 30 minutes. International dental trauma guidelines (IADT) recommend:
- Find the tooth and hold it by the crown (the white part you normally see). Do not touch the root.
- If it is dirty, rinse it briefly (about 10 seconds) in cold milk, saline or, if nothing else is available, cold running water. Do not scrub it, use soap or wrap it in tissue.
- Put it back into the socket if the person is conscious and cooperative, making sure it faces the right way. Push gently, then bite on a clean handkerchief or gauze to hold it in place.
- If you cannot replant it, keep it moist: place it in a small container of milk, or saline, or in the person's own saliva (for example in a cup they spit into). Do not store it in water and do not let it dry out.
- See a dentist immediately, ideally within 30 to 60 minutes. The dentist will reposition the tooth, splint it to the neighbouring teeth and plan follow-up, which often includes root canal treatment.
Baby (milk) teeth should not be put back, because this can damage the adult tooth developing underneath. Keep the child calm, control bleeding with gauze, and have them seen by a dentist.
Common urgent dental problems and what to do
| Problem | What to do now | How soon to be seen |
|---|---|---|
| Severe toothache | Painkillers you normally tolerate, following the leaflet; avoid very hot or cold food; do not put aspirin on the gum | Within 24–48 hours; sooner if swelling appears |
| Swelling of the gum or face without the danger signs above | Cold compress on the outside of the face; do not apply heat | Same day or next day; hospital if it spreads |
| Broken or chipped tooth | Keep any fragments in milk or water; rinse with warm water; cover sharp edges with sugar-free gum or dental wax | Within 1–2 days; same day if painful or pink/red spot visible |
| Tooth pushed out of position | Do not force it; bite gently on gauze | Same day |
| Bleeding after an extraction | Bite firmly on folded gauze for 20 minutes; sit upright; avoid rinsing | Contact the dentist if it continues; hospital if heavy and uncontrolled |
| Lost filling or crown | Keep the crown; avoid chewing on that side; temporary dental cement from a pharmacy can help short-term | Within a few days |
| Broken or loose denture | Do not glue it yourself; keep all pieces | Within a few days; see loose denture: what to do |
| Loose or painful implant | Avoid chewing on it | Within 1–2 days |
Managing pain safely while you wait
Over-the-counter painkillers such as paracetamol or ibuprofen can help, but only if they are safe for you. Check with a pharmacist or doctor if you are pregnant, have stomach ulcers, kidney disease, asthma, take blood thinners or other regular medicines. Do not exceed the dose on the packet, and never place a tablet against the gum, which can burn the tissue.
Antibiotics do not cure toothache from an inflamed nerve and are not a substitute for treatment. They are useful when infection is spreading, as decided by a dentist or doctor. Please avoid taking leftover antibiotics without advice. The NHS has helpful guidance on dental abscesses and when to seek urgent help (NHS: dental abscess).
What happens when you contact El Nabi with an urgent problem
Message or call our clinic in Maadi and, if possible, send a clear photo and a short description: what happened, when, where the pain or swelling is, and whether you have fever or any of the danger signs above. We will tell you honestly whether you should come to the clinic or go to a hospital first. When you are seen, we examine the area, take X-rays where needed, relieve pain and control infection, then explain the definitive treatment options, such as root canal treatment, a filling, a splint or extraction.
Our clinic hours are confirmed by phone or WhatsApp. If you cannot reach a dentist and you have any danger sign, do not wait: go to a hospital emergency department.
Preventing dental emergencies
- Wear a mouthguard for contact sports and cycling.
- Do not use your teeth to open bottles or crack hard shells.
- Treat toothache early; many swellings start as a tooth that was hurting for weeks.
- Keep regular check-ups so cracked fillings and decay are found before they cause pain. See our general dentistry services.
When to see a dentist
Any knocked-out, pushed or broken tooth, swelling, persistent pain or bleeding after treatment should be assessed promptly. If in doubt, message us on WhatsApp with a photo, and if any warning signs appear, go straight to hospital.
Recognise yourself in this?
Send us a message or a photo of your X-ray on WhatsApp. Prof. Nouran will look at your case and give you a clear plan, with no pressure to start.
