Emergency Dentist in Kensington: What to Do When Pain Won’t Wait

Dental pain knows no favourites. It may begin in the middle of a meal, awaken you at 3 am or arrive on a Sunday morning when there has been no work or food for a while. Having worked in dentistry for more than 20 years, I have only one rule. If the pain is stopping you from sleeping, eating, talking or working, then you should be seen on that day.

Toothache, swelling, a broken tooth, a crown falling off, bleeding from the site of an extraction or damage to the mouth may require immediate advice.

Check for danger signs first

Some symptoms take the problem outside of a dental appointment. Call 111 or go to A&E if you experience swelling that affects your ability to breathe, swallow or speak, affects your throat, affects your neck or affects your eye area. The same applies if you experience profuse bleeding that will not stop, a severe injury to the face or jaw, double vision, vomiting after a head injury or experiencing a loss of consciousness.

Both can indicate a spreading infection or facial trauma. The dental chair cannot substitute emergency care if your airway, eye, jaw, or head is at risk.

Toothache that lasts more than two days

If you have a toothache that persists for more than 2 days, you need to see a dentist. Painkillers will only hide symptoms; they will not eliminate decay, deal with an abscess, repair a crack or cleanse an infected nerve.

Be aware of the tooth pain while biting, bad taste, bleeding from the gum, pyrexia, swelling of the cheek or jaw, or pain causing awakening. A large hole may be irritating the nerve; a fractured tooth may be flexing; an infection of the gum may be trapping pus close to the apex; no room can allow an impacted wisdom tooth to become painful and swell.

Use paracetamol or ibuprofen if you can, while you are waiting for an appointment. Dose them according to the packet. A pharmacist can give you advice if you are taking other medicines, if you have asthma, stomach ulcers, kidney disease, liver disease, or if you are taking blood thinners.

Warm salt water solutions may relieve soreness around the gums. Children should not use salt rinses as they may swallow them. Soft foods should be used, with chewing on the unaffected side, and avoiding hot, cold or sweet foods and beverages.

Swelling or a gum boil

Swelling is a cause for concern. A dental abscess is the result of infection forming pus in the tooth, gum or jaw. This will not resolve itself. Although the pain may lessen and the pressure fluctuate as the pus drains into the mouth, dental attention is still required.

Dental abscess. If you think you have an abscess, you should visit a dentist. If you go to the dentist, he/she will examine the tooth, gum, bite and surrounding tissues. Treatment. Drainage of the abscess, root canal treatment or extraction may be indicated. Antibiotics in a few selected situations.

Monitor for fever, swollen glands, difficulty opening your mouth, difficulty swallowing, or swelling that extends.

A broken tooth, lost filling, or loose crown

A broken tooth may look worse than it feels. Pain level alone does not tell you how serious it is. A small chip may need smoothing or a repair. A deeper fracture can expose dentine or the nerve. A crack that runs under the gum can make the tooth hard to save.

Keep any crown, veneer, or broken fragment if you find it. Do not glue it back with household adhesive. Cover a sharp edge with orthodontic wax or sugar-free chewing gum for comfort. Avoid chewing on that side. Book a dental appointment, even if the pain seems mild.

A knocked-out adult tooth

A knocked-out adult tooth needs emergency dental care. Time matters. Hold the tooth by the crown, not the root. If it is dirty, rinse it with milk, saline, or saliva. Do not scrub it. Try to place it back into the socket if it slips in without force. Bite on a clean cloth to hold it there.

If you cannot replace it, put it in milk or saliva and seek help at once. Do not store it dry. Do not put a baby tooth back into the socket, because that can damage the adult tooth underneath.

Mouth injuries can bleed. Apply pressure with clean gauze or cloth. If bleeding stays heavy, or the injury involves the face, jaw, or head, use A&E.

What the emergency dentist will look for

Questions should be asked for an emergency appointment. What is the pain? When did it start? What makes it worse? What relieves it? Is there any swelling? What treatment have you had? Are you taking any medicines? Do you have any medical problems?

The examination may involve percussion of the tooth, inspection of gum health, sensitivity to cold, bite evaluation and an X-ray. Treatment may involve temporary dressing, smoothing of a jagged edge, drainage of an abscess, commencing root treatment, removal of a loose fragment, recementing of a crown or extraction of a non-restorable tooth.

What not to do

Do not ignore swelling. Do not take extra doses of painkillers. More tablets can harm you without giving better pain control. Do not use alcohol on the gum. Do not place heat on facial swelling. Do not wait for antibiotics from a GP when the problem needs dental treatment.

Before you call

Have a clear description ready. Say where the pain is, how long it has lasted, what triggers it, and whether you have swelling, fever, bleeding, trauma, or trouble opening your mouth. Mention pregnancy, allergies, medical conditions, and medicines.

Dental emergencies feel chaotic. A calm plan helps. Check danger signs first. Protect a broken or knocked-out tooth. Use safe pain relief. Contact a dentist or NHS 111. Seek A&E care when breathing, swallowing, vision, head injury, severe swelling, jaw injury, or heavy bleeding enters the picture.