Dental Emergencies: What to Do in the First Hour
Knocked-out teeth, fractures, abscesses, and lost crowns. Step-by-step first response for the situations where minutes genuinely matter.
March 24, 2026 · 6 min read · Reviewed by Dr. Marianna Zadov, DDS
A knocked-out permanent tooth
This is the one true time emergency in dentistry. Pick the tooth up by the crown, never the root. If it is dirty, rinse it briefly with milk or saline — not tap water and never scrub it, because the root surface cells must survive.
If you can, reinsert it into the socket immediately and bite gently on a clean cloth. If not, store it in cold milk or the patient's own saliva. Get to a dentist within thirty to sixty minutes. Baby teeth are not reimplanted.
Fractures, cracks, and lost restorations
Save any fragments in milk. Rinse with warm water, apply a cold compress outside the cheek, and avoid chewing on that side. Sharp edges can be covered temporarily with orthodontic wax or sugar-free gum.
For a lost crown, clean it and try seating it with denture adhesive or temporary cement from a pharmacy for comfort only. Never use household glue. Exposed dentin is vulnerable and the tooth can shift within days, making the original crown no longer fit.
Swelling and infection
Facial swelling, fever, or a bad taste from a draining bump indicates infection that needs prompt attention. Swelling that spreads toward the eye or under the jaw, or any difficulty breathing or swallowing, is an emergency-room situation, not a wait-until-morning one.
Do not place aspirin against the gum. It burns the tissue and does nothing for the nerve. Over-the-counter ibuprofen, if appropriate for you, is far more effective for dental pain.
Preventing the preventable
A large share of urgent visits come from small problems monitored too long: a crack seen on an X-ray, an old filling with a gap, a wisdom tooth that flares periodically.
Custom mouthguards for sport, night guards for grinders, and addressing early findings at routine visits eliminate most of what we see in the emergency chair. Call us as soon as something happens — same-day slots are held for urgent care.
Talk it through with us
This article is general education, not personal dental advice. For a recommendation specific to your mouth, book an exam with Dr. Zadov or read more about our preventive care.