When a dental emergency strikes—whether it’s a sudden toothache in the middle of the night, a knocked-out tooth after a game at Fenway, or a broken crown on a busy Monday morning—most Boston patients have the same urgent questions running through their minds: “Is this serious enough to call the dentist right now?” “What can I safely do at home?” and “Should I head to the ER or wait for my dentist’s office to open?”

At The Face Dental Group in Boston, we understand that dental emergencies rarely happen at convenient times. As a board-certified prosthodontist with training from Tufts University and the University of Freiburg, I’ve seen thousands of emergency cases throughout my career, and I can tell you that knowing what to do in those critical first minutes can make the difference between saving and losing a tooth—or between a simple repair and a complex, costly restoration.

This guide walks you through the seven most common emergency questions we hear from patients across Boston, from Back Bay to Beacon Hill, along with practical, safe steps you can take before reaching our office. Remember: when in doubt, always call us at (617) 236-5969. We maintain emergency protocols specifically to help patients like you during these stressful moments.

1. “Is This Tooth Pain an Emergency or Can It Wait?”

This is perhaps the most common question we receive, and it’s an important one. Not all tooth pain requires dropping everything and rushing to the dentist, but some situations absolutely do.

When Tooth Pain Is a True Emergency

You should treat tooth pain as an emergency and call us immediately if you experience:

• Severe, throbbing pain that keeps you awake at night and doesn’t respond to over-the-counter pain medication
• Facial or gum swelling, especially if accompanied by fever above 101°F
• Pain following trauma—whether from a fall, sports injury, or accident
• Signs of infection including a bad taste in your mouth, pus, or a “pimple-like” bump on your gums (which may indicate an abscess)
• Difficulty swallowing or breathing—in this case, call 911 or go directly to an emergency room

Dental abscesses are particularly serious. They represent active infections that can spread to other parts of your body if left untreated. I’ve treated patients who waited too long, thinking the pain would resolve on its own, only to develop infections that required hospitalization.

When It May Be Urgent But Not Emergency-Level

Some situations, while uncomfortable, can typically wait for a same-day or next-day appointment:

• Mild to moderate pain that improves with ibuprofen or acetaminophen
• A broken filling or chipped tooth without severe pain
• Sensitivity to hot or cold that resolves quickly

What to Do Before Reaching Our Office

While you’re arranging to see us, here’s what you can safely do at home:

• Take over-the-counter pain medication as directed on the package (ibuprofen or acetaminophen, if medically appropriate for you)
• Rinse with warm salt water (½ teaspoon salt in 8 ounces of warm water) to help clean the area and reduce inflammation
• Avoid temperature extremes—stick to room-temperature foods and beverages
• Don’t chew on the affected side to prevent further damage
• Apply a cold compress to the outside of your cheek if there’s swelling (20 minutes on, 20 minutes off)

Call our emergency line at (617) 236-5969 even outside regular business hours. We have protocols in place to help emergency patients get seen as quickly as possible, often the same day.

2. “I Knocked Out a Tooth. What Do I Do Right Now?”

A knocked-out permanent tooth represents one of the most time-sensitive dental emergencies we see. The actions you take in the first 30 to 60 minutes can literally determine whether we can save your natural tooth.

For Adult (Permanent) Teeth: Every Second Counts

If you or a family member has had an adult tooth completely knocked out, follow these steps immediately:

1. Find the tooth and handle it carefully—pick it up only by the crown (the white part you normally see), never by the root
2. Do not scrub or clean the root—if the tooth is dirty, rinse it very gently with milk or saline solution, never tap water with soap or chemicals
3. Try to reinsert the tooth if possible—gently place it back into the socket and bite down on a clean cloth or gauze to hold it in position
4. If you cannot reinsert it, keep the tooth moist—the best option is cold milk; alternatively, you can place it in your cheek (only if the patient is conscious and mature enough not to swallow it)
5. Call us immediately and let us know you have an avulsed tooth—we will do everything possible to see you within the hour

The periodontal ligament cells on the root surface can only survive outside the mouth for a limited time. Research consistently shows that teeth replanted within 30 minutes have the best long-term prognosis. In my practice, I’ve successfully replanted teeth that patients brought in quickly and properly stored, and many of these teeth are still functioning years later.

For Baby (Primary) Teeth: Different Protocol

If a child’s baby tooth is knocked out, do not attempt to reinsert it. Reinserting a primary tooth can damage the developing permanent tooth underneath. Instead, call our office for guidance. We’ll need to examine your child to check for injuries to surrounding teeth and soft tissues, but the knocked-out baby tooth itself will not be replanted.

3. “My Tooth Broke or Chipped. Is It Urgent?”

Broken and chipped teeth are among the most common dental emergencies we treat at our Boston practice. The urgency level depends on several factors.

When a Broken Tooth Requires Emergency Care

Seek immediate dental care if:

• A large portion of the tooth is missing, especially if you can see pink or red tissue in the center (this may indicate nerve exposure)
• You experience sharp pain with air, temperature changes, or chewing
• There’s bleeding that doesn’t stop after 15-20 minutes of gentle pressure
• The tooth has sharp edges cutting your tongue, cheek, or lips
• The break extends below the gum line

What to Do Before Your Emergency Appointment

Take these steps to protect the tooth and minimize discomfort:

• Rinse your mouth with warm water to remove any debris or blood
• Save any broken pieces—place them in a small container with milk or saline solution and bring them to your appointment; sometimes we can reattach fragments
• Apply a cold compress to the outside of your cheek to reduce swelling (10-20 minutes on, then off)
• Cover sharp edges temporarily with dental wax or even sugar-free gum to protect your soft tissues (never use super glue or other household adhesives)
• Avoid chewing on that side and stick to soft foods until the tooth is repaired
• Take over-the-counter pain medication if needed

As a prosthodontist, I specialize in restoring damaged teeth, and I can tell you that the sooner we see you after a fracture, the more treatment options we typically have available. A tooth that receives prompt care often requires less extensive—and less expensive—treatment than one that’s left untreated for days or weeks.

4. “My Crown or Filling Fell Out. Do I Need Emergency Care?”

Lost crowns and fillings are extremely common, and while they often feel dramatic, they don’t always constitute a true emergency. However, they do require prompt attention.

When to Seek Urgent Care

Schedule an emergency appointment if:

• The exposed tooth is very sensitive or painful
• You can see a deep, dark cavity or soft area in the tooth
• The crown came off a tooth that has had root canal treatment and now feels loose or fragile
• You have an important event coming up and need the restoration replaced quickly

Temporary Measures Before Your Appointment

Here’s what you can do to protect the tooth until we see you:

• Keep the crown or filling—place it in a safe container and bring it to your appointment; we can often recement crowns if they’re undamaged
• Clean the crown gently—rinse it with water, but don’t scrub away any remaining cement
• Try temporary dental cement—available at most pharmacies, this can hold a crown in place for a short time (this is a temporary solution only)
• Avoid that side when chewing—especially stay away from sticky foods like caramel or chewing gum, and hard foods like nuts or ice
• Keep the area clean—brush very gently around the exposed tooth and rinse with warm salt water after meals

One important note from my experience: don’t wait too long to have a lost restoration replaced. An unprotected tooth can decay rapidly, and the tooth may shift slightly, making it difficult or impossible to recement the original crown. Most Boston dental offices, including ours, will try to fit you in quickly for lost crowns and fillings because we know that exposed tooth structure is vulnerable.

5. “My Gums or Mouth Won’t Stop Bleeding. Is That an Emergency?”

Persistent oral bleeding can indeed be a serious emergency, depending on the cause and severity.

Warning Signs of a Bleeding Emergency

Seek immediate care if:

• Bleeding continues beyond 15-20 minutes despite firm, continuous pressure
• You’re soaking through gauze every 10-15 minutes
• You feel dizzy, weak, or lightheaded
• You’re taking blood thinners (like warfarin, Plavix, or newer anticoagulants) and cannot control the bleeding
• There’s rapid swelling along with bleeding

Immediate Steps to Control Bleeding

1. Sit upright—don’t lie flat, as this increases blood flow to the head
2. Apply direct pressure—fold a clean piece of gauze or a dampened tea bag and place it directly over the bleeding site
3. Bite down firmly for a full 15-20 minutes without peeking or removing the gauze
4. Avoid disturbing the area—don’t spit, use straws, smoke, or rinse vigorously, as these actions can dislodge clots
5. Apply ice to the outside of your face near the bleeding area

If bleeding continues despite these measures, call our emergency line immediately or, if it’s after hours and you cannot reach a dentist, go to an urgent care center or emergency room. This is particularly important for patients on anticoagulation therapy, as we may need to coordinate with your physician.

6. “I Have Something Stuck Between My Teeth. When Is It an Emergency?”

While an object lodged between teeth might seem minor, it can actually become quite serious if not addressed properly.

When to Seek Professional Help

Contact us if:

• You cannot remove the object with gentle flossing
• The area becomes swollen, painful, or starts bleeding significantly
• You have increasing pain over several hours
• You can feel the object but cannot see it—it may be embedded under the gum tissue

Safe Removal Techniques

Try these methods first:

• Dental floss—gently guide floss between the teeth, curve it around one tooth, and slide it up and down; repeat on the other side
• Interdental brushes—these tiny brushes can sometimes dislodge food particles that floss cannot
• Water irrigation—a water flosser or even a gentle stream of water from a syringe can help
• Waxed floss—if regular floss shreds or gets stuck, waxed varieties slide more easily

What NOT to Do

Never use these to remove stuck objects:

• Pins, needles, or other sharp metal objects
• Knives or scissors
• Excessive force with any tool

These can seriously damage your gums, tooth enamel, or existing dental work. If gentle flossing doesn’t work after a few tries, it’s time to call us. We have specialized instruments that can safely remove lodged objects without causing damage.

7. “I Got Hit in the Face and My Tooth Feels Loose. What Should I Do?”

Dental trauma from facial injuries—whether from sports, falls, or accidents—is surprisingly common here in Boston, especially during hockey season or icy winter months.

Assessing the Severity

After facial trauma, check for these signs that require immediate dental care:

• Loose teeth—any tooth that moves more than normal
• Teeth that feel “off” when you bite—possible displacement
• Chips or cracks in visible tooth structure
• Bleeding from the gums around teeth
• Tooth sensitivity that wasn’t present before the injury
• Jaw pain or difficulty opening/closing your mouth fully

Immediate Care Steps

Before reaching our office:

• Apply a cold compress to the outside of your face to minimize swelling
• Rinse gently with warm water to clean the area, but don’t rinse vigorously
• Control any bleeding with gauze and gentle pressure
• Don’t wiggle the tooth—avoid touching it with your tongue or fingers
• Eat only soft foods and avoid chewing on the affected side
• Document the injury—take photos if visible, and note the circumstances (this may be important for insurance or if the injury occurred due to someone else’s negligence)

Even if a traumatized tooth seems fine initially, internal damage may not be immediately apparent. Teeth can develop problems weeks, months, or even years after trauma. That’s why we recommend examining any tooth that has been injured, even if it looks normal and doesn’t hurt. As someone who has treated countless trauma cases throughout my career in Boston, I’ve seen too many situations where early intervention could have prevented tooth loss.

When to Call vs. When to Go to the ER

One question we hear frequently is whether to call the dentist or head straight to the emergency room. Here’s a general guideline:

Call Your Dentist First For:

• Severe toothache
• Knocked-out tooth (while heading directly to the office)
• Broken or damaged teeth
• Lost crowns or fillings
• Dental abscesses without systemic symptoms
• Soft tissue injuries contained to the mouth

Disclaimer: This article is for informational purposes only and does not constitute medical advice.
Please consult with Dr. Wael Att, DDS, PhD or another qualified dental professional for personalized recommendations.

Schedule Your Appointment

Ready to improve your dental health? Contact The Face Dental Group in Boston, MA to schedule your appointment today.

📞 Call Now: (617) 236-5969

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Tagged Boston dentistry, dental emergency, emergency dentistry, tooth pain, urgent dental care