Four levels. Read the top box first, because a small number of mouth injuries are not dental problems at all.
Emergency room, now
Trouble breathing or swallowing. A head injury with confusion, vomiting or any loss of consciousness. A jaw that will not close or line up. Swelling that reaches the eye or the neck. Bleeding that has not slowed after 15 minutes of firm pressure.
Call 911 or go to the nearest emergency department.
Call us right now
A knocked-out permanent tooth. A tooth pushed up into the gum or hanging loose. A swollen face or a gum boil. Pain that woke your child in the night.
Ring the office. After hours the line reaches our on-call dentist.
Call us today
A chipped or cracked tooth. A knocked-out baby tooth. A lost filling or crown. A toothache that comes and goes. A tooth that has turned grey since a fall.
We hold open slots every weekday for exactly this.
Next business day is fine
A small chip with no pain and no sharp edge. A poking orthodontic wire once wax is on it. Food stuck between teeth that floss has cleared. A loose baby tooth that is simply taking its time.
Book online and tell us what happened in the notes.
Pick what happened
What to do right now
Nine of the calls we take most often, with the first five minutes written out. Read the steps, then ring us. You can do both at once.
The next 30 minutes matter more than anything else
A permanent tooth is out of the mouth
This is the one childhood dental injury where speed changes the outcome. The cells on the root surface stay alive for a short window, and they die quickly in open air or in tap water.
Do this now
Find the tooth and pick it up by the crown, the chewing part. Never touch the root.
If it is dirty, rinse it for a second or two in milk or saline. Do not scrub it and do not use soap.
If you can, slide it straight back into the socket the right way round and have your child bite gently on a clean cloth.
If you cannot, drop it into a cup of cold milk. Saliva works too. Water does not.
Call us on the way. We will have a room ready when you arrive.
Please do not
Scrub or wipe the root
Let the tooth dry out on a tissue
Store it in tap water
Wait to see how your child feels in the morning
Then, at the office. Once the tooth is back in place we splint it to the neighbouring teeth for a few weeks and check the nerve at intervals. Some replanted teeth need root canal treatment later, and we will tell you honestly what we are watching for.
Baby teeth are never replanted. Pushing one back into the socket can damage the permanent tooth developing directly above it, which matters far more than the few months of space you would save.
Do this now
Fold a piece of clean gauze, place it over the socket and have your child bite down for about ten minutes.
Hold a cold pack wrapped in a cloth against the lip or cheek to settle swelling.
Offer cool water and soft food. Skip straws for the rest of the day.
Keep the tooth in a bag for the tooth fairy, and call us so we can check the area.
Please do not
Push the tooth back in
Rinse vigorously, which restarts the bleeding
Assume a missing front baby tooth needs a space maintainer, most do not
Then, at the office. We check for a retained root fragment, look at the developing permanent tooth on an X-ray and talk about whether speech or spacing will be affected. For a front baby tooth the answer is usually no.
Same day if there is pain, pink showing or a sharp edge
A tooth is chipped or cracked
Small enamel chips are cosmetic and can wait a day. If you can see a pink or red dot in the middle of the break, the pulp is exposed and it needs treating today.
Do this now
Rinse the mouth gently with warm water and check for any loose fragments.
Find the broken pieces if you can and keep them in milk. Front teeth can sometimes be bonded back together.
Cold pack on the outside of the lip, soft foods, nothing hot or icy.
Call us and describe what you can see in the middle of the break.
Please do not
File a sharp edge down yourself
Use household glue on a fragment
Let your child test the tooth by biting on it
Then, at the office. Most chips are smoothed and rebuilt with composite bonding in a single visit. A deeper fracture may need a crown, and an exposed nerve is treated before anything cosmetic happens.
Call the same day, even if your child says it is fine
A tooth is loose, pushed in or out of line
Dentists call these luxation injuries. A tooth driven up into the gum is intruded, one shifted sideways is laterally luxated. Both look alarming and both are managed, but not by you at the kitchen table.
Do this now
Leave the tooth exactly where it is. Do not wiggle it and do not try to push it back into line.
Soft food only, and no biting on that side at all.
Cold pack on the outside of the lip for the swelling.
Call us. We will fit you in today and take an X-ray to see how the root and the tooth above it are sitting.
Please do not
Reposition the tooth with your fingers
Let your child keep testing how loose it is
Wait to see whether it tightens up on its own
Then, at the office. Depending on the tooth and the direction, we may splint it, reposition it under local anaesthetic or simply monitor it. Intruded baby teeth often re-erupt by themselves over a few weeks.
Call today. Night pain always gets a same-day slot
A tooth aches
Most childhood toothache is either food packed between teeth, a cavity that has reached the dentine, or an irritated nerve. The pattern tells us a lot, so note when it hurts and for how long.
Do this now
Rinse with warm salt water and floss gently on both sides of the sore tooth to clear trapped food.
Hold a cold pack against the outside of the cheek for short stretches.
Keep food soft, lukewarm and off that side.
Call us and tell us whether the pain is sharp and short, or a dull ache that lingers and wakes them at night.
Please do not
Hold aspirin or a painkiller against the gum, it burns the tissue
Use a numbing gel on a young child without asking us first
Apply heat to a swollen area
Then, at the office. We will talk you through pain relief on the phone, sized to your child. Please do not guess a dose from a sibling's bottle or an internet chart. At the visit we find the source and treat it.
A soft yellow or white bump on the gum above a tooth is usually a draining abscess. It often stops hurting once it drains, which fools parents into waiting. Facial swelling is a different level of urgent.
Do this now
Call us straight away, whatever time it is.
Note whether the swelling is moving toward the eye, under the jaw or into the neck, and whether there is a fever.
Keep fluids going, cool and soft.
Go to the emergency room instead if your child has trouble breathing or swallowing, cannot open their mouth, or the eye is closing.
Please do not
Squeeze or pop the gum boil
Put heat on a swollen cheek
Start a leftover antibiotic from a previous illness
Then, at the office. We drain and treat the source, which usually means a pulpotomy and crown or, if the tooth cannot be saved, removal with a space maintainer planned. Antibiotics alone never fix a dental abscess.
Mouths bleed dramatically and heal quickly. What matters is whether the edges of the cut meet on their own once the bleeding stops.
Do this now
Clean the area gently with cool water.
Press a folded piece of clean gauze firmly over the cut for a full ten minutes without lifting to peek.
Cold pack on the outside afterwards, then soft cool food.
Call us if a tooth was involved, or if the cut is on the lip border or gapes open when the pressure comes off.
Please do not
Keep checking the cut every 30 seconds
Use an antiseptic mouthwash on a fresh wound in a young child
Ignore a numb lip after a fall
Then, at the office. Deep cuts, anything crossing the lip border and wounds still bleeding after 15 minutes of pressure need urgent care or an emergency department for stitches. We are happy to look first and tell you which it is.
Orthodontic wires and loose space maintainers are annoying rather than dangerous, as long as nothing is swallowed and the cheek is protected.
Do this now
Roll a small ball of orthodontic wax and press it over the sharp end.
If a wire is long and free, a clean pencil eraser can tuck it back against the tooth.
Salt water rinses for the sore spot on the cheek.
Call your orthodontist for braces, and call us for a loose or lost space maintainer.
Please do not
Cut a wire with household scissors or nail clippers
Remove a loose band or bracket yourself
Leave a space maintainer out for weeks, the space closes fast
Then, at the office. A lost space maintainer is worth a quick appointment. Neighbouring teeth drift into the gap within months, which turns a simple problem into an orthodontic one.
General information, not dental advice, and never a substitute for being seen. We do not give medication doses on this website. Call us and we will talk you through pain relief for your child.
Why we can nearly always fit you in
Slots we hold empty
Two appointments a day at each office are kept open for emergencies and released only at the end of the afternoon. Call before 2 pm and you will almost always be seen the same day.
Call us and describe it. Our team triages parent calls all day and we would far rather tell you it can wait until Tuesday than have you sit on something that cannot.
