When to Go to the Emergency Room for a Dental Problem
The emergency room is equipped to handle medical emergencies that threaten your life or overall health. For dental problems, the ER is the right choice only in specific, serious situations.
Go to the ER If You Experience
- Difficulty breathing or swallowing due to swelling in the mouth, throat, or neck. This can indicate a spreading infection that could compromise your airway.
- Facial swelling that is spreading toward the eye, under the jaw, or down the neck. This suggests the infection is moving beyond the tooth into deeper tissue spaces.
- Uncontrolled bleeding from the mouth that does not stop after 15 to 20 minutes of firm pressure with gauze.
- A suspected broken jaw (unable to open or close the mouth, misaligned bite after trauma, severe pain with jaw movement).
- Trauma to the face involving a head injury, loss of consciousness, or other injuries that need medical evaluation beyond the teeth.
- High fever (above 103 degrees Fahrenheit) combined with facial swelling, which may indicate a systemic infection.
Why These Need the ER
These situations require medical equipment and monitoring that a dental office does not have. Airway compromise from a spreading dental infection can become life-threatening. Jaw fractures may need imaging (CT scan) and possible surgical intervention. Severe bleeding may require IV access and blood pressure management.
ER doctors can stabilize the situation, start IV antibiotics, control bleeding, and arrange for follow-up with an oral surgeon. This is the appropriate first step for these serious conditions.
When an Emergency Dentist Is the Better Choice
For the majority of dental emergencies, an emergency dentist or your regular dentist with same-day availability is the faster and more effective option. Dentists have the training and tools to actually treat the problem, not just manage the symptoms.
See an Emergency Dentist For
- Severe toothache or throbbing tooth pain. The dentist can diagnose the cause (infection, crack, decay) and begin treatment the same day.
- A broken, chipped, or cracked tooth. The dentist can bond, crown, or stabilize the tooth depending on the damage.
- A knocked-out permanent tooth. This is time-sensitive. A dentist can reimplant the tooth within the first 30 to 60 minutes for the best chance of saving it.
- A lost crown or filling. The dentist can re-cement the crown or place a temporary or permanent restoration.
- A localized dental abscess (a pimple-like bump on the gum near a tooth). The dentist can drain the abscess and start treatment of the underlying infection.
- A broken or lost denture, retainer, or orthodontic wire causing pain.
What a Dentist Can Do That the ER Cannot
An emergency dentist can take dental X-rays to diagnose the source of pain. They can perform root canals, extract teeth, drain abscesses with direct access to the infection, re-cement crowns, repair broken teeth, and reimplant knocked-out teeth. The ER has none of these capabilities.
When you go to the ER for a toothache or broken tooth, the typical outcome is a prescription for antibiotics and pain medication, along with advice to see a dentist. The underlying dental problem is not treated. This means you still need a dental appointment after the ER visit, and you have spent time and money on the ER visit without getting definitive treatment.
Cost: Emergency Dentist vs. Emergency Room
The cost difference between an ER visit and an emergency dental appointment is significant. Understanding this can help you make a more informed decision when you are in pain and trying to decide where to go.
An ER visit for a dental problem typically costs $400 to $1,500 or more, depending on the facility, what imaging is done, and whether IV medications are administered. This often results in a prescription and a referral to a dentist, meaning you still face the cost of the dental visit on top of the ER bill.
An emergency dental appointment typically costs $100 to $500 for the examination, X-rays, and initial treatment (such as draining an abscess, starting a root canal, or temporarily stabilizing a tooth). Definitive treatment like a full root canal or crown is additional but is the same cost whether you see the dentist after an ER visit or go directly.
If you have medical insurance but not dental insurance, the ER visit may be partially covered. However, many patients find that the out-of-pocket cost of an emergency dental visit is still lower than their ER copay or coinsurance. If you have dental insurance, emergency dental visits are typically covered at the same rate as any other dental treatment.
What the ER Can and Cannot Do for Dental Problems
ER doctors are medical physicians, not dentists. They are trained to identify and stabilize life-threatening conditions. When it comes to dental problems, the ER's capabilities are limited.
What the ER Can Do
- Prescribe antibiotics for dental infections
- Prescribe or administer pain medication
- Control severe bleeding with pressure, packing, or sutures
- Order imaging (X-rays, CT scans) to evaluate fractures or spreading infections
- Administer IV antibiotics and fluids for severe infections
- Refer you to an oral surgeon for follow-up
What the ER Cannot Do
- Perform a root canal
- Extract a tooth (in most hospitals, unless an oral surgeon is on call)
- Fill a cavity or repair a broken tooth
- Re-cement a loose crown
- Reimplant a knocked-out tooth
- Diagnose the specific dental cause of your pain with dental-specific tools
How to Find Emergency Dental Care
When a dental emergency happens outside of regular office hours, you still have options. Start by calling your regular dentist's office. Many practices have an after-hours answering service or emergency phone number. Dentists who provide emergency coverage will often see you the same evening or early the next morning.
Emergency dental clinics operate in many cities with extended hours, including evenings and weekends. Dental schools with emergency clinics can also provide after-hours care at a reduced cost. If you are unsure where to go, the ADA's Find-a-Dentist tool or a local dental society hotline can help you locate a provider.
What to Do While You Wait for Your Appointment
- For tooth pain: Take over-the-counter ibuprofen (follow the label for dosing). Avoid placing aspirin directly on the gum, as this can burn the tissue.
- For a knocked-out tooth: Pick it up by the crown (not the root). Gently rinse it with water if dirty, but do not scrub it. Place it in a glass of milk or hold it inside your cheek to keep it moist. Get to a dentist within 30 to 60 minutes.
- For a broken tooth: Rinse with warm water. Apply a cold compress to the outside of the cheek. Save any broken pieces.
- For a lost crown: If possible, place the crown back on the tooth with a small amount of denture adhesive or toothpaste as temporary cement. Do not use superglue.
- For bleeding: Apply firm, steady pressure with a clean gauze pad or damp tea bag for 15 to 20 minutes.
Find a Dental Specialist Near You
In a dental emergency, the right specialist depends on the situation. Oral surgeons handle fractures, extractions, and complex trauma. Endodontists handle emergency root canals. Every specialist on My Specialty Dentist has verified credentials. Search by location and specialty to find providers who can help.
Find a Dental Specialist Near You