Dental emergency: what to do in the first hour

Reviewed by Jinyu Sun, DDS · November 12, 2026 · 5 min read

Call first, then read on

If a tooth has been knocked out, you are in significant pain, or your face is swelling, call (302) 656-8266 (Wilmington) or (302) 838-8600 (Bear) now. We keep time in the schedule for same-day emergencies, and the sooner we know you are coming, the sooner we can see you. For swelling that affects breathing or swallowing, or after a serious injury, go to the emergency room first.

Knocked-out adult tooth

This is the one true race against the clock. Pick the tooth up by the crown, not the root. If it is dirty, rinse it gently with milk or saline for a few seconds; do not scrub it. If you can, place it back in the socket and bite gently on a clean cloth to hold it. If not, keep it in a cup of milk or tucked inside your cheek, and get to us within 30 to 60 minutes. Teeth replanted quickly often survive for years.

Broken or chipped tooth

Rinse your mouth with warm water and save any pieces. Cold compresses on the outside of the cheek help with swelling. A small chip can usually wait a day or two; a large break that exposes the inner tooth hurts and needs attention the same day. Avoid chewing on that side.

Severe toothache

Rinse with warm salt water, floss gently to dislodge anything trapped, and take an over-the-counter pain reliever as directed. Do not put aspirin on the gum; it burns the tissue. A toothache that wakes you at night, or pain with swelling or fever, usually means infection and should be seen within a day.

Lost crown or filling

This is uncomfortable but rarely urgent. Keep the crown if you have it. Temporary dental cement from the pharmacy can hold a crown in place for a day or two; a bit of sugar-free gum can cover a sharp edge. Call us and we will fit you in within a day or two.

What we do when you arrive

your dentist examines the tooth, takes an X-ray if needed and treats the cause of the pain, not just the symptom. Most emergencies are resolved in one visit: a filling, a temporary crown, a root canal started, or a tooth stabilized. You leave with a written plan for any follow-up and a clear idea of the cost.