Contact us for immediate assistance
If you have a dental emergency during office hours, please contact us as soon as possible and we will fit you in. If your emergency is after office hours, you can contact Dr. Steve Mocrae on his dental emergency cell phone line at 1 (705) 896-2050. If you fail to reach is, please dial 911.
Dental emergencies require immediate and appropriate response. We are here to help you, especially when you need it most. Below, you will find some useful information on many common emergency issues. This brief emergency overview is not intended for self diagnosis.
As a quick reference, this page covers the following emergency topics:
Toothache | Broken/chipped tooth | Lost filling | Swollen gums | Gums bleed easy and are sore | Jaw joints click, are sore and/or lock open | Denture does not fit or is loose | Crown, bridge, or veneer is loose | Implant loose | Tooth knocked out | Teeth/tooth hit hard, but seems visually not broken | Sore or swelling in mouth | Teeth look longer and are slowly moving away from each other | Teeth became loose | Teeth getting worn down | Back teeth generally sore in the morning or when under stress | Wisdom teeth area soreness and swollen neck
Sensitive teeth can be a sign of a cavity. Severe ache, especially up at night, is usually sign of infection and possibly the tooth has died. Infections can be alleviated with medication and treatment. If the tooth has died then either a root canal or extraction will be needed. Another common reason for a toothache is daytime clenching or night time grinding of teeth. Night time grinding of teeth is called bruxism. An appliance worn at night called a night guard can help with Bruxism problems.
Broken or chipped tooth
If you have a broken or chipped tooth, immediate care is important to prevent further complications and expenses. An exam and x-ray will be carried out at the time of your appointment. The most common causes of a broken or chipped tooth include having a cavity, a blow or injury to the teeth, and worn down teeth from grinding which causes breakage and chipped teeth. Treatment usually involves a simple filling, however it is possible more comprehensive treatment may be needed to save the tooth (such as a root canal or a crown). Sometimes the damage has been too extensive and extraction is required. If so, replacement options will be discussed. Of course you can always choose to not replace the lost tooth and leave the space as is.
In most cases a tooth with a lost filling does not ache. There is often no pain, or pain while chewing only when something gets stuck in the hole (such as food particles). Sharp areas may be present. The most common reason for a filling coming out is that a cavity has started to form underneath it. However, fillings can also simply break down over time and fall out. The third most common reason is the tooth itself was weak and broke, taking the filling with it. Treatment is usually to refill the tooth. Depending on the situation more comprehensive treatment such as a crown may be needed.
If one area of your gums are swollen the most likely cause is a localized gum infection. This could be commonly cause by a food particle or floss stuck under the gums. We find that popcorn kernels often cause this. Another main cause is gum disease. When there is gum disease, some areas can have more damage than others, and then an infection called a gum abscess can form. Hormonal changes in women also cause localized gum abscess and this is especially true in pregnancy.
Gums bleed easy and are sore
If all of the gums bleed easily and are possibly sore, this indicates rather active gum disease. At this degree there could be already permanent damage.
Jaw joints click, are sore and/or lock open
The jaw bone has two joints, one on either side by your ears. As you talk or eat, the jaw hinges open and closed. These jaw joints are called the uempro mandibular joints. The joints can be damaged by a blow, they could be worn out, or they can break down due to improper a bite pattern. This then can lead to joints that click or are sometimes sore. Mild clicks or infrequent soreness generally are not of major concern and usually do not require treatment. However, if there is significant clicking, soreness, or locking open and it affects your daily life, treatment may be warranted. Further jaw joint problems can at times cause dizzy spells, ringing in the ears, headaches and other problems. Symptoms like the above are called temporomandibular joint dysfunction (TMD). Treatment often involves wearing a specially designed appliance called a splint for three months, sometimes permanent splint usage is necessary to continue to control the unpleasant symptoms. In these cases comprehensive orthodontic treatment may be considered so that someday the patient can stop wearing the splint. In this special orthodontic treatment, teeth are moved to a new position more harmonious for the jaw joint. In this case the splint not only is used to decrease the symptoms but also as a diagnostic tool. The splint can indicate to the dentist where to move teeth for better harmony.
Denture does not fit or is loose
Although a denture may fit and function properly at first, over time changes can occur both in the mouth and of the denture. These changes can lead to a loose fit or improper function. The dentures themselves will wear or break down over time. The mouth also goes through changes. Over time the bone ridge that the denture sits on will slowly shrink away. This process usually is over a long period of time, but in some cases is rapid. A dentist must assess the situation, and will be able to give you treatment options. Sometimes the denture can be adjusted right there to quickly fix the problem. A denture reline may be needed for more complicated cases. Ultimately, the denture may need to be completely replaced. It is important to realize that dentures do not last forever. When a denture starts to have issues, early treatment can possibly extend the dentures life and save you on costs. In some cases there are dentures that hold onto remaining teeth, called partial dentures. For these dentures, there could be changes in the teeth that affect the fit. The teeth can have cavities, or gum disease can set in and cause teeth to drift out of position or become loose.
Crown, bridge, or veneer is loose
These dental components can sometimes become loose, which could be due to several causes. The most common two reasons are that the cement gave away or the tooth broke. For cement problems, usually they can simply just be cemented back on. If the tooth broke sometimes the tooth can be rebuilt and the item cemented back on again. If the part of the tooth that the crown held onto changes enough, then a new crown may need to be made. In severe cases the tooth may have to be extracted and a tooth replacement method carried out. There should never be any changes with your crown, bridge or veneer. If this happens, seeing a dentist as soon as possible will give a better chance to repair the problem and avoid having a new unit made or a tooth extraction.
Implant is loose
If the implant seems loose, the most common reasons are that the cement gave away or the screw became loose. For these two possibilities, re-cementing or tightening is all that is needed. However, the implant itself could be loose and if so, this is much more serious. This will usually lead to an implant replacement. Again, any changes should be examined by a dentist immediately to prevent further complications.
Tooth or teeth knocked out
Once out, baby teeth are not replaced. If the root is left this can sometimes lead to a dangerous dental infection. The root should be removed if possible by a dentist. If an adult tooth is knocked out, these same concerns exist. For adult teeth that have been knocked out and not damaged, it is possible for a dentist to try and place it back in. In this case, you need to keep the tooth in a small cup with your saliva and if you are bleeding, it is fine to have blood in the container. If saliva cannot be obtained, the tooth can be stored in milk. The faster you can obtain treatment from a dentist, the better. Dentists will only try to re-insert the tooth if it has been out of the mouth for an hour or two. It’s important to first make sure the tooth and bone was not damaged. There is no way to know this without an x-ray of the bone and a dentist inspecting the tooth.
Treatment is usually replanting the tooth, bonding it in place to teeth next to it, and making sure there is no heavy biting on the tooth. Teeth that are planted usually will require root canal treatment, and most of them will not last indefinitely. As a precaution, it is also wise to be assessed medically. This depends on how bad your body was injured in the accident. You may want to hurry and save your tooth. However, if you are possibly hurt medically from the blow, it is important to first see a hospital emergency care unit. Your general health is important and emergency treatment may be necessary first, taking priority over dental treatment. It is quite common for a patient to first be treated at the local hospital emergency ward, then to come to us for dental treatment.
Tooth or teeth hit hard, but does not look broken
There could be a blow to your teeth which visually seems okay. However, the tooth could have a hairline crack that only a dentist with special instruments such as a close up camera can see. The root could also be fractured and an x-ray would need to be taken to determine this. Sometimes teeth look okay but the blow has moved them out of place so that the bite is off and now heavy on this tooth. If left like this, damage will likely occur, and the tooth could possibly crack or die. The tooth could also look okay, but now be loose. Prompt visit to a dentist will be necessary for the best chance to treat hidden problems or to save the tooth.
Soreness or swelling in mouth
Here we are talking about soreness or swelling caused by an allergic reaction, hot burn, something rubbing against tissue (oral jewelry), injury, a gland or duct problem, bone growth, sexually transmitted disease, or even cancer. The explanation for the above would take several books to properly cover. Thus, any sore or swelling in the mouth should be looked at by a dentist promptly. The dentist may, if concerned, refer the patient to an Oral Surgeon for identification of the cause. Tissue removal called a biopsy may be needed. Usually the answer is not cancer. In my many years of practice as a dentist, there has been only a handful of cases that were actually cancer, while most other cases were one of the other possibilities. However as previously stated, a prompt dental visit is needed to identify the cause.
Teeth look longer and are slowly moving away from each other
If your teeth look longer, this is usually a sign of gum disease where the gums are receding. Trauma can also cause this, and an example is a lip piercing. The inside component of the jewelry can rub against the gum and cause localized gum recession. When teeth are slowly (over months or years) drifting away from each other (you see spaces between the teeth now), gum disease is the most likely cause. Gum disease can destroy the bone that teeth are anchored into. This spacing could also be caused by grinding and clenching. Grinding and clenching can cause teeth to drift apart. For this problem, a night guard is needed. Much more complicated causes could be a change in your tongue or cheek muscles or an airway change.
Teeth became loose
If one tooth becomes loose without it being hit, the most common reason is that it has died and chronic infection has set in or there is gum disease. If multiple teeth are loose, the most common reasons are gum disease, or grinding and clenching of teeth. Grinding and clenching is called bruxism. A night guard can be worn if bruxism is occurring.
Teeth are getting worn down
This condition is from clenching and grinding teeth. This is called bruxism, and often happens when you are asleep. The teeth can also become chipped. If this is severe enough the teeth will need to be repaired with one of the following: bonding on filling material, veneer or crown. If Bruxism continues, it can possibly lead to tooth death and the need for extraction or root canal.
Back teeth are generally sore in the morning or when under stress
This is an indication of teeth grinding at night called bruxism. The causes can be an improper bite or stress. Treatment would be to have a night guard made by a Dentist. If left over time, this bruxism actually can even kill a tooth, leading to the need of a root canal. People who have severe bruxism problems can have several back teeth that have had root canals.
Wisdom teeth area is sore
This usually is where your gums behind your last teeth are sore. This is an indication that wisdom teeth are pushing their way up, but are stuck part way. In this case the gums become infected. Treatment would be to see a dentist. For wisdom teeth problems, a large x-ray called a panorex is advised. Then if warranted, a later appointment is booked to have the wisdom teeth removed. Our office has a digital panorex machine. The unit is computerized and takes x-rays with much less radiation. Wisdom teeth extraction is usually done with regular freezing. However, we have full general anesthesia for sleep dentistry. This is hospital grade anesthesia where you are completely asleep.
Face or neck swelling from a dental infection
This is where the infection is going from the tooth to the body. It is possible that the infection can quickly get worse and be life threatening. Swelling of the neck can block the body’s airway. Swelling of the face below or around the eye is dangerous also. The eye is the pathway to the brain so you must go immediately to the local hospital emergency ward. Treatment may involve IV antibiotics or surgical drainage.
Feeling weak with a possible fever
A dental infection could lead to a rare but possible blood infection. You may not even have a toothache. With a blood infection, the patient may feel only weak and tired with or without a fever. This has the potential of becoming a life threatening situation. Immediate care at the local hospital emergency clinic is necessary.