UK Dental Treatment Emergencies and Toothaches "Self-Help" possibilities.

These general tips and self-help dental treatments information listed further BELOW for any UK Dental Emergencies, toothaches, accidents etc, are NO substitute for seeking the professional, personal advice from your Dentist or Doctor immediately.

We still emphasise the importance of getting Professional help/advice as soon as possible!

Everyone in the UK can get medical OR dental advice and help 24 hours a day from calling 0845 46 47 NHS Direct !

SWINE FLU may affect availability of Dental Care too, so DON'T leave problems to get worse later. Find a Dentist NOW !!!

It has been getting progressively more difficult to get prompt (let alone immediate) treatment for Dental Emergencies in England particularly as NHS Dental services are struggling to meet ordinary demand, thus more people are waiting to see an NHS Dentist and as they languish on hidden waiting lists, naturally their mouths get in a worse state and so Toothache, Gum Diseases, Infections and other Dental Emergencies are more common and more teeth extractions likely as everything deteriorates to even worse unhealthy levels.

Ever since Parliamentary answers to Dental Questions in 2005, we have known Toothache was the 2nd commonest reason for contacting NHS Direct for all possible medical conditions and advice nationally - this "Trend" continued over the Holidays Christmas 2006 to New Year 2007, with Dental pain and Toothaches occupying the 2nd and 4th top-ten positions for NHS Direct statistics ! (Dental could have been the top NHS problem if the statistics hadn't been split-up into 2 categories, but let's not get into Department of Health Spin how political interference and targets has helped to ruin NHS Dentistry!)

2008 and 2009 wasn't much better really and with a change in Government in 2010 there is now a planned White Paper for NHS Dentistry in 2011 to be approved by Parliament & ordering a NHS Dental Review to try and sort out such serious NHS Dentistry planning problems mainly in England, but also in Wales - these latest findings acknowledge what we have known for several years already - NHS Dentistry needs EMERGENCY HELP itself !

STOP PRESS - Children with rotten teeth are now the 3rd most common reason for all Hospital admissions in England !!!

For Dental Emergencies, your first point of call should be your own Dentist, but as registration was abolished in England and Wales in 2006 by the then "new" contract, still in force today, you may find Access is still a problem. Scotland is less badly affected as the Scottish Parliament decided not to follow E&W experimentation and thus retained Registration of patients, so you should find a Dentist much easier there, then be able to stay with them as you'll be registered. Northern Ireland was more like the Scottish system but they are now moving to the problematic E&W system, so access will get more difficult there probably.

About 50% of the population were not registered with a Dentist in England and Wales, so your Primary Care Trust ( Heath Authority/Board ) are now responsible to help you access ANY NHS Dental Care and/or cover your Emergency treatment needs. There has been a big effort by government to create extra places by emphasising Access - so far between 2006 and 2010, they have spent an extra £4Billion in that time period for (as of May2010) only an increase of 321,000 adults but a DECREASE in seeing children by 102,000, so that works out at some £18,000 extra per extra NHS patient seen - is this good management and value of our public taxpayer's money?

Sadly the NHS Dental system is still broken, but neither you nor ourselves can change this unless our New Government is now willing to listen to solutions, remove Targets that are not based on patient care (ie: change all of them) and have at least a Good Emergency Dental Service available Nationally, which is still one of the worst parts of the system frankly :(

So, Officially if you have a Dental problem/emergency, you can call NHS Direct for Advice and possible treatment on 0845 46 47 anytime.

However, their service is variable, they may not get back to you promptly OR not offer Emergency Dental treatment for another 48hours, leaving you in pain and distress, so the advice below is to help in those situations where you can't always get the advice and treatment you need promptly.

If you have such a severe problem that it is threatening your general health, you may be advised to go straight to the nearest Accident and Emergency Dept. at Hospital - see some examples of these below, which is then followed by a section of dental "self-help" information that you may find useful after contacting NHS Direct, for Dental pain, Toothaches or inconvenient Dental problems.

Serious Dental Emergencies that could rapidly lead to a deterioration of General Health are fortunately rare, but do require IMMEDIATE MEDICAL or A+E Attention !!!  Some people still die in the 21st century from Dental Problems left untreated !!!

Urgent examples include the following, potentially dangerous conditions:

Fractured Jaws - affects speech, teeth may not meet together properly, swelling inside mouth, limited mobility, pain etc. Need bones resetting urgently! Most commonly happens after an accident, blow to chin etc.

Uncontrolled Bleeding - Any bleeding that cannot be controlled by firm continuous pressure from a pack for 10 minutes may need suturing to prevent bleeding to death.
Most commonly happens after extraction, due to infection or alcohol, asprin, drugs etc.Copied from © 2000-2010 Smile Specialist® & Tony©

Loss of Conciousness - No matter how brief, anyone who was unresponsive may have suffered internal brain damage that could worsen if left without investigation!
Most commonly happens after a blow to the head or accident - don't confuse with epilepsy, but if unsure, still dial 999, 112 etc. or go straight to A+E.


Swelling in Neck/Face -This can get rapidly larger and obstruct the airway and cause breathing problems! Most commonly due to rapidly spreading infection or bleeding.

The pictures below show the rapid swelling distorting the face of a young child, who has a significant Dental Emergency and who needs treatment without delay, if they are not to suffer greatly or even die. Swelling can quickly spread to the neck and airway, or infection enter the blood and cause Septacaemia (blood poisoning). Fortunately, most Dental problems are not this severe and some treatments can be delayed without deterioration of general health, but always seek a Professional opinion first.

The above facial picture shows the swelling distorting the face.            The mouth view above shows the bad abcessed rotten tooth!

All of the above Emergencies often need immediate medical assistance from Hospital A+E !!!

They will often contact their Specialist Oral Surgeon to treat any Dental causes or problems arising from the mouth - or you may ask the attending Doctors to do this too !

Non Life-Threatening Dental Problems

These are the more common toothaches, broken dentures, chipped teeth, lost fillings, loose crowns etc. that are usually very inconvenient socially, with any pain being controlled with over the counter painkillers or remedies from the local Chemist or Pharmacy. Even good Dental treatments can result in complications/problems, if the tooth was badly decayed or had many problems in the past.

This is why regular Dental Care and early dental treatment and prevention is ALWAYS best !

The 50% of the Population in the UK who are registered with a Dentist, will have access to their own Practice Emergency contact number.

Unfortunately, the UK Government system used to remove you from NHS Family Dentists list if you haven't been back within 15 months - so you were not then entitled to use that NHS Dentist's Emergency services and their NHS list may then be full if you try to register again later!
Now from 1st April 2006, where in order to increase Access (theoretically at least) to anyone, the NHS will be droping the concept of registration totally, so no-one will be NHS registered and no-one will have priority over anyone else. Thus previous regular attenders on the NHS will be "competing" with irregular attenders for the same, limited availability!

This is why you may find it even more difficult not only to see the same Dentist every time you go, but to even have to wait a LONG time before being seen at all, EVEN in an emergency - so as a public service, the guidance for self-help is given below so that you can minimise the pain, discomfort and dental health consequences of delayed emergency and proper dental treatments and care.

The above limitations/Access problems DO NOT APPLY to any Private Dental Care, where generally more time and wider options can be offered because, put simply, you pay direct and the service is centred around you, not any artificial government targets (eg:UDAs) for the NHS, which are universally unpopular by patients and dentists alike.

However this website is NO SUBSTITUTE for regular Dental Care and Advice and if you find yourself in severe dental need and these informative pages help you in any way,

PLEASE, PLEASE, PLEASE make a promise to yourself to find a Dentist who will fix your teeth and care for you as a person as soon as your emergency needs are dealt with - you may have to search a while to find the right Practice/Dentist for you and this may involve some travel and costs too, but it is ALWAYS better to get your mouth healthy and then keep it that way in the long-run. Anyone with a problem though can still call NHS Direct 0845 46 47 for Dental or Medical Advice, UK, 24 hours a day!

But be warned, if you say to NHS Direct that you are registered with a Dentist, they may "not offer emergency treatment" saying you must go back and try to contact your own Dentist for emergency care. If you say you haven't got a regular Dentist (which on the NHS in England and Wales is true now that registration has been formally removed!), they will be obliged to give you advice and arrange for any emergency treatment needed.

Unfortunately for many, from the 1st April 2006 the NHS has "down-graded" Dental Emergency definitions to those that are serious or  "life-threatening" (eg:at the top of the page, uncontrolled bleeding etc,) so out of hours Emergency Dental treatment demands will be reduced for the NHS, helping the system to meet it's targets whilst keeping adults and children in pain waiting perhaps 48 hours before being seen somewhere, depending upon NHS Access for "urgencies", as they now will be known :(

Clearly, the best solution is for you and your family (even babies) is to register with your Dentist AND keep going for your regular Check-ups and personal advice! Prevention is always better than cure, so don't delay registering with a Dentist, whether NHS or Private, get registered! Copied from © 2000-2010 Smile Specialist® & Tony©

Remember also, Private patients cannot be taken off Dentists lists by Government, only NHS patients are taken off their individual Dentist's list by Government systems automatically! It also makes sense to visit your Dentist to get your Oral health checked out before any major trips, summer holidays, important events, Christmas time etc. Remember to do this earlier than needed, because most Dentists appointment books are very busy and are more booked up at these times too.

Unfortunately, even regular dental patients can get occasional problems too, so the following general guide is given for everyone as an "adjunct", additional to the personal Professional advice that you should seek immediately in the first place, but if you are away visiting or on holiday etc, you may still be able to apply some of the self-help tips below.

Again any UK citizen can call NHS direct for advice on 0845 46 47 (from abroad use UK country code +44 then 845 46 47) 24 hours a day.

The hints and tips below do NOT substitute for your Dentist, NHS Direct, Specialist or Professional advice !!!

Also remember that the Large Supermarket Chains may have a number of Pharmacies within them, that often stay open late, Bank Holidays, Sundays etc. (eg: Sainsbury's, Asda, Tesco's etc.) and some of the larger hypermarkets/pharmacies abroad also have self-help dental kits to purchase too.Copied from © 2000-2010 Smile Specialist® & Tony©

Possible Temporary remedies -

Toothache is either caused by the nerve in the tooth root being alive, inflamed and sore, such that it reacts badly to hot and cold or sweet things, or by the nerve dying and making an abcess at the end of the root. The dead nerve doesn't feel hot or cold or sweet (though other teeth might nearby). Both need Professional Dental treatment as soon as practical, to treat the central cause, but temporary treatments may gain you some time to seek help.

Please remember - Always read and follow the instructions on any medicines, tablets or remedies before use!

PAINKILLERS such as Ibuprofen (Nurofen) are good for toothaches, because it is anti-inflammatory as well. However, asthmatics are not supposed to take these, so try paracetamol or ask your chemist for an alternative. Children under 12 years old should avoid Asprin (Reye's Syndrome), with liquid paracetamol (Calpol) a good alternative. Codeine (eg: Codamol) makes you drowsy, so unless you want to sleep better at night, don't take during the day, otherwise you can't drive safely, might hurt yourself, need someone to accompany you etc. Never exceed maximum recommended doses! This is dangerous and will not work any better than the recommended dosage would anyway!

OIL OF CLOVES is available from most Chemists/Pharmacies and is useful to apply on cotton wool on a tooth with a "live" nerve toothache. Keep pressed onto the tooth/cavity for a full minute. The helpful effect is only temporary though as it gets washed away by saliva easily.Copied from © 2000-2010 Smile Specialist® & Tony©

TOPICAL ANAESTHETIC gel available at Pharmacies again. Useful for gum ulcers around wisdom teeth, loose baby teeth tugging painfully on a child's gum, or soft tissue injuries and accidental bites. Not much good for teeth problems though as again it gets washed away by saliva.

ANTISEPTIC MOUTHWASH for gum infections around wisdom teeth, gum diseases and bleeding gums, multiple mouth ulcers etc. Chlorhexidine (Corsodyl) is good but quickly stains teeth brown. Other good alternatives are Betadine, Eludril etc. Again, let it soak in for a full minute before spitting it out for maximum benefit - if this gives a burning sensation that cannot be tolerated for a full minute, then dilute with some water until it is only a mild sensation that you can tolerate for a full minute.We tend to not recommend Listerine as it is often high in alcohol and shouldn't be used for children and could fail a breathaliser test if stopped by the police!
Some Supermarket own brands of "Antiseptic" labelled mouthwash are misleading in our opinion and if you read the contents they are often nothing more than a cheap version of a Fluoride (NaF) mouthwash, which is great to rinse with before bedtime on a daily basis to help prevent cavities, but fairly useless to help treat a mouth infection !

DIFFLAM spray (antiseptic and anti-inflammatory) is useful to spray on particular areas, such as wisdom teeth gum areas or into large cavities.

SALT MOUTHWASH is a natural antiseptic rinse and good for post-extraction healing, Denture rubs and mouth ulcers if you cannot get to a Chemist for a good antiseptic mouthwash mentioned above. A "teaspoon"of salt dissolved in a tumbler of warm water works well. Hold in the mouth for one minute then spit out, around 4 times daily or as needed.

ANTIBIOTICS only work for "dead" nerve abcesses and gum infections. They are essential for infection that causes swelling, but you need to see a Dentist or Doctor to prescribe these. You will still need Dental Treatment later as Antibiotics cannot get inside a dead tooth, so the infection will return worse if left untreated ! This is a common mistake: Tooth Abcesses nearly Always need dental treatment later if they are not to come back twice as bad!

AVOID the things that make toothache worse, so drink liquids through a straw, eat soft foods on the other comfortable side etc.Copied from © 2000-2010 Smile Specialist® & Tony©

DO NOT take Alcohol or additional Asprin (keep taking any prescribed medicine for heart or clotting problems), otherwise these will make you bleed even more, which is bad news if you need a tooth out later on.

Choose a safer alternative, such as paracetamol or ibuprofen. Remember, Codeine containing painkillers makes you more "drowsy", so you shouldn't drive, operate machinery, boil water etc, get someone else to help you if you take these - always read the labels for warnings and follow all instructions etc !

Loose Crowns, Bridges etc.

Rarely cause pain that stops one sleeping, but are very socially inconvenient. If the cement came loose, rinse your mouth out with luke-warm water first so no lose bits get in the way etc, check the Crown/Bridge/Veneer fits back onto the tooth (is it the right way around) and gently bite on it first to make sure it will seat down fully without being proud - if it doesn't do this without anything in the Crown/bridge/Veneer then it won't be any better with something added inside and may end up even more ill-fitting or proud. Double check no food or old cement particles getting in the way and if still proud, just leave off until can find a dentist for an emergency visit, via yellow pages etc.

If the Crown/Bridge/Veneer seems to fit OK, then just use a non-setting sticky paste (eg:mix some flour and water into a paste), place inside the crown hollow and press onto the tooth (the right way around!) then gently squeeze down onto this - you can then gently tooth-brush away any extra cement or if it's only a little, just leave it in place and it will dissolve away naturally.

This temporary method will not make any difficulties for your Dentist, but gives enough grip short-term to avoid social embarrassment of a missing front tooth when you smile etc. This will need re-applying several times during the day though.

You can also use "Polygrip" or other water soluble Denture adhesives to stick items back in with, using the same methods above, but only put a little in the hollow part of the crown and spread it around the sides, as these are very thick and may stop the Crown sitting down fully.Copied from © 2000-2010 Smile Specialist® & Tony©

If the tooth has fractured-off inside the crown, then it cannot grip the remaining root sufficiently, so keep the Crown but see a dentist ASAP.

These temporary methods are helpful until you can get to your Dentist. Otherwise store in a "soap box" to protect any items and prevent their loss!

However, any loose items should be removed before sleep so you don't accidently inhale or choke on these items! SOME LARGER UK CHEMISTS and Supermarkets actually have emergency dental kits with temporary materials to use, and may stay open late too - again always follow the instructions and get to a Dentist as soon as practicable!

WARNING !!!! - NEVER use super-glue in the mouth. It is poisonous and sets so fast that some people have ended up with their finger permanently glued to their mouth !!! Other glues have nasty chemicals in them too which apart from poisoning you, may also turn a simple Dental Treatment into a Complex medical one.

Fractured Dentures

Whilst it may be possible to glue removable Dentures outside the mouth, unless the Fractured pieces are a perfect fit, You are likely to ruin it, meaning it may not be used at all or even repaired later. The commonest reason for a Denture fracturing is due to the Gums shrinking more and more, so that the denture flexes too much and eventually "cracks" with use. You will need another denture then anyway. Should you attempt repair with super-glue, ALWAYS wear gloves (eg: the vinyl ones free at garage diesel pumps) and make sure the two pieces are NOT twisted out of line (the banana effect) when they are pressed firmly together, or it won't fit at all.

Other causes are simply too much wear and tear or accidently dropping it whilst cleaning it at home. HOME INSURANCE may cover the damage costs of replacement Dentures, if these were accidently damaged in the home - it is worth reading your policy small print! Always clean Dentures over a towel or bowl of water etc, to prevent damage if dropped and when travelling, keep an old denture as an emergency "social" replacement, as new dentures often take 4 visits over a month to make.


Tooth Knocked out ?

The INFORMATION PAGE titled Acute Trauma and Fractured Teeth, has full details: Remember, if the person was unconcious at all, you must get medical attention immediately as there could be bleeding in the Brain (eg: call 999, go to A+E etc) -

ONLY second teeth that have been knocked out whole, with it's root still intact, can be re-implanted at all. Not first (baby) teeth or those where the Crown has broken and the root left behind, just whole second Teeth with complete root intact. Even then SPEED is essential and the greatest Success of re-implantation is acheived if done within the Hour, ideally in less than 30 mins!!!

Store the tooth in Milk or tucked in the person's cheek. If greater than 24 hours has passed, then there is little chance at all of re-implantation working.

DO NOT scrub or touch the root (even if dirty) and hold it by the Crown part. Rinse under water to remove gross dirt and/or just place in milk.Copied from © 2000-2010 Smile Specialist® & Tony©
Get Professional help immediately. Make sure the tooth is re-implanted into the socket facing the right way around!

These general tips and guidance are NO substitute for seeking professional, personal advice from your Dentist or Doctor immediately.

We hope you have found this web-page useful for general information about Dental Emergencies and possible self-help hints and tips, if for some reason you cannot access Professional advice immediately. As always, prevention is better (and more pleasant) than cure and we hope by Accessing regular dental care and advice, that you maximise dental health and minimise dental problems for yourself and your family, wherever you are in the World. A smile for life is a great gift - some would say it's priceless !!!

You can use the above website menu or just click-a-link here for Specialist or Advanced aspects of Cosmetic Dentistry, Tooth Veneers, Tooth Whitening, Dental Tooth Implants and smaller Mini-Implants, Dental Ceramic Crowns, Gum Diseases and Bad Breath, Root Canal treatments or Dental CPD Courses, are just some of the subjects you can learn more about here on our award winning dental website www.smilespecialist.co.uk.

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Best Wishes from the Smile Specialist Team.