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Call now, then read the rest

Fort Smith: (479) 226-3500 Roland, Oklahoma: (918) 503-6262

Office hours are Monday through Thursday, 8:00 a.m. to 5:00 p.m., at both locations. We hold room in the schedule for emergencies and will see you the same day when we can. If you reach us after hours, leave a message. We return after-hours messages promptly.

Below is what to do while you wait. Find your situation and start there.

Three situations that are not dental office problems

Go to an emergency room or call 911 now if any of these apply:

• Facial swelling that is affecting your breathing or swallowing. Swelling that has closed your eye, crossed to your neck, or is making it hard to swallow your own saliva is a spreading infection and it is a medical emergency.
• Bleeding you cannot control. If bleeding has not slowed after 20 minutes of firm, continuous pressure, or you are on blood thinners and it will not stop, go.
• A suspected broken jaw. Especially after a fall, a car accident, or a blow to the head. If your teeth suddenly do not fit together, your jaw will not open or close, or you have numbness in your lip or chin, that needs imaging today.

Also go for any head injury with loss of consciousness, confusion, or repeated vomiting.

For everything else, a dental office is faster, cheaper, and far more likely to fix the problem. Emergency rooms rarely have a dentist on staff. They can manage pain and infection, but they do not do fillings, crowns, or root canals.

Knocked-out permanent tooth: you have about 30 to 60 minutes

This is the one true race against the clock.

1. Find the tooth. Pick it up by the crown, the chewing part. Do not touch the root.
2. Do not scrub it, do not use soap, and do not dry it. If it is dirty, rinse briefly with milk or saline. A few seconds only.
3. Put it back in the socket if you can. Push gently until it is level with the neighboring teeth, then bite softly on a clean cloth to hold it.
4. If you cannot reinstall it, keep it wet. Milk is the best option. Saline works. So does your own saliva, holding it in your cheek, if the person is old enough not to swallow it. Do not store it in water.
5. Call us immediately: Fort Smith (479) 226-3500, Roland (918) 503-6262.

Success drops sharply after the first hour out of the socket. Getting the tooth back in place quickly gives it the best chance, though not every replanted tooth survives long term.

Baby tooth knocked out: do not put it back in. Reimplanting a baby tooth can damage the permanent tooth developing above it. Call us and we will check the site.

Cracked, chipped, or broken tooth

1. Rinse your mouth with warm water.
2. Save any pieces you can find and bring them.
3. Cold compress on the outside of the cheek, 20 minutes on, 20 minutes off, to control swelling.
4. If a sharp edge is cutting your tongue or cheek, cover it with orthodontic wax or a small piece of sugar-free gum.
5. Over-the-counter ibuprofen, taken as directed on the label, if you can take it safely.
6. Eat soft food, chew on the other side, and avoid anything very hot or very cold.

Call the same day. A small chip may only need bonding, while a crack that reaches the nerve gets worse and more expensive the longer it waits. Pain when you release a bite, rather than when you press down, often points to a crack.

Abscess or facial swelling: do not wait this one out

An abscess is an infection with a collection of pus. Signs include a throbbing ache, a pimple-like bump on the gum, a bad taste, swelling in the face or jaw, tenderness in the neck glands, or fever.

First, check the ER list above. If swelling is affecting your breathing or swallowing, or you have a fever with rapidly spreading swelling, go to an emergency room now.

Otherwise:

1. Call us today. Infections do not resolve on their own.
2. Rinse with warm salt water, half a teaspoon in a cup of warm water, several times a day.
3. Cold compress outside the cheek for swelling. Do not apply heat to the face, which can encourage the infection to spread.
4. Ibuprofen as labeled, if appropriate for you.
5. Do not try to pop or drain it yourself. Do not take leftover antibiotics from a previous prescription.

Antibiotics alone do not cure a dental abscess. They can knock down the swelling, but the source has to be treated, usually with a root canal or an extraction, or the infection comes back.

Lost crown, lost filling, or a loose bridge

Uncomfortable but rarely urgent. Still call, because an exposed tooth can decay quickly and can shift enough that the crown no longer fits.

1. Keep the crown. Rinse it, put it somewhere safe, and bring it in.
2. Temporary dental cement from a pharmacy can hold a crown for a day or two. Denture adhesive works in a pinch. Never use super glue.
3. If the exposed tooth is sensitive, clove oil on a cotton swab may take the edge off.
4. Avoid chewing on that side and skip sticky foods.

Members of our Bridges and Implant Crown Warranty or Crowns Warranty get free re-cementation and priority repair scheduling. Both plans include an after-hours emergency visit at $250.

Severe toothache with no obvious injury

1. Rinse with warm water and floss gently around the tooth. Trapped food is a common cause.
2. Ibuprofen as directed on the label. It generally works better than acetaminophen for dental pain because it reduces inflammation. Follow your physician's guidance and the label.
3. Never put aspirin directly on the gum. It burns the tissue and does not help the tooth.
4. Cold compress outside the cheek.
5. Sleep with your head elevated. Lying flat increases pressure and pain.
6. Avoid extreme temperatures and very sweet food.

Call us in the morning, or now if it is during office hours. Pain that wakes you at night, lingers more than 30 seconds after something cold, or has spread to your ear or jaw usually means the nerve is involved and a root canal is on the table.

Bleeding gums, a cut lip, or bleeding after an extraction

1. Fold clean gauze, place it directly on the bleeding site, and bite down with firm, continuous pressure for 15 to 20 minutes. Do not keep lifting it to look.
2. If gauze is not available, a moistened black tea bag works well. The tannic acid helps clotting.
3. For a cut lip or tongue, rinse gently, apply pressure, and use a cold compress.
4. After an extraction, for 24 hours: no smoking, no straws, no spitting, no vigorous rinsing. All of them can dislodge the clot and cause a dry socket.
5. Sit upright rather than lying down.

If bleeding will not stop after 20 minutes of firm pressure, go to an emergency room.

Jaw injury or trauma to the face

Go to an ER now if you cannot open or close your mouth, your bite suddenly feels wrong, you have numbness in your lip or chin, or there is significant swelling with bruising under the jaw.

If it is less severe, stabilize the jaw with a wrap or a scarf tied over the top of the head, apply a cold compress, eat nothing solid, and call us. We have CBCT 3D imaging and can see what is happening in the bone and the joint.

If the jaw locked while yawning or chewing with no injury involved, that is a TMJ episode rather than a fracture. Cold compress, soft food, and call us for an appointment.

Cost, insurance, and what to expect at the visit

An emergency visit starts with a limited exam and an X-ray of the problem area. Then we get you out of pain, either definitively or with a temporary measure, and lay out the options for the permanent fix.

We are in network with Aetna, America's, Assurant, Blue Cross Blue Shield, Cigna, Sun Life, Guardian, MetLife, United Concordia, Healthchoice, Delta Dental Premier, and Principal.

No insurance? Our Smile Savers plan includes two limited exams a year along with cleanings and X-rays, with no waiting period, starting at $440 a year. For larger treatment, CareCredit offers no-interest terms of 6 to 24 months, and Cherry approves in about 30 seconds. We take cash, check, credit, debit, HSA, and FSA.