Patient information · Urgent care
Dental pain out of hours
what a doctor can help with, and what only a dentist can fix
Toothache almost always needs a dentist, not a doctor. We can help with pain relief and with the complications of dental infection, but we cannot treat the tooth itself — and antibiotics alone do not cure toothache. The one situation that is a genuine emergency is spreading facial swelling.
Call 999 or go to an emergency department if there is
- swelling spreading towards the eye, or closing the eye
- swelling under the jaw or in the neck, or a raised tongue
- difficulty breathing or swallowing, drooling, or a changed voice
- difficulty opening the mouth more than a couple of centimetres
- a fever with facial swelling, or feeling seriously unwell
- swelling that is rapidly getting worse over hours
A dental abscess that spreads into the tissues of the face and neck can obstruct the airway and is life-threatening. This is not a wait-and-see situation. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Antibiotics are not a cure for toothache
Antibiotics may settle an infection temporarily, but the cause — a decayed or cracked tooth, or a dying nerve — is still there, and the pain reliably returns once the course finishes. The definitive treatment is dental: a filling, root canal treatment, drainage or extraction. Repeated courses of antibiotics without dental treatment lead to worse infections and resistant bacteria. Please do not treat a prescription as the end of the matter.
Finding an emergency dentist
- Contact your own dentist first — most practices have an out-of-hours message with arrangements.
- If you do not have a dentist, or cannot reach yours, call NHS 111, which can direct you to an urgent dental service.
- Emergency departments do not have dentists and cannot treat teeth. They manage spreading infection and facial trauma only.
Controlling the pain until you are seen
- Paracetamol and ibuprofen taken together, each at its normal dose, is considerably more effective for dental pain than either alone. Check both suit you.
- Take them regularly by the clock rather than waiting for the pain to peak.
- Rinse with warm salty water — half a teaspoon of salt in a glass of warm water, several times a day.
- Clove oil on a cotton bud applied to the tooth gives short-lived relief for some people.
- Avoid very hot, very cold, sweet or hard foods, and chew on the other side.
- Sleep with your head raised, which reduces throbbing.
- Never hold an aspirin against the gum — it burns the tissue and does not help the tooth.
A knocked-out tooth
Time matters enormously here — a permanent tooth reimplanted within the hour has a good chance of surviving.
- Pick the tooth up by the crown — the chewing part — never by the root.
- Do not scrub it or use soap or disinfectant. If dirty, rinse briefly in milk or saliva.
- Put it back into the socket if you can, the right way round, and bite gently on a clean cloth to hold it.
- If you cannot reimplant it, keep it in milk, or in the person's own saliva inside the cheek if they are old enough not to swallow it. Never store it in water.
- Get to a dentist immediately.
Baby teeth are the exception
Never attempt to put a knocked-out baby tooth back in. Reimplanting it can damage the developing permanent tooth underneath. Take the child to a dentist, but leave the tooth out.
What we can help with
- assessing and treating spreading facial infection, including antibiotics and urgent referral
- pain relief where over-the-counter medicines are not enough
- checking whether facial pain is actually dental — sinus infection, jaw joint problems, shingles and nerve pain are all mistaken for toothache
- reviewing whether an infection has settled after dental treatment
- a sick note if dental pain has kept you from work
Book an appointment if you have facial swelling, a fever with dental pain, pain that is not controlled by regular painkillers, or you are not sure whether the problem is your tooth or your sinus. We are open seven days a week — but if the swelling is spreading or you are struggling to swallow, go to an emergency department instead of waiting.
Seen today for dental infection
Same-day appointments most days, seven days a week, 9am–7pm, on Whitechapel Road.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.