Emergency Tooth Extraction: What to Do and When to Seek Care

If you have severe tooth pain, facial swelling, a knocked-out tooth, or a broken tooth with bleeding, you should seek emergency dental care the same day—call an oral surgeon or dentist immediately, and go to an emergency room if you have difficulty breathing or swallowing or swelling that is spreading toward your eye or neck. Not every dental emergency ends in an extraction; many are treated by saving the tooth. But severe infection, a fractured tooth that can't be repaired, or advanced decay may require an emergency tooth extraction to stop pain and prevent the problem from spreading.

Why This Guide Exists

Dental emergencies are frightening precisely because they happen fast and off-hours. Knowing what to do in the first few minutes—and when a situation truly needs urgent care—can save a tooth, prevent a dangerous infection, and get you out of pain sooner.

At Curtin Oral Surgery & Associates, we provide emergency dental care for patients across Southern New Hampshire from our Londonderry and Salem offices. This guide walks through the most common dental emergencies, what to do right now, and when an extraction is the right call.

What Counts as a Dental Emergency?

Contact us right away if you're experiencing any of the following:

• A knocked-out (avulsed) tooth — time is critical; reimplantation is most successful within the first hour.
• Severe, persistent tooth pain that isn't relieved by over-the-counter medication.
• Facial or gum swelling, which can signal a spreading infection or abscess.
• A broken or cracked tooth with pain or bleeding.
• Bleeding that won't stop after applying gentle pressure.
• A dental abscess — a pimple-like bump on the gum, often with pain, fever, or a bad taste.

Seek emergency room care immediately if you have trouble breathing or swallowing, or swelling that is spreading toward your eye or neck—these can be signs of a serious infection.

What to Do for a Knocked-Out Tooth

For an adult permanent tooth, acting quickly gives the best chance of saving it:

1. Pick it up by the crown (the chewing surface)—never touch the root.
2. Gently rinse with water if it's dirty. Do not scrub, and don't remove any attached tissue.
3. Try to reinsert it into the socket if you can, holding it in place by biting on clean gauze.
4. If you can't reinsert it, keep it moist in a cup of milk (or saline). Avoid storing it in plain water.
5. Call us immediately. Reimplantation is most successful within the first hour.

What to Do for Severe Pain or Swelling

• Rinse with warm salt water to clean the area and ease discomfort.
• Use a cold compress on the outside of your cheek to reduce swelling.
• Take over-the-counter pain relief as directed while you arrange care.
• Don't place aspirin directly on the gum —it can burn the tissue.
• Call promptly. Swelling and throbbing pain often point to infection that needs professional treatment.

When Does a Dental Emergency Require an Extraction?

Whenever possible, the goal is to save your natural tooth. An emergency tooth extraction becomes necessary when a tooth is too damaged or infected to preserve, such as:

• A severe infection or abscess that has destroyed too much of the tooth or surrounding bone.
• A fracture below the gum line that can't be restored.
• Advanced decay that has compromised the tooth's structure.
• Trauma that has broken the tooth beyond repair.

When an extraction is needed, we keep you comfortable with the right sedation option and can discuss tooth-replacement options—such as dental implants—once you've healed.