Who to ring

Routes and numbers checked .

  1. Call 999

    Anything life-threatening — trouble breathing, speaking or swallowing, a lot of swelling inside the mouth, not being able to open your mouth, a swollen or painful eye or sudden trouble with your eyesight, collapse, a suspected severe allergic reaction.

  2. Go to an emergency department

    Bleeding that will not come under control, swelling spreading towards the eye or down the neck, a serious injury to the face or jaw, and any knock to the head that caused blacking out, being sick or double vision. Do not drive yourself — have someone take you, or ring 999 for an ambulance.

  3. Ring a dentist, the same day

    Everything else that will not wait — which is most of it.

If an adult tooth has been knocked out

Minutes matter here more than anywhere else in dentistry. A baby tooth is never put back in — it would damage the adult tooth forming above it. Front adult teeth come through from about six, so under six it is a baby tooth and from about twelve it is an adult one. In between: a baby tooth is small with a short, blunt root, an adult tooth is noticeably bigger with a long one. If you genuinely cannot tell, keep it in milk and ring a dentist straight away. If the knock also caused blacking out, being sick or double vision, the head comes first — ring 999 or go to an emergency department, and take the tooth with you in milk.

  1. Pick it up by the crown — the part that shows in the mouth. Do not touch the root.
  2. If it is dirty, rinse it gently — in milk, in salt water, or in spit. Any of the three is better than the tap. Plain water will do if none of them is to hand: a few seconds under the tap is better than letting the tooth dry out. Do not scrub it, and do not stand there soaking it — rinse, then straight back in.
  3. Put it straight back into the socket, the right way round, and bite gently on a clean cloth to hold it there.
  4. If you cannot put it back, keep it in milk. Saliva is next best — spit into a cup and put the tooth in that. Salt water also works. Plain water is a poor substitute and should not be used if anything else is to hand, but a tooth in water is better than a tooth that dries out. What you must not do is wrap it dry in a tissue.
  5. Get to a dentist within the hour. Ring ahead and say what has happened.

Go even if you cannot find the tooth, go even if you have managed to put it back — it has to be checked and splinted — and go even if more than an hour has passed. A late tooth is still worth taking in.

England

Ring your own dentist.

Otherwise NHS 111, by phone or at 111.nhs.uk, at any hour. They will arrange urgent treatment if you need it.

A GP cannot help with a dental problem.

Scotland

In working hours, ring your own practice — or your health board’s dental helpline if you are not registered with one.

Out of hours — from 6pm on weekdays, and from 6pm Friday to 8am Monday — 111 reaches NHS 24.

NHS 24 is a separate service from NHS 111 in England, on the same number.

Wales

Ring your own dentist.

Otherwise ring your health board's dental helpline — that is what NHS Wales asks you to do first. In Cardiff and the Vale it is 0300 10 20 247. In the Aneurin Bevan area (Blaenau Gwent, Caerphilly, Monmouthshire, Newport, Torfaen) it is 01633 744387, weekdays 9am to 12.15pm and 1.15pm to 4pm, with advice only outside those hours. In Betsi Cadwaladr, Cwm Taf Morgannwg, Hywel Dda, Swansea Bay and Powys, ring 111, at any hour.

Which number you ring depends on where you are, not where you are registered.

Northern Ireland

Ring your own practice first, whatever the day — they will tell you what out-of-hours arrangements they have. If you are not registered, ring local practices, and ask about the Dental Access Scheme if you cannot get seen.

At weekends and on bank holidays, the Emergency Dental Clinics triage by telephone on 028 2566 3510, lines open 8am to noon. You will be given an appointment if you need one.

Do not attend a clinic without an appointment. On a weekday evening or overnight there is no dental service at all — listen to your practice's answerphone, and use 999 or an emergency department only for the signs above.