Emergency Dentistry

I have a dental emergency — can I be seen today?

Smile Solutions reserves daily emergency appointments so that urgent problems can be seen promptly rather than waiting for the next routine opening.

Call 13 13 96. The practice is at Level 1, 220 Collins Street, Manchester Unity Building, Melbourne CBD, and an after-hours emergency service is available to existing patients.

Acting quickly matters for reasons beyond comfort: prompt treatment can save teeth, prevent permanent damage, and avoid more extensive and costly treatment later. A tooth that could have been saved on the day is often not salvageable a week later.

Six signs of a dental emergency

If you have any of these, see a dentist for treatment as soon as possible:

• Bleeding from the gums
• Gum pain
• Difficulty opening your mouth, chewing or speaking
• Facial swelling
• Sensitivity to hot and/or cold in the mouth
• Toothache

Facial swelling deserves particular attention. Swelling indicates a spreading infection, and swelling that involves the eye, the floor of the mouth, or that makes breathing or swallowing difficult, is a hospital emergency department matter — not something to wait on.

What the practice treats urgently

We provide emergency treatment for:

• toothache
• broken or chipped teeth
• infections
• denture repairs
• impacted wisdom teeth
• lost or damaged fillings
• knocked-out or displaced teeth

Because general dentists, hygienists and Dental Board–registered specialists all practise within the same organisation and the same building, an emergency that turns out to need specialist treatment — a complex root canal, a surgical extraction, an acute gum problem — can be escalated internally rather than referred across the city.

Time-critical situations

In a few emergencies, how fast you act changes what can be done:

For a knocked-out adult tooth: hold it by the crown, never the root; rinse briefly and put it straight back in the socket even if bleeding; if that is not possible, keep it wet and bring it in. The International Association of Dental Traumatology (IADT) lists suitable storage "in descending order of preference" as milk, HBSS, saliva (spat into a glass) or saline. Never let it dry out: the IADT's guidance is that "minimizing the dry time is critical for survival of the PDL cells" and that "after an extra-alveolar dry time of 30 minutes, most PDL cells are non-viable". It also states that "the decision to replant a permanent tooth is almost always the correct decision even if the extra-oral dry time is more than 60 minutes" — so a delay is a reason to hurry, never a reason to give up on the tooth. Never reinsert a knocked-out baby tooth — store it in milk and bring it.

While you are waiting

• Stay on a soft diet
• Manage pain with over-the-counter analgesia at the labelled dose
• Keep the area clean; brush gently, or use a moist cotton swab if brushing is too painful
• Do not place aspirin directly against the gum — it burns the tissue
• Do not apply heat to a swollen face

Preventing the next one

Many dental emergencies are the visible end of a slow problem: a cracked tooth that had been sensitive for months, a large old filling that finally failed, decay that never caused pain until it reached the nerve.

Regular check-ups and six-monthly hygiene appointments catch these while they are still routine treatment. Custom-fitted mouthguards prevent most sporting injuries.

Common questions

Is this actually an emergency, or can it wait?

Go to a hospital emergency department or call 000 now if there is facial swelling that involves the eye or the floor of the mouth, difficulty breathing or swallowing, uncontrolled bleeding, a fever with facial swelling, or any loss of consciousness after an injury. These are medical emergencies, not dental appointments.

Same day: a knocked-out or displaced adult tooth, severe pain that analgesia is not controlling, a dental abscess, or an injury that has loosened teeth.

Within a day or two: a broken or chipped tooth without severe pain, a lost filling or crown, a denture that has broken, or a wisdom tooth that has flared up.

Routine: sensitivity that comes and goes, a chip you can only feel with your tongue, mild gum bleeding when brushing. Book it — but you do not need an emergency slot.

An adult tooth has just been knocked out. What do I do, right now?

1. Find the tooth and pick it up by the crown — the chewing part. Never touch the root, because the living cells on its surface are what allow it to reattach.
2. If it is dirty, rinse it gently for a few seconds in milk, saline or the patient's own saliva. Do not scrub it, do not use soap, and do not use tap water for more than a moment — tap water damages the root surface cells.
3. Put it straight back into the socket, the right way round, and bite gently on a clean cloth to hold it. Bleeding is not a reason to stop.
4. If you cannot replant it, keep it wet. The IADT's order of preference is milk, then HBSS, then saliva (inside the patient's cheek if they are conscious and old enough not to swallow it), then saline. If you have none of those, use water — it is a poor medium and it damages the root surface cells, but the IADT is explicit that "although water is a poor medium, it is better than leaving the tooth to air-dry". What you must never do is let the tooth dry — not in a tissue, not in a bag, not in an empty container.
5. Phone 13 13 96 and come immediately.

The single most important variable is how long the root spends dry. Replanting within minutes gives the best outcome; a tooth kept moist can still be worth replanting well beyond that, so bring it even if hours have passed.

My child knocked out a baby tooth — same steps?

No. A knocked-out baby tooth is never put back. Replanting it risks damaging the adult tooth developing in the bone above it.

Keep it, keep it moist, and bring it so the dentist can confirm the whole tooth is accounted for and nothing has been pushed up into the gum or inhaled. Phone 13 13 96. See Children’s Dental Emergencies.

Can I just take antibiotics until I can get an appointment?

Antibiotics do not treat toothache and do not cure a dental infection. The source of the infection is inside the tooth or below the gum, where the blood supply that carries an antibiotic no longer reaches. Antibiotics buy time; they do not fix the cause — the tooth still needs treatment.

Taking them without treatment tends to produce a cycle of partial relief and return, and contributes to antibiotic resistance. If a dentist prescribes them it is usually because infection is spreading and treatment has to be staged — not as an alternative to treatment. An abscess left alone does not stay local.

What can I safely take for the pain in the meantime?

Over-the-counter analgesia at the dose on the label. Do not place aspirin or any tablet directly against the gum — it causes a chemical burn on top of the original problem. Do not apply heat to a swollen face. A cold pack against the outside of the cheek is safe.

Tell the dentist everything you have taken and when, including anything you took overnight.

What will an emergency appointment cost?

An emergency appointment is an examination first. The cost depends entirely on what is found and what is done, and it cannot honestly be quoted over the phone before anyone has looked.

What you are entitled to is the cost explained before treatment starts, itemised with ASDS item numbers. If pain relief is the priority, ask for the immediate step to be quoted separately from the definitive treatment — stabilising a tooth today and restoring it later is a legitimate and common plan. See Price Guide and Payment Plans.

I am not an existing patient. Can I still be seen?

Yes — daily emergency appointments are reserved and new patients can use them. Phone 13 13 96.

The after-hours emergency service is for existing patients. Outside opening hours, anyone with a genuine medical emergency should attend a hospital emergency department.

A filling fell out, or my crown came off. Is that urgent?

Usually not an emergency, but do not leave it. An unprotected tooth is easy to crack, and the exposed surface decays quickly. The same applies if a temporary filling comes out between appointments.

If a crown has come off cleanly, keep it — it can often be re-cemented, which is far cheaper than remaking the crown. Do not glue it back yourself with household adhesive. Avoid chewing on that side and book promptly.

The pain stopped on its own. Do I still need to come in?

Yes — and this is the single most misread signal in dentistry. Pain from an inflamed nerve often stops when the nerve dies. The problem has not resolved; it has moved to the next stage, and the next event is usually an abscess.

A tooth that hurt badly and then went quiet needs an examination, not relief — a dead nerve is the usual reason root canal treatment is recommended.

Why is my wisdom tooth suddenly painful?

A partly erupted wisdom tooth has a flap of gum over it that traps bacteria — the resulting infection (pericoronitis) flares, settles, and flares again. Warm salt-water rinses and scrupulous cleaning of the area may settle an early episode, but recurring flare-ups are the usual reason for removal, and for the recovery that follows.

Swelling, difficulty opening your mouth, or difficulty swallowing means it should be seen urgently. See Wisdom Teeth.

Practical details

The practice is on the corner of Collins and Swanston streets, opposite Melbourne Town Hall, a short walk from Flinders Street and Melbourne Central stations — getting here and contact details.

This page contains general information, not clinical advice, and it does not substitute for examination by a registered dental practitioner. In a medical emergency call 000 or attend a hospital emergency department.

Smile Solutions trades under ABN 28 193 514 103.