Dental Emergencies After 60: What to Do and When to Get Help

A severe toothache in the middle of the night.

A broken crown while eating.

A denture that suddenly cracks.

A tooth knocked out in a fall.

Dental problems rarely happen at a convenient time.

The important first step is knowing whether the problem requires:

• emergency medical care
• urgent dental treatment
• a dental appointment soon
• temporary home care until the dentist is available

Not every painful dental problem is life-threatening.

But some mouth and facial problems should not wait.

When to Call 911 or Go to an Emergency Department

Seek emergency medical care if you have:

• difficulty breathing
• difficulty swallowing associated with facial or mouth swelling
• rapidly spreading swelling involving the face or neck
• uncontrolled bleeding
• major trauma to the face or jaw
• loss of consciousness or other serious symptoms after facial trauma

These situations can involve the airway, major blood loss, or injuries beyond the teeth.

A hospital emergency department can manage those immediate medical dangers.

You may still need follow-up treatment from a dentist afterward.

When to Call a Dentist Urgently

Contact a dentist as soon as possible for problems such as:

• severe or persistent tooth pain
• localized facial or gum swelling
• an abscess or drainage
• a knocked-out permanent tooth
• a loose adult tooth after trauma
• a painful cracked or broken tooth
• a lost crown or filling that causes significant pain or leaves the tooth vulnerable
• dental trauma
• a broken denture that prevents comfortable eating or injures the tissues
• a loose implant restoration
• significant pain after recent dental treatment

Your dentist can help determine whether you need same-day treatment or the next available appointment.

1. Severe Toothache

A toothache can result from:

• tooth decay
• a cracked tooth
• an inflamed or infected tooth nerve
• an abscess
• gum disease
• another dental problem

Pain may be:

• throbbing
• sharp
• constant
• triggered by biting
• triggered by hot or cold

What to Do

• Rinse gently with warm water.
• If food appears trapped between teeth, carefully clean between them.
• Avoid chewing on the painful side.
• Contact your dentist.

Don’t Put Aspirin on the Tooth or Gum

Aspirin placed directly against oral tissues can cause a chemical burn.

If you need an over-the-counter pain reliever, use only one that is safe for you and follow the label or advice from your healthcare professional.

This is especially important after 60 because medicines such as ibuprofen, naproxen or aspirin may not be appropriate for everyone with:

• kidney disease
• stomach ulcers
• heart conditions
• anticoagulant treatment
• other medication interactions

Acetaminophen also has dosing limits and may not be appropriate for everyone.

If you are uncertain, ask a pharmacist or healthcare professional.

2. Facial Swelling or Dental Abscess

A dental abscess is an infection that can develop from:

• deep decay
• a cracked tooth
• periodontal disease

Possible signs include:

• tooth pain
• gum swelling
• facial swelling
• pus or drainage
• bad taste
• fever

An abscess needs dental treatment.

Antibiotics alone do not necessarily eliminate the source of the infection.

Depending on the cause, treatment may involve:

• drainage
• root-canal treatment
• periodontal treatment
• extraction
• antibiotics when indicated

When Swelling Becomes a Medical Emergency

Go to an emergency department or call 911 if swelling is associated with:

• difficulty breathing
• difficulty swallowing
• rapidly worsening facial or neck swelling
• other signs of serious illness

Do not wait overnight hoping severe swelling will disappear.

3. A Knocked-Out Permanent Tooth

A tooth completely knocked from its socket is called an avulsed tooth.

Time matters.

What to Do

1. Find the tooth.
2. Pick it up by the crown — the part normally visible in the mouth.
3. Avoid touching the root.
4. If it is dirty, rinse it gently rather than scrubbing it.
5. If possible, place it gently back into its socket without forcing it.
6. If you cannot replace it, keep it moist.
7. Contact a dentist immediately.

Milk or an appropriate tooth-preservation solution can be used to keep the tooth moist.

Do not allow the root to dry out.

A dentist should evaluate the injury immediately.

What If a Tooth Simply Falls Out Without an Accident?

That is different from a tooth knocked out during trauma.

An adult tooth that becomes extremely loose or falls out without an injury may indicate:

• advanced periodontal disease
• severe decay
• root fracture
• another serious dental problem

Save the tooth if possible and contact a dentist.

Do not automatically push it back into the socket as you might with a freshly avulsed healthy tooth after trauma.

The dentist needs to determine why it came out.

4. Cracked or Broken Tooth

A tooth may crack after biting:

• ice
• a hard seed
• popcorn kernels
• hard candy

Teeth with large older fillings may also be more vulnerable to fracture.

What to Do

• Rinse gently with warm water.
• Apply a cold compress to the outside of the face if swelling is present.
• Avoid chewing on the tooth.
• Save any pieces you find.
• Contact your dentist.

A broken tooth does not always hurt immediately.

That does not mean it should be ignored.

5. Lost Filling

A lost filling may leave:

• a rough edge
• sensitivity
• a hole that traps food

Keep the area reasonably clean and contact the dentist.

Avoid repeatedly chewing hard foods on the affected tooth.

Do not attempt a permanent repair with household glue or other non-dental materials.

Temporary dental filling products may be useful for very short-term protection when professional care is unavailable, but they do not replace treatment.

6. Lost or Loose Crown

If a crown comes off:

• save it
• keep the tooth clean
• avoid chewing on the tooth
• call the dental office

Do not permanently glue it back yourself.

Household glues are not appropriate for use in the mouth.

The dentist needs to determine:

• why the crown came loose
• whether the tooth has decay or fracture
• whether the crown can be recemented

7. Loose Adult Tooth

An adult tooth should not suddenly become loose.

Possible causes include:

• trauma
• periodontitis
• fracture
• infection

Avoid wiggling it repeatedly.

Chew on the other side and contact a dentist.

A loose tooth is especially important to evaluate if it is accompanied by:

• swelling
• pus
• pain
• gum recession
• recent trauma

8. Broken Denture or Partial Denture

A broken denture is usually not a medical emergency.

But it can become urgent when it:

• cuts the mouth
• prevents eating
• interferes significantly with speech
• has sharp broken components
• can no longer be worn safely

What to Do

• Remove it if it is causing injury.
• Save all pieces.
• Contact your dentist.
• Ask whether a repair is possible.

Do not repair the denture with household glue.

Do not bend metal clasps yourself.

An incorrect repair can make professional repair more difficult or damage the mouth.

9. Denture Sore Spot

A minor sore area usually does not require an emergency department.

But call your dentist if:

• the sore persists
• it becomes increasingly painful
• the denture repeatedly rubs the same area
• you notice significant redness, swelling or ulceration
• the denture suddenly no longer fits

Persistent sores beneath dentures should not simply be accepted as normal.

10. Loose Dental Implant or Implant Crown

A dental implant itself should not move.

Sometimes what feels loose is actually:

• the implant crown
• a screw
• an attachment

rather than the implant in the bone.

Either way, have it checked.

Avoid repeatedly wiggling it or chewing hard food on it.

If the actual implant appears mobile, contact the dental office promptly.

11. Bleeding From the Mouth

Minor gum bleeding during brushing is different from uncontrolled bleeding.

If bleeding follows dental treatment:

• follow the dentist’s instructions
• apply firm pressure with clean gauze if instructed

Seek urgent help when bleeding:

• is heavy
• does not slow with appropriate pressure
• is accompanied by weakness, fainting or other concerning symptoms

If you take a blood thinner, do not stop it on your own.

Contact the dental team and prescribing clinician when necessary.

12. Bitten Lip, Tongue or Cheek

For a minor soft-tissue injury:

• rinse gently
• apply a cold compress
• use clean gauze and pressure for bleeding

Seek professional care when:

• bleeding will not stop
• the wound is deep
• pain is severe
• significant swelling develops

13. Something Stuck Between the Teeth

Try gentle floss or another familiar interdental cleaner.

Do not use:

• needles
• pins
• knives
• other sharp objects

If the object cannot be removed, contact the dentist.

Dental Emergencies and Older Adults

A dental problem can have a bigger practical impact after 60 if you also have:

• diabetes
• dry mouth
• anticoagulant treatment
• dentures
• implants
• multiple crowns or bridges
• difficulty chewing
• limited mobility

Make sure the dentist knows your:

• health conditions
• medications
• allergies
• recent medical changes

Prepare Before an Emergency Happens

Keep your dentist’s contact information easily available.

Ask:

• Do you provide same-day emergency appointments?
• What should I do after hours?
• Is there another practice you refer patients to when you are closed?

If you have a caregiver, make sure that person knows:

• who your dentist is
• which medicines you take
• where your dental insurance information is kept

A Simple Dental Emergency Kit

Useful items can include:

• sterile gauze
• dental floss
• small clean container
• cold pack
• flashlight
• medication list
• dentist’s phone number
• tooth-preservation product if desired

You do not need a large collection of home dental remedies.

The most useful tool is knowing whom to call.