Chipped a Tooth? What to Do in the First Hour

11 minutes ago

6 min read

Fall in western New York is a season of ladders, wet leaves, frozen driveways at 6 a.m., and kids back on the ice. It is also, reliably, the season we get the most calls that start with some version of: I think I broke a tooth, what do I do?

The honest answer is that what you do in the first hour matters a great deal, and most people spend that hour doing the wrong things. Not out of carelessness. Nobody plans for this, so they improvise, and the improvised version usually involves scrubbing something, wrapping something in a dry tissue, or waiting until morning to see if it feels better.

So consider this the page to save now, before you need it. Here is how we would want you to handle each kind of dental emergency, and when it is worth calling us the same day instead of waiting.

A tooth gets knocked completely out

This is the one true race against the clock. An adult tooth that has been fully knocked out can often be put back and can reattach, but the odds drop sharply with every ten minutes it spends out of the mouth. Under an hour is good. Several hours is a long shot.

What to do:

Pick the tooth up by the crown, the chewing part. Never touch the root.
If it is dirty, rinse it gently in milk or saline for a few seconds. Do not scrub it, do not use soap, and do not dry it off.
If you can, put it back in the socket right away and hold it there with light pressure or by biting on a clean cloth.
If you cannot reinsert it, store it in a cup of cold milk. Milk is much better than water. Saliva works in a pinch; keeping it in your own cheek is an option for an adult, but never for a small child who might swallow it.
Call us immediately at (585) 247-1530 and say the words knocked-out tooth so we prioritize you.

One important exception: if it is a baby tooth, do not put it back. Reimplanting a primary tooth can damage the permanent tooth developing underneath. Save it, call us anyway, and we will check what is going on with the tooth above it.

A tooth is chipped or cracked

This is the most common one, and the most commonly ignored. A corner comes off a front tooth on a water bottle, a molar cracks on a piece of hard candy or a popcorn kernel, an old filling gives out on a bagel.

Rinse with warm water. If there is bleeding, press a clean gauze or cloth against it. Use a cold compress on the outside of the cheek to keep swelling down. Save any fragment you can find in milk or saliva and bring it with you, because in some cases we can bond it back.

Then call us, even if it does not hurt. That last part is the piece people get wrong. A crack that does not hurt today can still run into the nerve, and enamel is not going to repair itself. What starts as a chip that could be smoothed or bonded turns, over a few months of chewing on it, into a crown or a root canal. Pain is a late signal in dentistry, not an early one.

One thing worth flagging for adults: if you grind your teeth at night, you are far more likely to crack one. Grinding fatigues the tooth over years, and then something ordinary finishes the job. If we repair a cracked tooth and never address the grinding, we are usually going to see you again for the tooth next to it.

Serious toothache or a swollen face

A tooth that throbs, keeps you up, radiates into the jaw or ear, or comes with a swollen cheek or jaw is not a wait-and-see situation. Swelling especially. That is a sign of infection, and infections in the mouth spread through tissue planes toward the airway and the eye. Facial swelling that is growing, along with fever or trouble swallowing, means an emergency room, not a morning appointment.

Short of that, call us. Rinse with warm salt water, take whatever over-the-counter pain reliever you normally take safely, and use a cold compress. What does not help: putting aspirin directly on the gum, which burns the tissue, or heat on the outside of the face, which can draw an infection outward.

We do treat infected and abscessed teeth here, including root canal treatment, and the sooner we see it the more of the tooth we can usually save.

Something came loose: a crown, filling, or bridge

Less dramatic, still worth a call. A crown that pops off leaves a prepared tooth underneath that is often quite sensitive and can shift if it stays uncovered for weeks. Keep the crown, put it somewhere safe, and do not try to glue it back with a household adhesive. Over-the-counter temporary dental cement from the pharmacy is acceptable for a night or two if you cannot get in right away.

A lost filling is the same idea. Keep the area clean, avoid chewing on that side, and get in before food packs into the open space and starts new decay under the edge.

What not to do

Do not wait for pain before calling. The most expensive dental problems are the quiet ones.
Do not scrub, dry, or wrap a knocked-out tooth in dry tissue.
Do not use super glue on a crown or a chipped tooth.
Do not put aspirin directly on the gum.
Do not assume an emergency room can fix a tooth. Most can manage pain and infection but cannot restore or reimplant a tooth.
Do not brush aggressively over a fresh injury. Clean, gentle, and let it settle.

A little prevention, since it is that season

Most of the broken teeth we see in the fall are not exotic. They come from a handful of ordinary situations.

Hockey, basketball, and wrestling season starting up without a mouthguard
Wet leaves and the first icy steps of the year
Ladder work on gutters, usually by someone who should have had a second person there
Hard fall foods: caramel apples, candy apples, popcorn kernels, ice chewing
Old fillings on a grinder's teeth finally giving out

Two of those are easy to get ahead of. If someone in your house plays a contact sport, a mouthguard is one of the cheapest pieces of protection in existence compared with rebuilding a front tooth. And if you wake up with a sore jaw or your partner hears grinding at night, ask us about a nightguard at your next visit. It is a much easier conversation than the one that starts with a fractured molar.

How to reach us when it happens

Westside Family Dentistry is at 2300 Buffalo Rd #800a in Rochester, serving families in Gates, Chili, and the western suburbs. Our office hours are Monday through Thursday 8 a.m. to 5 p.m., with a lunch break from 1 to 2, and Friday 8 a.m. to 2 p.m.

If you are dealing with something urgent during those hours, call (585) 247-1530 and tell whoever answers exactly what happened. Dental emergencies get worked into the day; that is part of how a family practice runs. If it is after hours and a tooth has been knocked out or the swelling is serious, do not sit on it waiting for us to open. Get to an urgent care or emergency room, and call us first thing so we can follow up on the tooth itself.

Dr. Martin Lubes has practiced on Rochester's west side for over thirty years, and our team's approach to an emergency visit is the same as any other: figure out what is actually going on, explain it plainly, and fix the smallest version of the problem we can. No one is going to make you feel foolish for how it happened. We have heard every version of it, and most of them involve leaves.

Not an emergency, but overdue for a checkup? That is the better call to make. Reach out through westsidefamilydentistry.net or give us a ring to get on the schedule before the holidays fill it up.