It is late, a tooth is throbbing, and the question is whether to ring someone tonight or book for next week. The answer depends less on the pain than on what else is happening: swelling, fever, trouble swallowing or breathing, bleeding and injury decide how fast you need help. Most dental problems sit somewhere between today and a few weeks, and only a small number need a hospital.
This page sorts common problems into rough timeframes. It is general information, not a diagnosis. If you are unsure, ring a dentist, or call healthdirect on 1800 022 222 for advice from a registered nurse at any hour. In NSW, the public Oral Health Contact Centre is on 1800 679 336.
Call Triple Zero or go to hospital for these signs
NSW Health's oral health access policy, PD2024_034, lists red flags that mean a person should be sent to an emergency department or healthdirect rather than wait for a dental appointment:
- Facial swelling with difficulty breathing, difficulty opening the mouth or swallowing, confusion or dizziness, or feeling very sick or getting worse quickly.
- A dental injury with loss of consciousness or altered consciousness, or with other injuries such as a head injury.
- Significant bleeding that does not stop, for example after an extraction.
For children, the policy adds swelling that affects the eye and a child who is refusing fluids. healthdirect also advises emergency care when a toothache or gum swelling affects breathing or speaking, or comes with swelling around the eye or neck, and notes that heart pain can sometimes be felt as a toothache.
These signs come first because an infection from a lower back tooth can spread into the floor of the mouth and the neck, lifting the tongue and narrowing the airway. That needs hospital care. It is not something to sleep on.
How much it hurts is a poor guide to urgency
Pain is the signal most people use, and it misleads in both directions. A tooth can be intensely painful for a night without being dangerous, and a tooth with a dying or dead nerve can be quiet for months while infection builds at the root tip.
A common trap is pain that fades by itself after a few days of throbbing. This can mean the nerve inside the tooth has died. The pain stops because the tissue sending it has stopped, but the bacteria remain. If you had days of pain and it has gone, book anyway.
Pain that wakes you at night tends to point to an inflamed nerve rather than passing sensitivity. Our article on why toothache gets worse at night explains the reasons.
How the public dental system ranks dental problems
NSW public dental services triage patients using priority codes with a recommended maximum waiting time for each. These are targets for the public system, not a promise that it is clinically safe to wait that long, but they give a sensible sense of order.
| Problem | Adults | Children |
|---|---|---|
| Facial swelling of suspected dental cause, bleeding that persists after dental surgery, recent dental injury (children also: pain with fever or refusing fluids) | 1 day | 1 day |
| Dental pain that disturbs sleep, without facial swelling | 1 week | 3 days |
| Dental pain during waking hours that does not disturb sleep | 30 days | 14 days |
| Broken tooth or filling, or decayed teeth, in children | Not listed separately | 60 days |
Private practices are not bound by these codes, and a private dentist will often see an urgent problem sooner. The table is most useful as a guide to which problems should jump the queue.
Have these seen today
Facial swelling
Swelling from a tooth means infection has spread beyond the tooth into the surrounding tissue. Even without red flags, it should be assessed the same day, and the direction it is heading matters more than its current size. If it starts to reach the eye or neck, or you develop a fever or trouble swallowing, go to hospital.
A knocked-out adult tooth
This is the clearest race against time in dentistry. Hold the tooth by the crown, not the root. If it is dirty, rinse it briefly in milk or saline, then put it back in the socket if you can and bite gently on a clean cloth. If it cannot go back, keep it in milk or saline, or inside the cheek for an older child or adult. Avoid water and never let it dry out. See a dentist immediately, ideally within 30 minutes. Our knocked-out tooth first aid guide sets out each step.
A knocked-out baby tooth
Never put a baby tooth back in, as this can harm the adult tooth developing above it. Comfort the child, press gently on any bleeding and see a dentist as soon as possible. Our article on why a knocked-out baby tooth should not be replanted explains why.
Bleeding after an extraction
Some oozing in the hours after an extraction is expected. Bleeding that keeps soaking through gauze despite firm, steady pressure needs attention the same day, and heavy bleeding that will not stop is a hospital problem.
Book within the week
Toothache that wakes you at night, with no swelling, belongs here. So does a cracked tooth that gives a sharp jolt when you bite or release, because cracks tend to spread and treating one before the nerve is involved usually keeps the options smaller. A gum boil, a small pimple-like bump on the gum, often means an infection is draining and also deserves a prompt look.
For a mouth ulcer, patch or lump with no obvious cause, see a dentist or GP if it has not healed or changed within 3 weeks. Most turn out to be harmless, but a persistent change should always be examined.
Weeks, not months: problems with no pain
A lost filling or a crown that has come off without pain is not an emergency, and no guideline sets a safe waiting time. The tooth is unprotected, though. Unsupported enamel can chip, exposed dentine can become sensitive, food packs in, and over time neighbouring teeth can drift so a crown no longer fits. Aim to be seen within a few weeks, and sooner if the tooth becomes sensitive or a sharp edge is catching your tongue.
Gums that bleed when you brush fit here too. This is usually inflammation and very treatable. healthdirect advises seeing a dentist or OHT if your gums still bleed after 3 to 4 days of good brushing and flossing.
Below that sit the minor things: a chipped corner only you notice, occasional sensitivity to cold, staining or a rough edge. Write them down and raise them at your next check-up.
All of these timeframes assume there is no swelling, fever, night pain or uncontrolled bleeding. If any of those appear, the problem moves up the list straight away.
A hospital treats the danger, not the tooth
Hospital emergency departments manage airway problems, serious infection, bleeding, facial injuries and pain. They are generally not set up to fill, extract or root fill teeth. If you go to hospital with toothache and none of the red flags, you can expect an assessment, pain relief and advice to see a dentist, and the tooth will still need treatment.
For a problem that is urgent but not dangerous, a dentist or an after-hours dental service is usually faster and more useful. Our guides to when to go to hospital for a dental problem and dental emergencies after hours and on public holidays cover the options.
Looking after yourself until your appointment
healthdirect suggests resting with your head raised, using a cold compress wrapped in a cloth on the outside of the face, avoiding very hot or very cold drinks, and asking a pharmacist or doctor about pain relief such as paracetamol or ibuprofen, following the packet instructions. Gargling with salt water, without swallowing it, may ease a mild toothache.
Some common remedies cause harm. Holding an aspirin tablet against the gum can cause a chemical burn and does nothing for the tooth. Heat on a swollen face is not recommended. Clove oil and oil pulling do not treat an infection.
Antibiotics are not a way to buy time. healthdirect notes they are usually not used for toothache unless there is a clear infection, and even then the source of the infection still needs dental treatment.
Questions we are often asked
Can I go to hospital for a toothache?
Yes, and you should if any of the red flags above are present. For toothache alone, a dentist will usually be able to do more, because hospitals rarely treat the tooth itself.
Is a swollen face from a tooth an emergency?
Treat it as a same-day problem at the least. NSW public services give facial swelling of suspected dental cause their highest dental priority, with a recommended wait of 1 day. It becomes a hospital matter if breathing, swallowing or opening the mouth is affected, if it reaches the eye or neck, or if you feel very unwell.
How long can I leave a broken tooth that does not hurt?
Usually a few weeks rather than a few days, as long as there is no pain, swelling or sharp edge. The risk is not sudden danger but further breakage turning a small repair into a larger one.
If you are unsure where your problem fits, it is better to have it looked at than to spend another night guessing. Our team in Melrose Park can assess the problem and explain the options. We are open Monday to Saturday, with late appointments until 9pm on Thursdays and Sunday visits by appointment. You can read about our general dental care or see our current deals.
This article is general information only and does not replace an examination. Symptoms can look similar and have very different causes, so if something is worrying you, have it assessed. In an emergency, call Triple Zero.
