Dental Emergencies in Singapore: 8 Situations and What to Do First

Most dental problems are handled at a private dental clinic. However, a small number are severe medical emergencies that require hospital care. Go straight to the nearest Accident & Emergency (A&E) department if you have:

• Facial swelling affecting your breathing or ability to swallow.
• Swelling spreading towards your eye, under your chin, or down your neck.
• Uncontrolled bleeding from the mouth that does not slow after 20–30 minutes of firm, direct pressure.
• Suspected jaw fracture or significant facial trauma following an accident.
• High fever accompanying facial swelling, indicating a systemic or spreading infection.

1. Knocked-out adult tooth

What’s happening: An impact such as a fall or a sports injury has knocked a permanent tooth completely out of its socket. The ligament cells on the root surface may still be alive, and a tooth that is handled correctly can sometimes be replanted.

What to do now:

1. Pick the tooth up by the crown — the chewing surface. Do not touch the root.
2. If it is dirty, rinse it gently under cold running water for no more than 10 seconds. Do not scrub it, do not use soap, and do not wrap it in tissue.
3. If you can, place the tooth back into its socket the right way round and hold it there by biting gently on clean gauze or a handkerchief. Do not force it if it does not slide in smoothly.
4. If you cannot replant it safely, store the tooth immediately in a small container of cold milk or saline solution. Avoid storing it in plain tap water.

Safety note: If the injured person is dazed, confused, or very young, do not attempt to replant the tooth or store it inside their cheek — it is a serious choking hazard. Bring the tooth in milk or saline instead.

How urgent: Same day, and within the hour if at all possible.

2. Knocked-out baby tooth

What’s happening: A baby tooth has been knocked out by a bump or fall. Baby teeth are not replanted, because replanting can damage the permanent tooth still developing in the gum.

What to do now:

1. Check for bleeding and apply gentle pressure with clean gauze.
2. Do not try to put the baby tooth back into the socket.
3. Rinse the mouth with water to clear debris.
4. Keep the tooth if you find it, so the dentist can confirm it came out whole.

How urgent: Call the clinic the same day for a phone triage, and expect to be seen within 24–48 hours. A baby tooth is not replanted, but an early check rules out a fracture of the bone around the socket, or a piece of root left behind.

3. Cracked or broken tooth

What’s happening: A tooth has fractured, usually from trauma or from biting something hard. The crack may involve only the enamel, or it may run deeper towards the pulp, where the nerve and blood supply sit.

What to do now:

1. Rinse your mouth with warm salt water to clean the area.
2. If there is bleeding, apply gentle pressure with clean gauze.
3. If a fragment has broken off, keep it and bring it with you.
4. Avoid chewing on that side until you have been assessed.

How urgent: Same day if the tooth is painful or the edge is cutting your tongue or cheek; otherwise within a few days.

4. Severe toothache that wakes you at night

What’s happening: Pain that throbs, or that wakes you from sleep, often points to inflammation or infection inside the pulp of the tooth. Deep decay, a crack, or wisdom tooth pain are common causes.

What to do now:

1. Avoid very hot and very cold food and drink.
2. Sleep with your head raised on an extra pillow, which can ease the pressure sensation.
3. Over-the-counter pain relief such as paracetamol may help. Do not place an aspirin tablet against the gum — it burns the tissue.

How urgent: Same day. Pain at night usually means the problem will not settle on its own.

5. Dental abscess or facial swelling

What’s happening: An abscess is a pocket of infection at the root of a tooth or in the gum beside it. Swelling of the gum, cheek or jaw means the infection is spreading into the surrounding tissue. Treatment is usually either root canal treatment or extraction, depending on whether the tooth can be saved.

What to do now:

1. Do not squeeze or try to burst the swelling.
2. Rinse with warm salt water to keep the area clean.
3. A cold compress on the outside of the cheek can help with the swelling.
4. If the swelling starts to affect your eye, neck, breathing or swallowing, go to A&E rather than waiting for a dental appointment.

How urgent: Same day.

6. Lost filling or crown

What’s happening: A filling or crown has come out, usually because of decay underneath it, a crack in the tooth, or the bond giving way over time. The inner tooth is now exposed to bacteria and to hot and cold.

What to do now:

1. Rinse with warm water to clear food from the cavity.
2. Keep the filling or crown in a small container and bring it with you.
3. If a crown is loose but still sitting on the tooth, temporary denture adhesive from a pharmacy can hold it in place. Never use household superglue.
4. Avoid chewing on that side.

How urgent: Within 24–48 hours, sooner if the tooth is sensitive or sharp.

7. Something stuck between teeth, or a wire poking from braces

What’s happening: Food wedged between teeth can press on the gum and become surprisingly painful. For brace wearers, a wire can shift or a bracket can come loose, leaving a wire end rubbing against the cheek.

What to do now:

1. For trapped food, use dental floss or an interdental brush gently. Do not use pins, needles or anything metal and sharp.
2. For a poking wire, cover the end with orthodontic wax to stop it cutting the cheek.
3. Do not cut or bend an orthodontic wire yourself.
4. If the gum around the spot is swollen or bleeding persistently, mention it when you call — it may be gum inflammation rather than trapped food.

How urgent: Within a week, or sooner if the wire is causing an ulcer.

8. Bleeding that will not stop after an extraction

What’s happening: Some oozing for a day after an extraction is expected. Heavy or continuous bleeding usually means the blood clot over the socket has been disturbed — often by rinsing, spitting, smoking or using a straw.

What to do now:

1. Fold clean damp gauze into a pad and place it directly over the socket.
2. Bite down firmly and steadily for 30 minutes. Do not keep lifting it to check — that restarts the bleeding.
3. Do not rinse vigorously, spit, smoke or drink through a straw for the rest of the day.
4. Sit upright rather than lying flat.

How urgent: Same day if bleeding continues after two rounds of firm pressure. Separately, deep pain starting three to four days after an extraction can indicate a dry socket, which needs a dressing rather than pressure.