A dental emergency is a condition that needs immediate treatment. Although most people would realize a broken or knocked-out tooth is a dental emergency, many -- like Allen -- don't realize that a toothache with severe pain and facial swelling may also require emergency treatment.

2. What are symptoms of a serious dental injury?

•Severe toothache and jaw pain

•Pain when chewing or experiencing a change in temperature

•Facial swelling

•Isolated bleeding from a particular area of the mouth

•A change in tooth color, which may take place over time

•Obvious pus from infection around the gum area

•Difficulty breathing

If you have facial swelling and are having difficulty breathing, call 911 or get to an emergency room right away.

3. When to go to the dentist immediately (serious emergencies)

Severe pain: Severe dental pain is a sure sign of injury or infection -- a signal telling you to see a dentist right away. The cause of severe pain in the mouth can be an injury, infection, abscess, broken tooth, or a reaction to recent dental work. In any of these cases, your dentist must assess whether you need antibiotics or other medication, and whether any dental procedures -- including root canal work -- need to be done right away.

Persistent bleeding: If your mouth won't stop bleeding even after applying pressure and cold compresses, see your dentist immediately. Persistent bleeding can lead to nausea and panic in children, and it generally signals a deeper wound or more complex injury.

Broken tooth: If you've fractured a tooth but haven't exposed the dentin (the more fragile inner layer of the tooth) and you're not in a lot of pain, you can wait a day or two to get to the dentist's office. But if the crack has gone deeper, reaching the underlying dentin or pulp, or second layer, you're likely to feel increasing pain and should see a dentist immediately. Dead pulp tissue quickly decays, causing serious abscesses or infection. If the pulp, or nerve center of the tooth, isn't protected, it may mean painful and expensive root canal work down the line.

Knocked-out tooth: Even if you've just fallen on your face or taken the brunt of a baseball bat, if you have dislodged a tooth, it's important to keep your wits about you. Whether or not your tooth will successfully be reimplanted is directly related to how quickly you're able to get to the dentist.

When a tooth gets knocked out, find it immediately. If it's still in your mouth, be careful not to poke or push your other teeth -- you may unwittingly cause further damage to teeth that are loose or cracked but not dislodged. Be very careful to handle only the crown (the part of the tooth that is normally visible) and not the root (the part of the tooth usually hidden by the gum). Try to place it in a container of milk or a saline solution. If neither of these is on hand, you can tuck the knocked-out tooth between your cheek and gum (being careful not to swallow it) and transport it to the dentist that way.

Never scrub the tooth, because you may damage living root and connective tissue. A knocked-out tooth has the best odds of being reimplanted if you get to a dentist's office and have the tooth placed back in the socket within 30 minutes. Even if more time has elapsed, don't hesitate to see a dentist, because you may still be able to save the tooth.

4. Significant injuries to the cheeks, lip or tongue

Slight cuts from accidentally biting your tongue or cheek, or minor burns from gulping hot coffee or eating a baked potato before it cools are nothing to get excited about. You can simply rinse the injured area with warm water and keep it clean. But deeper cuts, tears, punctures, or burns should be treated right away in a hospital emergency room or wound care clinic, as you may need stitches or further treatment. An emergency medical technician should immediately treat punctures or lacerations that have penetrated the mouth.

5. Is there anything I should do before I call for help?

•Don't panic. It's normal to feel scared, even terrified, but try to take control of your reactions. When you call a hospital, you need to be able to calmly describe the injury.

•Stop any bleeding. Not all injuries are visible, but you still need to see as much of the dental area as you can, and blood can block your view. If you have a first-aid kit, use gauze (or any clean cloth) to apply gentle but firm pressure to the bleeding area. A cold compress on the outside of the mouth will help control both pain and inflammation.

6. When to go to the dentist promptly (minor emergencies)

Foreign objects lodged between the teeth: When's the last time you got a foreign object -- anything from, say, a chicken bone to a toothpick to a piece of fishing line -- lodged between your teeth? The result can be irritating or downright painful. Sometimes you'll be able to dislodge it yourself, depending on the material: Try to gently remove the object with dental floss, but never use a sharp instrument such as a needle or knife, because you may accidentally crack the tooth enamel or put a gash in your gum or cheek. Bottom line for trapped foreign objects: If you can't floss it out, visit your dentist.

A lost or broken filling: If it's painful, use an over-the-counter pain medication such as ibuprofen until you can see your dentist. Make sure to brush and floss to remove any bits of food that might slip into cracked fillings or open cavities and cause inflammation. Visit your dentist promptly to stop the infection from setting in.

Chipped tooth: This is by far the most common mouth injury. Chipping a tooth usually means you've knocked off a small piece of enamel, but doing so is no reason to panic. If the dentin has been exposed, the injury may cause discomfort or sensitivity to heat or cold. For pain, take an over-the-counter pain reliever such as ibuprofen and then call your dentist. Try to be seen as soon as possible so the fracture will not deepen. The dentist can determine if the tooth needs to be capped or filled, and make sure the fracture has not deepened.

7. What should I do to prevent and prepare for dental emergencies?

•Make sure your dentist's telephone number is readily available. Find out your dentist's 24-hour on-call arrangements, especially if you have kids. Know what hospital emergency room you will choose if you have a severe emergency or can't get to a dentist.

•Use mouth guards, helmets, and face masks when playing sports. Make sure your child's coach or sports group leader knows how to handle dental emergencies.

•If you or your child have dental caps, bridges, dentures, or implants, note it on your emergency ID card.

•Avoid eating and drinking in a moving car, and always use your safety belt.

8. What are the most important things to remember after an accident?

•Medical emergencies take priority over dental ones. If a patient is unconscious or having trouble breathing, get to a hospital first, and call your dentist later.

•Anyone who is unconscious or semiconscious with a dental trauma must be watched, and should never be left unattended.

•Remove any dental apparatus or hardware from inside your mouth -- that means dentures, removable braces, retainers, mouth guards, and dental jewelry on pierced lips or tongue. If you've fallen on the ground, foreign objects -- from drinking straws to gravel -- can block a clear view of the injury.

9. What if I've been in an accident and have a dental emergency?

Once you've been to the hospital emergency care center and it's been determined that yours is a dental and not a medical emergency, you can see a dentist for an emergency exam. At the hospital, a dentist or doctor will account for any missing teeth and will take stock of the injury to your jaw, nerves and tissues. A technician will take an x-ray of your mouth, and if the dentist suspects that a tooth has been swallowed, x-rays of the neck or chest may also be ordered. Depending on the injury, he or she may also refer you to an endodontist or to a dental or plastic surgeon for further treatment.

Remember, seek emergency dental care if you have dental pain accompanied by any of the following:

•Trouble breathing

•Persistent bleeding in the mouth

•Severe pain in the mouth or jaws

•Facial swelling and inflammation

Dental emergencies are rarely life-threatening, but they may become so if not attended to. If you don't panic, there's a good chance your healthy smile will return.

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