Severe Toothache: Sudden, intense tooth pain usually signals pulpitis — inflammation of the inner tooth pulp — or an abscess. This is your tooth telling you the infection has reached the nerve. Over-the-counter pain medication manages symptoms but does not address the underlying problem. You need a root canal or extraction to actually resolve it. Don't wait this one out.

Dental Abscess: A dental abscess is a pocket of bacterial infection — either at the tip of the tooth root (periapical abscess) or in the surrounding gum tissue (periodontal abscess). Signs include a persistent throbbing ache, swelling in the cheek or jaw, sensitivity to pressure, a bad taste or foul smell, and sometimes fever. Left untreated, the infection can spread to the jaw, neck, and in severe cases, the airway. This is one of the true dental emergencies.

Knocked-Out Tooth: A knocked-out permanent tooth can often be saved — but only within a tight window. The periodontal ligament cells on the root need to stay alive for reimplantation to work. Your window is roughly 30–60 minutes if the tooth is kept moist. Keep it in milk, saline, or reinserted in the socket. Never scrub the root. Children's baby teeth are not reimplanted — but permanent teeth absolutely should be.

Cracked or Fractured Tooth: A cracked tooth ranges from a minor cosmetic chip to a split that extends into the root. Symptoms vary: you might feel nothing, or sharp pain when biting and releasing. If the crack reaches the pulp, a root canal is typically needed. If it extends below the gum line or through the root, extraction may be the only option. The earlier this is treated, the better the prognosis.

Lost Crown or Filling: When a crown or filling falls out, the underlying tooth structure is exposed and vulnerable. Temperature sensitivity and pressure pain are common. This isn't usually a same-day emergency unless you're in significant pain — but don't leave it untreated for more than a day or two, as the exposed tooth can decay rapidly.

When dental pain is severe, the instinct is often to head to the nearest hospital ER. This is understandable — but in most cases, it's the wrong move, and here's why: emergency rooms cannot treat dental problems.

ER physicians and staff are not dentists. They can prescribe antibiotics for infections and pain medication, and they can handle true emergencies involving the airway or uncontrolled bleeding. But they cannot perform root canals, extract teeth, reimplant avulsed teeth, or repair cracked restorations. You'll often wait hours, pay $500–$2,000+ out of pocket (ERs are expensive), and leave with prescriptions that mask the problem — only to still need an emergency dentist the next morning.

When the ER is the right call: If you have swelling that's spreading rapidly into your neck or floor of the mouth, difficulty breathing or swallowing, a high fever combined with facial swelling, or uncontrolled bleeding after trauma — go to the ER or call 911. These situations involve airway compromise or systemic infection that requires emergency medicine, not dentistry.

For everything else: An emergency dentist who can see you same-day will treat the problem faster, more effectively, and almost always at lower cost than an ER visit followed by a dental appointment.