If something just went wrong, call 702-734-0776. It’s the same number day or night. During office hours you’ll get our front desk. After hours, the recorded message tells you how to reach Dr. Sandquist.
If a permanent tooth has been knocked all the way out, read the next section before you do anything else. It’s the one dental injury where the first few minutes really do decide how it turns out, and what you do right there matters more than anything we can do later.
A permanent tooth has been knocked out
The tooth can often be saved. What you’re actually trying to save is the thin layer of living cells on the root, and everything below comes back to that.
- Pick it up by the crown, the part you normally see when you smile. Don’t touch the root, and don’t scrub, wipe or disinfect it. Wiping the root clean is the most common way a tooth that could have been saved gets lost.
- Put it straight back in the socket if you can. Line it up the way it came out and push gently until it’s level with the teeth next to it. Bite softly on a clean cloth or a tea bag to hold it there. This gives it by far the best chance.
- If you can’t bring yourself to do that, put it in milk. Whole or skim, and cold is fine. Milk is close enough to your body’s own fluids in acidity and salt to keep those root cells alive for a few hours.
- Don’t use tap water. Water kills the cells you’re trying to protect, because it’s too dilute. If there’s no milk, tuck the tooth inside your cheek, or use saline. Use water only if there’s nothing else at all.
- Then get seen quickly. Call us on the way, not after you get here.
Why speed matters. The root is wrapped in periodontal ligament, the living tissue that holds a tooth in the bone and lets you feel what you’re biting. Once the tooth is out and dry, those cells start to die. Most teeth do well if they’ve been dry for less than about thirty minutes. Between thirty and sixty minutes the damage becomes permanent, and after an hour the outlook drops sharply.
Bring the tooth no matter how long it’s been. An hour isn’t a cutoff after which there’s no point. We’ll decide what can be done once we can see it, so please don’t throw a tooth away because you think you took too long.
Handling, storage media and dry-time thresholds follow Fouad AF, Abbott PV, Tsilingaridis G, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dent Traumatol. 2020;36(4):331-342.
A knocked-out baby tooth is the exception, and the advice flips. Don’t put it back. Putting a baby tooth back in can damage the permanent tooth still forming in the bone above it. Keep your child comfortable, stop any bleeding with gentle pressure, and call us. You don’t need to bring the tooth.
Day PF, Flores MT, O’Connell AC, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dent Traumatol. 2020;36(4):343-359.
What to do for everything else
None of these are a race the way a knocked-out tooth is, but what you do in the meantime still matters.
- A broken or chipped tooth. Save any pieces you can find in milk or saline, because a clean piece can sometimes be bonded back on. Rinse with warm water, hold a cold pack on the outside of your face if it’s swelling, and chew on the other side.
- A crown or filling came out. Keep the crown. It can usually be cemented back on, and that costs a lot less than a new one. Temporary cement from a pharmacy will hold it for a few days. Don’t use superglue. It isn’t safe in your mouth, it can damage the tooth underneath, and it often turns a quick re-cement into a much bigger repair.
- Toothache. If it’s safe for you to take, an anti-inflammatory like ibuprofen usually helps dental pain more than acetaminophen (Tylenol). Don’t hold an aspirin against your gum. It burns the tissue and does nothing for the tooth. Pain that wakes you up at night, or hangs around after something cold, is worth a call instead of a wait. Our article on the signs you may need a root canal explains why.
- Bleeding after an extraction. Fold some clean gauze, put it over the spot, and bite down firmly for a full fifteen minutes without lifting it to check. Most bleeding stops with steady pressure, and it keeps starting again when the pressure keeps getting interrupted. If it still won’t stop, call the office that took the tooth out, since they know exactly what was done.
- Something stuck between two teeth. Floss, gently. Never use a pin, a knife tip, or anything metal.
When it’s a medical emergency, not a dental one
Most dental problems can wait until morning. One can’t, and it helps to know the difference before you’re in it.
Go to a hospital emergency room now, instead of calling a dentist, if a tooth infection comes with any of these:
- Swelling that’s spreading toward your eye, or down under your jaw and into your neck
- Trouble swallowing, trouble breathing, or your voice sounds different
- A fever along with swelling in your face
- You can’t open your mouth normally
An infection that starts at a tooth can spread into the neck and start to affect your airway. It’s rare, but it’s a real emergency, and it needs a hospital, not a dental chair.
How to reach us
There’s one number, in and out of office hours: 702-734-0776. During the day you’ll reach the front desk. After hours the recorded message points you to Dr. Sandquist. Leave your name, your number and what happened, and tell us if you’re in pain.
These are our office hours:
In pain during the day? Call us
If you’re hurting on a day we’re open, call. We’ll do what we can to get you in, whether or not you’ve been here before. You don’t need to be a patient already to be seen for pain during office hours.
We can’t promise same day every time. Sometimes the schedule really is full, and sometimes we’re out of the office. Calling early in the day helps more than anything.
After hours is different
In the evenings, and Friday through Sunday, the phone reaches Dr. Sandquist himself, not an answering service. That only works for our own patients, whose history and records we already have, and for people one of our patients has personally referred.
So if you’re not a patient here and something happens at nine o’clock on a Friday night, here’s what we’d tell you. The first aid on this page still applies, and the section on swelling is the one to take seriously tonight. For treatment before we open, go to a hospital emergency room or an urgent dental clinic. We don’t have a relationship with any particular one, so we won’t pretend to send you somewhere specific. They’re open, though, and at that hour they’re the right call.
Then call us when we open, and we’ll take it from there.
Once the tooth feels better
Getting you out of pain is one visit with one job, and it’s a perfectly good way to become a patient here. What it can’t do is tell you whether anything else in your mouth is about to do the same thing. That’s the question most people end up asking on the drive home.
Dr. Sandquist has written about that choice, and about why deciding to wait can be a real decision and not just putting it off: Emergency care vs. a treatment plan: what happens after the pain stops →
If you’d like a dentist who works this way, the best time to find one is before something goes wrong. Here’s what a first visit looks like →