Knocked-out permanent tooth: the first 30 minutes decide it
This is the one situation where minutes genuinely determine whether the tooth is saved. The cells on the root surface die once dry, and it is those cells that let the tooth reattach.
Pick the tooth up by the crown, the chewing part, never by the root. If it is dirty, rinse it briefly in milk or saline, or in the patient's own saliva. Do not scrub it, do not use soap, and do not wrap it in tissue.
Put it straight back into the socket the right way round and bite gently on a clean cloth to hold it. This is by far the best outcome and anyone can do it.
If you cannot reinsert it, store it in cold milk. Milk is the best commonly available medium. Saline or the patient's own saliva, held in the cheek if they are old enough not to swallow it, are the next best. Never store it in water, which destroys the root cells faster than dry storage.
Get to a dentist immediately. Under 30 minutes gives a good prognosis; after about an hour outside the mouth the outlook falls sharply.
A knocked-out baby tooth is the exception: it must not be reinserted, because doing so can damage the developing permanent tooth underneath.
Facial swelling: the one that is medically serious
A dental abscess that spreads into the facial tissues is the dental problem most likely to become dangerous, and it is routinely underestimated because it starts as toothache.
Seek emergency medical care the same day, not a dental appointment tomorrow, if swelling is closing the eye, extending under the jaw or into the neck, if you cannot swallow or open your mouth properly, if breathing is affected, or if there is fever with rapidly spreading swelling.
These signs suggest infection tracking along tissue planes towards the airway. That is a hospital problem. Antibiotics from a pharmacy are not an answer to it, because the infection has to be drained.
Broken or chipped tooth
Rinse with warm water and keep any fragment in milk, since a clean fracture can sometimes be bonded back on. Cover a sharp edge with orthodontic wax or sugar-free gum to protect the tongue and cheek.
A small chip with no pain can wait a few days. A large fracture exposing pink or red tissue in the middle of the tooth has exposed the pulp and needs same-day attention.
Severe toothache
Take a standard painkiller you know you tolerate. Rinse with warm salt water. Keep the head elevated when lying down, as pulpal pain characteristically worsens when horizontal.
Do not place aspirin against the gum. It burns the tissue and does nothing for the tooth.
Do not start antibiotics on your own. Toothache from an inflamed pulp does not respond to antibiotics, and taking them delays the treatment that actually works while contributing to resistance.
Cold on the cheek helps some pulpal pain. If heat relieves it and cold makes it worse, mention that at the appointment, as it is a diagnostically useful detail.
Lost filling or crown
Keep the crown. If the underlying tooth is sensitive, temporary dental cement from a pharmacy can hold it for a day or two, but never use household glue. Chew on the other side and book within the week. This is uncomfortable rather than urgent.
Common questions
What do I do if my tooth gets knocked out?
Hold it by the crown, not the root. Rinse briefly in milk or saliva if dirty, without scrubbing, then put it straight back in the socket and bite on a cloth to hold it. If you cannot, store it in cold milk, never water, and reach a dentist within 30 minutes. Do not reinsert a knocked-out baby tooth.
When is a dental problem a medical emergency?
When facial swelling closes the eye, spreads under the jaw or into the neck, or affects breathing or swallowing, and when there is fever with rapidly spreading swelling. These suggest an infection tracking towards the airway and need emergency hospital care the same day, not a dental appointment.
Can I take antibiotics for a toothache?
Not on your own. Pain from an inflamed pulp does not respond to antibiotics, because the problem is inside a tooth that has no blood supply reaching it. Antibiotics have a place only in spreading infection, and self-prescribing delays the treatment that works.
Can a toothache wait until morning?
Usually yes, if there is no facial swelling, no fever and no difficulty swallowing or breathing. Manage it with a painkiller you tolerate, warm salt water rinses and an elevated head, and see a dentist the next day. Swelling changes the answer.
Medically reviewed
Reviewed by Dr. Dhanya Saxena, BDS, MHA, FMC, FAOI, oro-dental surgeon and aesthetic physician at Redefine Dental and Facial Aesthetic, Indira Nagar, Lucknow. Dental Council registration 20935. Last reviewed 30 August 2026.
This page is general information, not a diagnosis or a quotation. Prices are prevailing Lucknow market ranges. Your own treatment and cost are determined after an examination.