Abstract
See a dentist within the week if you have pain that will not settle on its own, gums that bleed at every brushing, swelling on the gum or face, or a filling or crown that has come loose. Swelling with a fever means the same day — it may be an abscess.
Most children see a dentist every six months. As we get older, many of us lose the habit — a full calendar, and the feeling that nothing hurts, so nothing is wrong. The trouble is that most dental problems only start hurting late, by which point treatment is more complicated and more expensive.
Brushing twice a day and flossing does not replace a professional cleaning. A brush cannot reach below the gum line, and once tartar has formed it will not come off by brushing.
Here are the signs that should not wait.
Pain that will not settle on its own
Toothache lasting more than two or three days, or waking you at night, almost always means the nerve is involved. Painkillers mask the symptom while the process continues underneath.
If severe pain suddenly stops after a few days, that is not recovery. More often it means the nerve has died and the infection is moving into the bone — the point at which a straightforward root canal becomes a complicated one.
Sensitivity to hot, cold or sweet
A tooth that reacts to a cold drink or hot food may have decay close to the nerve, a cracked filling, or a receding gum leaving the root exposed.
Sensitivity that is new and getting worse is worth looking at. Sensitivity you have had for years without change is usually less urgent, but it still has a cause.
Gums that bleed when you brush
Healthy gums do not bleed. Blood at every brushing means inflammation — gingivitis, which if untreated progresses to periodontitis and destroys the bone around the tooth.
Periodontitis is the leading cause of tooth loss in adults, and it usually arrives without pain. By the time a tooth feels loose, the bone is already gone.
Swelling on the gum or face
This is the one on the list that means today, not this week. Swelling, particularly with a fever or difficulty swallowing, may be an abscess — a bacterial infection that can spread.
Swelling with a fever does not wait. Do not sit it out, and do not take antibiotics left over from something else — they mask the signs without stopping the infection. Call the clinic the same day.
A filling or crown that has come loose
Fillings, crowns and bridges last a long time, but not forever. When one comes loose or cracks, the tooth underneath is exposed — usually a tooth that was already weakened, and which can fracture easily.
Keep the piece if you find it and bring it to the appointment. Sometimes it can be re-cemented.
A change in how your bite closes
If your jaw clicks painfully when you chew or open wide, or your teeth no longer seem to meet the way they used to, it may be a temporomandibular joint problem.
It is not a weekend emergency, but it does get worse if ignored for years — and it is far easier to treat early.
What to do until your appointment
For pain, an ordinary painkiller and rinses with warm salt water help temporarily.
Do not put aspirin directly on the tooth or gum. It burns the soft tissue and adds a chemical burn on top of the problem you were trying to treat. Aspirin is swallowed, not applied.
Avoid chewing on that side, and very hot or very cold food. If there is swelling, a cold compress on the cheek, from the outside, eases the discomfort.
And call. Almost every dental problem is cheaper and simpler to fix early.