Emergency dentist treatment

When Should You See an Emergency Dentist? 5 Clear Signs

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Toothache can sometimes wait for a routine appointment, but in other cases, the pain or problem is too severe to ignore. That’s when you may need to see an emergency dentist. Knowing the difference can help you get the right care quickly and avoid more serious complications.

Here are five clear signs it’s time to book an emergency dental appointment.

Book an Emergency Appointment at Riverdale

1. Severe or Persistent Toothache

Mild sensitivity can usually wait, but if you have pain that is intense, throbbing, or keeping you awake at night, it’s a sign something isn’t right. Severe toothache may be caused by infection, decay, or an abscess, all of which need urgent treatment.

2. Swelling in the Face or Gums

If you notice swelling around a tooth, in your gums, or even in your face or jaw, it could point to infection. Left untreated, infections can spread quickly and cause serious health risks. A call to an emergency dentist near you is essential if you notice sudden or painful swelling.

3. A Knocked-Out Tooth

Time is critical if you’ve lost a tooth through an accident or injury. Seeing a dentist within an hour gives the best chance of saving the tooth. In the meantime, gently rinse it in milk or saliva, avoid touching the root, and try to keep it moist until your urgent dental care appointment.

4. Broken, Cracked or Chipped Teeth

Not every chip needs immediate attention, but if your tooth has broken and is causing pain, cutting your tongue or cheeks, or exposing sensitive inner layers, it counts as a dental emergency. Your dentist can smooth, fill, or restore the tooth depending on the severity.

5. Lost Fillings, Crowns or Dental Work

When a crown, filling, or bridge falls out, it can leave your tooth vulnerable and painful. Even if it doesn’t hurt straight away, exposed teeth are more prone to damage and infection. An emergency dental appointment helps protect the tooth until a permanent solution is in place.

When to Go Straight to A&E

While most urgent issues can be handled by an emergency dentist, you should go to A&E immediately if:

  • You’re experiencing heavy, uncontrolled bleeding.
  • You have swelling that affects your breathing or swallowing.
  • You’ve had serious trauma to the face or jaw.

Our practices provide same-day and next-day appointments for patients in need of urgent help. Whether it’s severe toothache, swelling, or a lost crown, our team is here to provide fast and effective care when you need it most.

Find your nearest Riverdale practice.

How Do Dentists Treat Gum Disease?

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Gum disease ranges from gingivitis (inflamed, bleeding gums) to periodontitis (where the supporting bone is affected). It’s common – but treatable – when caught early. If your gums bleed when brushing or you have persistent bad breath, it’s time to book a check-up so a clinician can assess and plan the right gum disease treatment for you.

Find your nearest Riverdale practice.

The Step-by-Step Approach Dentists Use

Modern periodontal treatment follows a structured, evidence-based, four-step pathway. Your dentist or hygienist will tailor these steps to you.

Step 1: Build the Foundations

  • Assessment & coaching: exam, gum measurements, X-rays if needed; guidance on brushing technique and interdental cleaning (usually interdental brushes; floss for tight gaps).
  • Risk factor control: support for smoking cessation and diabetes control if relevant.
  • Professional cleaning above the gumline to remove plaque and calculus and set you up for success at home.

This first phase focuses on behaviour change and professional cleaning; for some with gingivitis, this alone resolves the problem.

Step 2: Deep Cleaning Under the Gums

If pockets remain, your dentist will carry out subgingival instrumentation (often called root surface debridement or “deep cleaning”) under local anaesthetic. This removes plaque and calculus from root surfaces you can’t reach at home. 

Expect some short-term tenderness; results are reviewed after healing. Routine antibiotics aren’t usually needed; short courses or local antimicrobials are reserved for specific cases.

Step 3: Managing Non-Responding Areas (and When Surgery Helps)

If some deep pockets persist, options include repeating targeted deep cleaning or, where appropriate, periodontal surgery (for example, access flap procedures or regenerative techniques) typically performed by dentists with additional training or periodontists. The aim is to reduce pocket depths and make areas cleanable at home.

Step 4: Maintenance to Keep Gums Healthy

Long-term success relies on supportive periodontal care: regular reviews (often every 3–12 months, tailored to your risk) with professional cleaning and ongoing home-care coaching. This step maintains stability and catches any recurrence early.

What You Can Do at Home (That Really Helps)

  • Brush twice daily for two minutes with fluoride toothpaste; spit, don’t rinse.
  • Clean between teeth daily – interdental brushes are usually first choice; floss for tight gaps.
  • Avoid mouthwash straight after brushing (it washes away fluoride).
  • Don’t smoke, and keep medical conditions like diabetes well controlled.

These habits reduce bleeding and help treatment work.

Are Antibiotics Needed?

Antibiotics aren’t usually needed. For most people, professional cleaning plus great home care is the cornerstone of dentist gum treatment. Systemic antibiotics are not recommended routinely and are considered only in particular situations (for example, certain aggressive presentations) or acute infections. Short-term antiseptics (like chlorhexidine) may be used selectively.

NHS or Private: How Is It Charged?

In England, periodontal treatment (non-surgical and surgical) is charged as Band 2 on the NHS; a simple scale and polish is Band 1 only when clinically necessary. Charges change periodically – check the current NHS poster or ask your practice team.

Explore the differences between private and NHS dental care.

When to Seek Urgent Help

Book emergency dental care if you have severe pain, facial swelling, loose teeth, or ulcers with other concerning symptoms. If the practice is closed, call your dentist’s out-of-hours line or NHS 111 for advice.

Book a Gum Health Check

Riverdale practices provide full periodontal treatment – from early gum disease care to advanced therapy and maintenance – so you can keep your smile healthy long-term.

Find your nearest Riverdale practice.

Dentist whitening teeth

How Do Dentists Whiten Teeth? Professional Options Explained

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Teeth whitening is one of the most popular cosmetic dental treatments in the UK. While whitening toothpastes and DIY kits promise results, the safest and most effective way to brighten your smile is through professional teeth whitening at the dentist.

Here’s what you need to know about how dentists whiten teeth – and the options available at Riverdale practices.

Find your nearest Riverdale practice.

Why Choose Professional Whitening?

Dentist teeth whitening treatments are carefully supervised by qualified clinicians. That means the gels used contain a higher concentration of whitening ingredients (typically hydrogen peroxide or carbamide peroxide) than anything you can buy on the high street – but because they’re provided and overseen by a dentist, they’re still completely safe.

Professional whitening ensures:

  • Noticeable results – teeth can be several shades lighter after treatment.
  • Even whitening – custom-made trays ensure consistent coverage, avoiding patchy results.
  • Safety – your dentist will check your teeth and gums first to prevent sensitivity or irritation.
  • Long-lasting impact – with good oral care and occasional top-ups, results can last many months or longer.

It’s why professional teeth whitening in the UK is considered the gold standard for a brighter, more confident smile.

Your Professional Teeth Whitening Options

Most Riverdale Healthcare practices offer:

  • Custom whitening trays and gels – Your dentist takes impressions of your teeth and creates thin plastic trays designed to fit perfectly. You’ll be given whitening gel to use with the trays at home, usually for a set time each day over one to two weeks. This gradual approach gives you control over the final shade.

  • In-practice whitening – Available at some practices, this involves a stronger whitening gel applied in the dental chair. The dentist monitors the process closely, and results can often be seen in a single session.

These approaches to teeth whitening at the dentist can also be combined – for example, a single in-practice treatment followed by take-home trays for maintenance.

Is Teeth Whitening Right for Everyone?

Your dentist will check your teeth and gums before recommending whitening. It’s not suitable for everyone – for example.

  • Crowns, veneers, and fillings won’t change colour.
  • People with gum disease or untreated decay may need treatment first.
  • Whitening isn’t recommended during pregnancy or breastfeeding.

But if you are a good candidate, a dentist teeth whitening treatment is a safe, effective way to restore brightness and boost confidence.

Alternatives to Whitening

Whitening isn’t the only way to improve the look of your smile. Your dentist may also suggest:

  • Composite bonding – A tooth-coloured resin is applied directly to the surface of your teeth, shaped and polished to cover discolouration, chips, or small gaps. Bonding is minimally invasive, often completed in a single visit, and can make an immediate difference.
  • Veneers – Thin porcelain or composite shells that fit over the front of your teeth. Veneers can change the colour, shape, or alignment of teeth, providing a longer-term solution for a brighter smile.

These treatments can be used on their own or alongside professional teeth whitening for a more complete transformation.

Book a Teeth Whitening Consultation

At Riverdale Healthcare, our practices provide professional teeth whitening in the UK, alongside a full range of dental treatments. Whether you’re looking for whitening alone or considering options such as bonding or veneers, our team will help you find the treatment that’s right for you.

Find your nearest Riverdale practice.

Dentist fixing a chipped tooth

How Do Dentists Fix a Chipped Tooth?

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Accidents happen – from biting down on something hard to slipping during sport, a chipped or broken tooth is one of the most common dental injuries. While it can be worrying, the good news is that dentists can fix a chipped tooth in several different ways, depending on how much of the tooth is damaged.

Here’s what you need to know about chipped tooth treatment and how Riverdale can help.

Find your nearest Riverdale practice.

When to See a Dentist

Not every small chip is an emergency, but it’s always worth having it checked. A chipped tooth can:

  1. Cause pain or sensitivity if the inner layers are exposed.
  2. Make the tooth more vulnerable to further damage.
  3. Lead to sharp edges that irritate your tongue or cheeks.

If you’re in pain, bleeding, or have lost a large part of your tooth, call for an emergency dental appointment.

Treatments for a Chipped Tooth

1. Dental Bonding

For small chips, your dentist can use composite bonding – a tooth-coloured resin that is shaped to fill the missing area and then hardened with a special light. Bonding blends in naturally with your other teeth and can usually be completed in a single visit. It’s one of the most common solutions for dentist repair of a chipped tooth.

2. Veneers

If the chip is larger or on a front tooth, your dentist may recommend dental veneers. A veneer is a thin shell of porcelain or composite placed over the front of the tooth to restore its appearance. Veneers are durable, natural-looking, and can also improve the overall shape and colour of your smile.

3. Dental Crowns

When a significant portion of the tooth has broken off, a dental crown may be the best solution. A crown is a cap that covers the entire tooth, protecting it from further damage and restoring function. Crowns are especially useful for back teeth, which take the most pressure when chewing.

4. Root Canal Treatment

If the chip has exposed the inner pulp of the tooth and caused infection, your dentist may need to perform root canal treatment before restoring the tooth with a crown or filling. This protects the long-term health of the tooth.

Temporary Fixes Until You See a Dentist

If you chip a tooth outside practice hours:

  1. Rinse your mouth with warm water.
  2. Keep any broken fragments safe in case they can be reattached.
  3. Use dental wax (available from pharmacies) to cover sharp edges and protect your mouth.
  4. Avoid biting on the chipped tooth until it’s repaired.

These steps aren’t a replacement for proper chipped tooth treatment but can help until your appointment.

Book a Chipped Tooth Appointment at Riverdale

At Riverdale Healthcare, our dentists are experienced in treating chipped teeth – from simple composite bonding to full crowns and veneers. We’ll always recommend the least invasive treatment that restores both comfort and appearance.

Find your nearest Riverdale practice.

Dentistry can sometimes feel full of unfamiliar terms. A scan changes that. When dentists show patients what is happening on screen, the conversation becomes clearer, easier to follow, and easier to remember.

This is especially useful for spotting early warning signs – such as gum recession, enamel wear, or bite issues. Patients can see the issue for themselves and understand why it matters, making them better equipped to take action before problems become serious.

Helping Patients Take Control of Their Dental Health with Intraoral Scanners

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By Lamia Murray, Service Development Manager at Riverdale Healthcare

For many people, the dentist’s chair can feel like a place where decisions are made for them, not with them. A dentist or dental nurse might explain an issue or suggest a course of treatment, but for the patient this can feel abstract, difficult to picture, and often overwhelming.

Traditional impression-taking – where the patient bites into a tray of putty-like material to create a mould of their teeth – can risk reinforcing this gap. Patients endure a messy, uncomfortable process, and then wait while plaster models are created behind the scenes – with little chance to see or understand the details themselves.

That approach is changing. At more and more Riverdale practices, intraoral scanners are transforming the patient experience. By producing fast, highly accurate digital images of a patient’s teeth and gums, they remove the discomfort of old techniques while opening up new ways to involve patients directly in their own care plans. 

This isn’t just about new technology. It speaks to a broader need in UK dentistry: creating greater transparency, improving access, and helping patients feel confident in their choices. At Riverdale, this is central to our vision, embodied in schemes like our Dental Essentials programme – giving more people access to high-quality care and helping them take back control of their dental health.

A clearer picture from the start

The scanners used across many Riverdale practices create precise 3D images in minutes. No messy impressions, no trays. Just a simple digital scan that provides a detailed record of the mouth.

The real difference is that patients can see it too. Instead of results being hidden away in a lab, scans can be shown on screen straight away. This creates a completely new type of conversation between dentist and patient. Both are looking at the same image, discussing it together, and understanding the details in real time. 

That is why many Riverdale clinicians now scan new patients at their very first appointment. It sets the tone for a relationship based on openness and clarity from the start.

From simulation to smile

Scanners are more than diagnostic tools – they can also help patients visualise the future. 

The software includes features like treatment simulators and “smile designs ” which can show how teeth might look after Invisalign, whitening, or composite bonding. For example, during an Invisalign consultation, a scan can show how teeth could potentially move throughout treatment – making it far easier for patients to see the potential outcome before they commit.

This makes a huge difference. Instead of imagining an outcome from a description, patients can see a projection of their own smile. That builds confidence, reduces uncertainty, and helps people make informed decisions about treatment – including about affordability. 

Faster routes to treatment

Digital scans can be sent instantly to dental labs. That means aligners, whitening trays, or even implant guides can often be ready within days rather than weeks. Less waiting, more certainty.

This speed is particularly visible during Riverdale practice open days. Patients can be scanned on the spot, explore treatment options, and discuss pricing with the dental team – often leaving with a clear plan in hand. What might once have required multiple appointments can now happen in a single visit

Education, not just information

Dentistry can sometimes feel full of unfamiliar terms. A scan changes that. When dentists show patients what is happening on screen, the conversation becomes clearer, easier to follow, and easier to remember.

This is especially useful for spotting early warning signs – such as gum recession, enamel wear, or bite issues. Patients can see the issue for themselves and understand why it matters, making them better equipped to take action before problems become serious.

Turning patients into partners

Perhaps the most exciting aspect of intraoral scanners is how they change the patient’s role. Dentistry has often felt like something being done to patients, but with a scan it becomes something they are part of. Many patients, when shown their scan, point out things they would like to change or ask about possible improvements. Treatment planning becomes a genuine partnership, giving people greater confidence in their decisions and commitment to their care.

This reflects exactly what Riverdale aims to achieve: dentistry that is clearer, faster, and more engaging – where patients feel informed, supported, and in control of their health. Intraoral scanners are not just advanced tools, but an important step towards a future of care that is transparent, accessible, and centred on the patient.

Find your local Riverdale practice.

What Are Your Options If You Can’t Afford Dental Treatment?

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Having Dental Implant Treatment in the middle of Coronavirus Outbreak

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During these unprecedented times we would like to give you some useful tips to help you resolve and reassure any possible dental implant related concerns you may have.

Recently placed implant(s)

If you have had implant(s) placed in the last week or two you will be due to have the stitches removed soon. You will have been informed if these are dissolvable or not. If they are dissolvable then there is no urgency to attend the practice, stay safe at home. A member of our team will give you a call to check on how you are doing. If the stitches are not dissolvable please contact the practice and we will arrange an appropriate time to have them removed.

3-month healing phase

After having had the implant(s) placed you will have a 3-month gap before the next stage of treatment, implant expose. Due to the current situation, several of our patients will be waiting longer than 3 months before this is carried out. Please do not worry, no harm will be done to the implant or you if this stage is not carried out after 3-months. This stage can be carried out any time after 3 months.

Implant expose

This stage is routinely carried out 3 months after placing the implant. Some patients will have had this part of the treatment already carried out. You will have had a small circular disc called a healing cap or healing abutment placed into the implant that protrudes through the gum. It is very important that this cap/abutment is kept very clean. You must brush the cap directly with your toothbrush (electric or manual) twice a day just like your teeth to keep it clean. No harm will be done to it. If it is kept clean and the gums around it healthy you will minimise any risk of problems.

A common issue with these healing caps is that over time they can become loose. Do not be concerned if this happens. Carry on brushing it and it will unwind fully and drop out. Keep the cap in a safe place. The gum will heal over the top and close the hole. Under current guidelines this is not a dental emergency and so you do not need to attend for any treatment. However, please do give us a call so we can make a note of it and plan to get you booked in as soon as we are able to resume normal services. It would also be very helpful if you can send a picture of the cap so that we can reassure you no further intervention is required.

Implant impressions

A small number of patients will have had impressions (moulds) of their teeth carried out to make the implant teeth or to start the stages to make the teeth. With the Government’s advice regarding social distancing and our governing bodies advice of not using any aerosol generating procedures, most laboratories will have closed or significantly limited the work they will be carrying out. Rest assured that when the time comes to fit your new teeth, if there are any adjustments, discrepancies or need for remaking you will not be charged for these. Many cases will be routine and we will be able to fit your new teeth with minimal disruption, once we are able to resume our normal service.

Completed Treatment

If your implant treatment has been completed, you will have been placed on our implant recall list. If you are due your implant check-up, this will be postponed until we are able to resume normal service.

Complications which may occur which are not deemed an emergency:

  1. Loss of a healing abutment. If the healing abutment (Small metal stopper protruding through the gum) can occasionally come loose during the healing phase. This is not a problem and can remain out during the healing phase and beyond.
  2. Loss of a dental implant. If the dental implant becomes loose and falls out the area will heal as normal. Please contact the surgery to advise of the situation and we can make appropriate arrangements to assess you for further treatment after it is safe to do so.
  3. Loss or loose implant crown. If the implant crown has fallen off, simply keep the crown safe and the area in your mouth that the crown once fit clean. Contact the surgery to advise of the situation. If the implant crown is loose and causing pain contact the surgery for further advice.
  4. Broken/chipped implant crown. This is not an emergency and no treatment is necessary.

 

Complications which may be deemed emergency care:

  1. Pain, swelling, with facial swelling associated with a dental implant or teeth
  2. Trauma due to a fall, RTA which has fracture, loosen or avulsed your implant/teeth.
managing an ulcer

Managing Wisdom Teeth Pain During Coronavirus Outbreak

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Adults can have up to 32 teeth. The wisdom teeth are the last to appear, right at the back of the mouth. They usually appear when you are between 17 and 25, although sometimes they appear many years later.

People often have jaws that are too small for all 32 teeth to fit (28 is often the most we have room for) so, if all the other teeth are present and healthy there may not be enough space for the wisdom teeth to come through properly.

Often there will be some slight discomfort as they do come through, but this will disappear once the tooth is fully in position.

If there is not enough room, the wisdom tooth may try to come through, but will get stuck against the tooth in front of it. The wisdom tooth will be at an angle, and will be described by the dentist as ‘impacted’.

What problems should I be prepared for?

If part of the wisdom tooth has appeared through the gum and part of it is still covered, the gum may become sore and perhaps swollen. This is called ‘pericoronitis’. Bacteria and bits of food can collect under the gum edge, making it difficult to clean the area properly.

This is a temporary problem that can be dealt with by using mouthwashes, special cleaning methods and possibly antibiotics. If the problem keeps coming back, it may be better to have the tooth removed once we resume normal surgery in the coming months.

What can I do to help relieve the discomfort of wisdom teeth?

A mouthwash of medium-hot water with a teaspoonful of salt will help to reduce gum soreness and inflammation (check that it is not too hot before using it). Swish the salt water around the tooth, trying to get into the areas your toothbrush cannot reach. Do this several times a day.

An antibacterial mouthwash containing chlorhexidine (CORSODYL) can also reduce the inflammation, but do not use if you have an allergy. Pain-relieving tablets such as paracetamol or ibuprofen (NOTE IBUPROFEN MAY NOT BE ADVISED IN PATIENTS WHO HAVE SYMPTOMS OF CORONAVIRUS) can also be useful in the short term, but talk to your dental team if the pain continues. The tablets should always be swallowed and not placed on the area.

What if this does not help?

If the pain does not go away and there is a swelling under your chin/jaw/neck that you can see from outside or you find it difficult to open your mouth, you should contact your dentist.

If you feel there is any tightness of your airway/throat or difficulty swallowing then you MUST go STRAIGHT TO A+E in hospital.

Bleeding Gums during Coronavirus Outbreak

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Gums can bleed for a number of different reasons. Gums might bleed on brushing due to mild inflammation but often stops soon afterwards.

If the bleeding hasn’t stopped within a few minutes press a clean cloth or piece of packing to the area and call the practice for advice.

Common causes of bleeding gums:

  • Trauma or ulcers – this can be due to mild trauma, like a burn from something like pizza, or a cut from a crisp or a graze from your toothbrush. If this is the case keep the area clean by rinsing with a mouthwash like Chlorhexidine or Corsodyl if you aren’t allergic to this. Or even just saltwater-a teaspoon of salt dissolved in half a tumbler full of warm water. If it is painful then Bonjela, Difflam mouthwash or even teething gel from your chemist may help along with whatever pain relief you would use if you had a headache. Also see separate ulcers advice.
  • Gingivitis – This basically means swollen gums which can be down to a number of reasons, but is normally because you need to tweak your brushing. Make sure you are flossing or using interdental brushes every day. Brush twice a day with either a manual toothbrush angling up towards the gum at 45 degrees and using a circular movement, spending a few seconds on each tooth before moving systematically around your mouth so you don’t miss anywhere. If you are using an electric or sonic toothbrush it’s the same advice just no need to do the circular movements as the toothbrush does that for you. Please don’t worry if there is blood or pink toothpaste when you first start doing this. The gums are likely to be swollen so bleed more readily, the good news is that if you persevere, within a few days you will notice less and less bleeding as a reward!
  • Gum Disease or Periodontal Disease – It is highly likely you are already aware that you suffer from gum disease if you come to the dentist regularly. What you may be experiencing is a localised flare up caused by some undisturbed plaque or food that’s become stuck. Normally localised use of an interdental brush to make sure the area is spotless along with some Chlorhexidine gel or mouthwash (as long as you are not allergic) on the interdental brush a couple of times a day will help settle the area within a few days. If it is painful take pain relief that you would normally take for a headache.

 

If you have any concerns please don’t hesitate to phone the practice.

Dental Pain

Dental Pulpal Pain during Coronavirus

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Correct as of 24th March 2020 9am

Toothache is extremely unpleasant, which is why your dentist always does everything they can to accommodate patients in pain. In these extraordinary times our ability to attend the Practice or have the personnel available to attend may be curtailed.

This guidance is an attempt to tell you what type of dental pain you may have, how severe it is and how you can manage the situation.

We are facing unprecedented times both in everyday life and in healthcare provision. The situation has and will continue to, move and change rapidly as new scientific information becomes available.

We ask you to understand that we are under guidance from the Department of Health and our Professional bodies and regulators which is limiting the treatment we can provide in an attempt to stop the spread of Coronavirus.

We are only able to offer an emergency service and it is important to understand what constitutes a dental emergency.

Teeth have nerve tissue (pulp) in the middle of them. If this nerve tissue becomes inflamed it can lead to mild, moderate or severe pain or infection. Inflammation of the nerve can occur if there is decay in the tooth or the tooth is cracked or has a large filling.

The treatment depends on the status of the pulp.

Normal Pulp

Teeth can still be sensitive to hot, cold or sweet things when the pulp is normal. You may experience discomfort for a few seconds from a stimulus that disappears when the stimulus goes. This is normal and does not need assessment or treatment, the stimulus can be avoided. You can use a sensitive toothpaste to brush the area and after brushing and rinsing, apply some sensitive toothpaste to the area leaving it in place.

Reversible Pulpitis

This occurs when the pulp is slightly inflamed but no permanent damage has been done. You may experience discomfort to hot or cold that disappears when the stimulus is removed. This doesn’t constitute a dental emergency. You can manage the symptoms by not having food and drink with extreme temperature like ice cream or hot drinks.

Again, sensitive toothpaste may help. Pain relief can be useful in these circumstances, the best pain relief for dental pain are over the counter analgesics. The best evidence is that Paracetamol and Ibuprofen combined offers the most effective pain relief. 500mg Paracetamol and 400mg Ibuprofen taken together 4 times a day with at least 4 hours between doses.

It is very important that you read the advice sheet for both of these drugs as some people shouldn’t take one of both of these drugs. If in doubt we advise to speak to your pharmacist or GP.

There is some emerging evidence that COVID 19 (Coronavirus) can be worsened by Ibuprofen. Whilst the evidence is currently weak, until we know more, we advise that Ibuprofen is not used if you have symptoms of Coronavirus.

Irreversible Pulpitis

This occurs when the nerve is irreversibly inflamed and can result in severe toothache which comes on with no stimulus, lasts for hours not minutes, disturbs sleep and is not controlled with painkillers. The tooth is typically not tender to bite on. The pain may be diffused, difficult to localise or spread to other regions. This constitutes an urgent case and needs assessment. You will need to ring your practice to undergo a phone assessment by members of the dental team. If it is decided you need treatment, you will be given advice on how you will access further assessment possibly at the practice or a regional centre. The guidance is changing by the hour and this information will be regularly updated. You will then be clinically assessed by a dentist who will decide with treatment is most appropriate. The treatment would be extraction of the tooth or removing the inflamed nerve and doing root canal treatment.

Infected Tooth

This occurs when the nerve of the tooth has died off and bacteria have infected the tooth. The symptoms are very different from pulpitis. Typically, the pain is well localised to a particular tooth, this tooth would not be sensitive to hot and cold but would be painful to pressure or biting. This constitutes an urgent case and needs assessment. As above, you would undergo phone and clinical assessment and the most appropriate treatment will be implemented. The treatment would be extraction of the tooth or removing the dead nerve and doing root canal treatment.

If an infected tooth is not treated, or becomes infected quickly, it can lead to localised swelling, severe pain and whole-body symptoms like fever, chills and malaise. This constitutes a dental emergency and needs urgent assessment.

If under these circumstances, the swelling interferes with your swallowing or breathing, or causes an eye to close this would need urgent hospital assessment. The best thing would be to go directly to Accident and Emergency without going to the dentist first.

Mr Michael Turner BDS MSc (Endodontology)