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If you’ve knocked out a tooth, pick it up by the crown, place it back in the socket or store it in milk, and see an emergency dentist within 30 to 60 minutes. For a severe toothache, call an emergency dentist the same day, but go to a Toronto ER if you have facial swelling, fever, or trouble breathing. Quick answer: A knocked-out tooth is a race against the clock: keep it moist and get to an emergency dentist fast. A toothache with swelling, fever, or breathing trouble isn’t a dental problem anymore; that’s an ER visit. Key Takeaways A knocked-out permanent tooth has the best odds of being saved if it’s back in the socket within 30 minutes , and the tooth must never dry out. Store a tooth you can’t reinsert in cold milk or saliva , never tap water. Never put a knocked-out baby tooth back in: call your dentist instead. Most toothaches need an emergency dentist , not the ER. But facial swelling, fever, or trouble breathing or swallowing means go to the hospital now . An ER can manage pain and dangerous infection, but it can’t fix the tooth: you’ll still need a dentist. When your day turns into a dental emergency It usually happens at the worst possible moment. A puck to the mouth at a rec-league game in Scarborough. A faceplant off a bike on the Don Valley trail. A molar that's been grumbling for a week suddenly screaming at 2 a.m. on a Saturday. One second you're fine; the next you're bleeding, panicking, and wondering whether this is a "call the dentist Monday" problem or a "get in the car now" problem. Take a breath. Most dental emergencies are manageable if you act quickly and know the right moves. This guide walks you through the two most common ones (a knocked-out tooth and a severe toothache) plus the warning signs that mean skip the dentist and go straight to a hospital. If you’re in pain right now and need to be seen today, our emergency dental services page explains how to reach us fast. A quick note: the steps below are general first-aid guidance, not a substitute for hands-on care. When in doubt, call an emergency dentist or 911. Knocked-out tooth: what to do in the first 30 minutes A fully knocked-out permanent tooth (dentists call it an avulsed tooth ) is one of the few dental problems where the clock genuinely decides the outcome. The living cells on the root start to die within about 15 to 60 minutes out of the socket. Move fast and follow these steps in order: Find the tooth and pick it up by the crown , the white chewing part. Never touch the root. Those root-surface cells are what let the tooth reattach, and handling them damages your chances. Rinse it gently, for no more than 10 seconds , only if it's dirty. Use milk or saline if you have it, cold water if you don't. Don't scrub it, don't use soap or mouthwash, and don't dry it off with a cloth or tissue. Put it back in the socket if you can. Line it up the right way, press it in gently with your fingers, and bite down softly on a clean piece of gauze to hold it there. This gives the tooth its best possible chance. If you can’t reinsert it, keep it moist. Drop it in a small container of cold milk , or tuck it inside your cheek (only if you’re sure you won’t swallow it). A tooth-preservation kit with Hanks solution is ideal if one’s on hand. Never store a tooth in tap water : plain water destroys the root cells within about an hour. Get to an emergency dentist within 30 to 60 minutes. Call ahead so they're ready for you. If you can't reach a dentist, go to the nearest hospital emergency room. One important exception: if it's a baby tooth, don't put it back in. Forcing a primary tooth into the socket can damage the permanent tooth developing underneath. Control the bleeding with gauze and call your dentist for guidance. Once you’re in the chair, the dentist will typically clean the socket, reposition the tooth, and splint it to the neighbouring teeth for a week or two. A root canal often follows a week or so later to keep the tooth from becoming infected. That’s a normal part of the protocol, not a sign something went wrong. Severe toothache: how to cope until you're seen Not every toothache is a middle-of-the-night crisis, but a severe one is your body waving a red flag. Pain that throbs, keeps you up, or doesn't ease with over-the-counter medication usually points to decay, a crack, or an infection that won't fix itself. Book a same-day emergency dentist. While you wait, a few things can take the edge off: Rinse with warm salt water (a teaspoon of salt in a cup of warm water) to clean the area and calm irritation. Hold a cold compress against the outside of your cheek for pain and swelling. Don’t apply heat to any facial swelling: warmth can help an infection spread. Take an over-the-counter pain reliever like ibuprofen or acetaminophen, following the label. Never place a painkiller tablet directly against the gum: it can burn the tissue. Floss gently around the sore tooth in case food is trapped, but stop if it hurts. These are stopgaps, not cures. A toothache that's bad enough to search "emergency dentist Toronto" at midnight needs a professional to find and treat the source. The red flags: when to go to a Toronto ER instead Here’s the line that matters most. A toothache is a dental problem until it becomes a medical one. Swelling means an infection has moved beyond the tooth, and a dental infection that spreads can become life-threatening. Go to the nearest emergency room, or call 911, right away if tooth pain comes with any of these: Trouble breathing or swallowing : this can mean the swelling is affecting your airway. Rapidly spreading facial swelling , especially toward your eye or down into your neck. A high fever alongside the swelling or pain. Uncontrolled bleeding that won't slow with 10 to 15 minutes of gentle pressure. Facial trauma or a possible broken jaw. Feeling severely unwell, confused, or drowsy. Toronto’s hospital ERs are open around the clock and can manage dangerous swelling, give IV antibiotics, and control pain. What they generally can’t do is the dental work itself: the root canal, the extraction, the reimplant. So for the tooth, you’ll still need a dentist afterward. That’s exactly why, for problems without those danger signs, calling an emergency dentist directly is faster, cheaper, and more likely to actually solve the problem. Other emergencies worth a same-day call A knocked-out tooth and a raging toothache aren't the only reasons to pick up the phone. A cracked or broken tooth with pain, a loose or pushed-out tooth , a lost filling or crown that leaves a sharp or aching tooth, or a dental abscess (a pimple-like bump on the gum, often with a bad taste) all warrant prompt attention. Rinse with warm water, use a cold compress for swelling, save any pieces you can, and call your dentist the same day. What about cost and coverage? Emergency fees vary by what’s needed, so ask for an estimate when you call: a good office will give you one. If you’re covered by the Canadian Dental Care Plan , which is now open to eligible Canadian residents of all ages without private insurance, confirm the practice participates before your visit, since not every office bills the plan. Don’t let cost worries stop you from being seen: a small problem caught tonight is almost always cheaper than the emergency it becomes next week.