Emergency Dental Care: Who Should You Call—A Dentist or the Hospital?

When sudden tooth pain strikes or a dental injury occurs, the decision of whether to call a dentist or head straight to the emergency room can feel overwhelming. In the U.S.,  where access to both healthcare and dental care can vary by state and insurance coverage, it's important to know who to contact for immediate help.

Let’s break down the facts—based on guidance from the American Dental Association (ADA), Cleveland Clinic, AMA Journal of Ethics, and peer-reviewed journals—to help you make the right choice at the right time.

What Qualifies as a Dental Emergency?

The ADA defines a Dental Emergency as a condition that is potentially life-threatening or requires immediate attention to stop ongoing tissue bleeding, alleviate severe pain, or treat acute infection. These include:

• Severe toothache or swelling
• Knocked-out or broken teeth
• Oral bleeding that won't stop
• Painful infections or abscesses
• Facial trauma involving the jaw or mouth

When to Call Your Dentist First

Dentists are your primary emergency room providers for most oral problems. They are equipped to perform processes such as root canal, extraction, restoration, or abscess drainage - services that are not usually provided in emergency rooms.

Call your dentist immediately for:

• Intense tooth pain (with or without swelling)
• A cracked, chipped, or knocked-out tooth
• A lost filling or crown
• Gum abscesses or localized infection
• Bleeding following a dental procedure
• Broken dentures, damaged braces, or loose implants

When to Go to the Hospital Emergency Room

Hospital ERs are necessary when a dental issue becomes systemic, traumatic, or life-threatening. While they can stabilize you with antibiotics or painkillers, they usually do not treat the tooth causes that ignite fractures or cavities.

Head to the ER if you experience:

• Facial swelling affecting your eyes, neck, or airway
• Difficulty breathing or swallowing
• High fever with oral swelling (possible sepsis)
• Uncontrolled bleeding in the mouth
• Jaw dislocation or fractures due to trauma
• Deep lacerations or wounds to the lips, tongue, or face

Dentist vs. Hospital: A Quick Comparison

For most dental emergencies, your first call should be to a dentist. If you experience a toothache or an abscess, a dentist is a suitable provider who treats the underlying cause. In cases of knock-out teeth, immediate tooth intervention can increase the possibility of saving the tooth, ideally by one hour. Bleeding after tooth procedures should also be directed to your dentist; if it becomes uncontrollable, an emergency room may be necessary in that case.

On the other hand, conditions associated with a broken jaw or facial leg, breathing difficulties or swallowing difficulties, or high fever with facial inflammation require immediate care from the hospital emergency room. These are potentially signs of life-threatening conditions such as deep facial infections or airway obstructions. In addition, if dental trauma is continuous with other major injuries, especially in an accident or physical attack, the hospital is the right place to go.

In summary, dentists manage most oral emergency conditions, but hospitals are required when the problem is outside the mouth or involves a systemic health risk. By knowing the difference, you can get timely and proper care.

What to Expect in the ER

At the ER, doctors can:

• Administer IV antibiotics for infections
• Prescribe pain medication
• Control bleeding
• Order facial X-rays or CT scans

But they won’t fill a cavity, do Root Canals, or replace a tooth. You will likely be referred back to a dentist afterward.

Source: Very Well Health, Pew Charitable Trusts Report on ER Dental Visits

Research-Backed Insight

A 2020 study at BMC Oral Health found that less than 2% of the emergency visits were admitted to the follow-up hospital. This indicates that most of the problems were non-life-threatening and could be treated quickly and cheaply by a dental supplier.

Meanwhile, the Pew Research Center estimates over 830,000 annual ER visits in the U.S. for preventable dental conditions, costing the healthcare system millions.

Sources: BMC Oral Health (2020), Pew Trusts Dental Emergency Report (2012)

Expert Advice: Be Prepared

• Keep your dentist’s emergency number saved.
• Know local 24-hour dental clinics in your area.
• For knocked-out teeth, store in milk or saline—not water—and get to a dentist fast.
• Use OTC painkillers and saltwater rinses to manage symptoms temporarily.
• Never ignore swelling, bleeding, or fever. It can escalate quickly.

Final Takeaway

Your dentist should have your first conversation for almost all dental matters, as long as there is no threat to your general health or respiratory tract. Is treating symptoms, your dentist treats the cause.

By knowing the difference, you not only save time and money, but you also make sure your oral health is not in a medical crisis.