Toothache After Hours
How to keep dental pain under control until you can see a dentist, the red flags that mean you need help urgently, and the right number to ring.
How Should I Handle Toothache in Greenwich Overnight or at a Weekend?
Take over-the-counter painkillers exactly as the packet directs, sleep propped up, rinse gently with warm salty water and avoid anything very hot, cold or sweet. Dial 999 or go to A&E if a swelling is affecting your breathing, swallowing or eye, if bleeding won't stop, or after a serious injury to the face. For other dental pain out of hours, Peninsula Dentists plan members have out-of-hours access, and anyone else can call NHS 111. From Monday to Saturday, ring us on 020 8788 6688 before 9.30am and we'll see you that day; the emergency appointment is £70.
When It Can't Wait: 999 or A&E
- A swelling is making it hard to breathe or swallow, or your mouth won't open more than a little
- The swelling is reaching up towards your eye or down into your neck, or is visibly growing hour by hour
- Bleeding hasn't stopped despite pressing firmly on it for 20 minutes
- You've had a significant injury to the face or jaw
- You have a high temperature and feel very ill as well as swollen
These situations are uncommon, but they're the ones where the problem has moved beyond dentistry and needs hospital care, and you shouldn't sit on them overnight. In every other case, the advice below will normally keep you comfortable, and the great majority of toothache can safely wait for a dental appointment.
Keeping the Pain Down Until Morning
- Use over-the-counter painkillers, sticking to the stated dose. Most people use paracetamol or ibuprofen; check the leaflet, and if you're on other medicines or unsure what suits you, a pharmacist can advise
- Sleep with your head higher than usual. An extra pillow cuts down the throbbing
- Swill gently with warm salty water, a teaspoon of salt stirred into a glass of warm water, several times a day
- Steer clear of extremes of temperature and of sugary things, and eat on the other side
- For swelling, hold an ice pack or a bag of frozen peas, wrapped in a tea towel, against your cheek
- Keep the area clean with gentle brushing and interdental cleaning, since food caught around a sore tooth makes it worse
- If a lost filling or crown has left a sharp edge, press a little sugar-free gum over it
- Never hold a tablet against the gum; it burns the tissue and won't help the pain
Still in Pain When We Open?
Ring us before 9.30am, Monday to Saturday, and we'll see you the same day.
Why It Hurts More at Night
When you lie down, more blood flows to your head, so an inflamed nerve in a confined space throbs harder, and without the distractions of the day the pain seems to grow. Propping yourself up helps for that reason. Pain that wakes you, or that starts without any hot, cold or sweet trigger, usually points to inflammation or infection in the pulp, the nerve at the core of the tooth, often because of deep decay, a crack or a big old filling. Painkillers may take the edge off, yet the problem won't resolve unaided, and antibiotics won't solve it either. The tooth needs treatment, usually a dressing or the opening stage of root canal treatment, both of which relieve the pain quickly. Our guide to root canal treatment describes what's involved.
Who to Contact Out of Hours
We're open Monday to Saturday from 8.30am to 5.30pm and closed on Sunday, so there's no walk-in service in the evening or on a Sunday. Outside our hours:
- Members of our dental plans can use the out-of-hours access their plan includes, along with worldwide emergency cover; see our dental plans for the details
- Anyone else can call NHS 111 for advice and, where necessary, to be directed to urgent dental care
- A pharmacist can help with painkillers and minor mouth problems, and plenty of pharmacies around Greenwich and the Peninsula open at weekends
Many toothaches can wait. If the ache is dull, responds to painkillers and comes with no swelling or other symptoms, it's usually fine to hold on until we reopen. Jot down when it began and what triggers it, as that helps us pinpoint the cause.
Getting an Appointment with Us
Phone 020 8788 6688 from 8.30am, Monday to Saturday. If you call before 9.30am we'll see you the same day, whether or not you're registered with us. The emergency appointment is £70, covering X-rays and any medication you need, and it's free for dental plan members.2 You can also book online, but when you're in pain a phone call is quickest.
You'll find us at 26-28 Chandlers Avenue, Greenwich Peninsula, beside Greenwich Millennium Village. North Greenwich station on the Jubilee line is about ten minutes' walk away, and buses 108, 129, 132, 161 and 486 stop at Millennium Village Oval Square. The practice has a ground-floor, step-free entrance. If you're in pain or swollen, please phone rather than message us, because WhatsApp is only answered during opening hours.
What to Avoid
- Placing aspirin or any other tablet on the gum or tooth. It causes a burn and does nothing for the toothache
- Going over the dose on the packet, however bad the pain. Call NHS 111 for advice instead
- Trying to pull out a loose or broken tooth yourself, or squeezing a swelling
- Sticking a crown back on with household glue. Put it somewhere safe and bring it with you
- Using alcohol as an anaesthetic, especially on top of painkillers
- Assuming all is well because a tooth that hurt for days has suddenly gone quiet. Often the nerve has died while the infection remains
At Your Emergency Appointment
Our priority is to stop the pain before you leave. We examine the tooth, take an X-ray if needed and explain what we find. In most cases we then treat it at the same appointment: a dressing, a temporary filling, draining an infection, or starting root canal treatment (the emergency stage is from £199 per canal), which removes the inflamed nerve and calms the tooth. Anything beyond the emergency appointment itself is explained and priced before we do it, and you'll go home with a plan for the permanent repair to consider in your own time. For knocked-out or broken teeth, lost crowns and swelling, our dental emergencies guide goes into more detail.
Questions
This guide explains the options in general terms. Only an examination can tell you which of them suits your own teeth.