Emergency Dentistry

Anything that hurts, bleeds or breaks and cannot wait: severe toothache, a chipped, cracked or broken tooth, a tooth knocked out completely, a lost filling or crown, or swelling, abscess and infection. If you are unsure, call (804) 290-8001; describing the problem takes a minute and tells us how fast you need to be seen.

Call us first so we can guide you and hold a time. A knocked-out tooth has the best chance if it stays moist, in milk or your own saliva, and reaches us within the hour. Swelling with fever, or any difficulty breathing or swallowing, is a medical emergency: go to the ER or call 911 immediately.

Call us first so we can guide you. For a knocked-out tooth, keep it moist (in milk or saliva) and bring it with you. For swelling with fever, or difficulty breathing or swallowing, seek emergency medical care immediately.

The right first move depends on what happened. A knocked-out adult tooth is the one true race against the clock. A cracked tooth, a lost crown or a bad toothache all need prompt care, but an extra hour will not change the outcome the way it does with an avulsed tooth.

A tooth knocked completely out. Pick it up by the crown, never the root. If it is dirty, rinse it gently in milk or saline for a few seconds, do not scrub it and do not use soap. If you can, push it straight back into the socket and bite gently on a clean cloth to hold it. If you cannot, put it in a cup of milk, or in saliva, and bring it. Water is the worst storage medium because it damages the root cells. Get to us within the hour if at all possible. Baby teeth are the exception: do not reimplant a knocked-out baby tooth, as it can damage the adult tooth developing above it.

A cracked or broken tooth. Rinse with warm water, use a cold compress on the outside of the cheek for the swelling, and keep any pieces. Avoid chewing on that side. A crack that reaches the nerve hurts sharply on release of biting pressure rather than on pressure itself, which is a useful thing to tell us on the phone.

A lost filling or crown. Keep the crown if you still have it; it can often be recemented. Temporary dental cement from a pharmacy is acceptable for a day or two, but superglue is not, because it is not biocompatible and it will usually mean the tooth has to be cut back further.

Severe toothache. Over-the-counter anti-inflammatories usually work better than painkillers alone for dental pain. Do not place an aspirin against the gum, which burns the tissue. A cold compress helps; heat makes an infection worse.

Bleeding after an extraction. Bite firmly on folded gauze for twenty minutes without checking it every two minutes, because disturbing the clot restarts the bleeding. If it continues heavily beyond an hour, call us. Full guidance is on the post-extraction care page.

Go to the ER or call 911 for difficulty breathing or swallowing, swelling that is closing an eye or spreading down the neck, a fever with facial swelling, uncontrollable bleeding, or a suspected broken jaw. Those are medical emergencies. For everything confined to a tooth, a dentist is both faster and more useful.

The distinction matters because a hospital emergency department is generally not set up to treat the tooth itself. In most cases they can give antibiotics and pain relief, which buys time but leaves the cause in place, and you will still need a dentist afterwards. For a dental abscess that is spreading, that hospital visit can be lifesaving, so the judgment call is about spread rather than severity of pain.

The warning signs of spread are worth memorizing: swelling that crosses the jawline into the neck, swelling that closes the eye, fever and feeling generally unwell, a floor of the mouth that feels raised, or any change in your voice or breathing. Any of those means hospital, now, not an appointment tomorrow.

We hold time in the daily schedule for urgent cases, so same-day care is usually possible when you call early. Our hours are Monday to Thursday 8:00 to 5:00 and Friday 8:00 to 1:00. Call as soon as you know there is a problem rather than waiting to see whether it settles.

Calling early genuinely helps. A call at eight in the morning can often be fitted in the same day; the same call at four thirty on a Friday leaves far fewer options. If you are phoning from Petersburg, Fort Lee or the south side of Richmond, say so, because knowing your drive time changes which slot we hold.

Tell whoever answers three things: what happened, when it started, and whether there is any facial swelling. That is enough to decide whether you need to come straight in, whether it is safe to wait until the afternoon, or whether you should go to the hospital instead.

We find the cause, stop the pain, and tell you the options and the cost before we treat. Often that means a single X-ray and a short procedure the same day. Where a full repair needs more time, we make the tooth comfortable and safe first, then schedule the definitive work.

1. History and examination. What hurts, what triggers it, how long it has been going on.
2. Imaging. Usually one targeted X-ray; 3D imaging where a root fracture or infection needs mapping.
3. Relief first. Numbing, draining an abscess, removing decay, or smoothing a sharp edge, depending on the cause.
4. A clear plan. What has been done today, what still needs doing, what it costs, and when.

Two realistic outcomes are worth naming in advance. An infected nerve means root canal treatment or extraction, and those are different in cost, visits and outcome; we will lay out both honestly rather than steering you. And a tooth that has already split below the bone sometimes cannot be saved, in which case we will say so on day one instead of charging you for a repair that will fail.

Most emergencies are not accidents. They are small problems that were ignored: a tiny cavity that reached the nerve, a hairline crack that spread, or gum infection that flared. Regular checkups catch those while they are still cheap and painless, which is the whole argument for preventive care.

The exceptions are genuine trauma. If you or your children play contact sports, a custom mouthguard is the single most effective protection available, and it costs a fraction of replacing a front tooth. If you grind at night, a night guard prevents the slow cracking that eventually becomes a Sunday-evening emergency.

And do not ignore a tooth that has started reacting to cold or sweet things, even if it settles quickly. That is the early stage; treated now it is a filling, left alone it becomes the pain that wakes you at three in the morning. Our cavity prevention page covers what regular care actually involves.

We keep time in the schedule for urgent visits, so pain is not left waiting until next week. Treatment is genuinely pain-free, with effective numbing before anything is done, and the fee is stated before we start, because a stressful moment is the worst time to be surprised by a bill.

You will also be treated by a general practice that can finish the job. A broken tooth can often be crowned the same day with our CEREC system rather than sent away for two weeks in a temporary, and an infection can be treated, root-filled or extracted here rather than referred on. Fewer handovers means fewer trips while you are already in pain.

Dr. Sean Sayyar has practiced in the Richmond area since 1998. The office is at 5231 Hickory Park Drive, Suite E, Glen Allen, just off I-95, with free parking directly outside.