Toothache at night: what to do until the practice opens

A warm-water rinse, gentle flossing and an over-the-counter painkiller can take the edge off toothache until the practice opens.

Then call Durban Dental Care on 031 563 2473 when we open. We see people in pain as soon as we can during practice hours, and easing the pain comes first.

Go to a hospital emergency department tonight if swelling spreads towards your eye or neck, or if you have a fever or trouble breathing or swallowing.

What not to do

• Don't put aspirin, or any other tablet, on the gum or tooth. Painkillers are swallowed.
• Don't take more painkillers than the label allows, even when the pain is bad. If the usual dose doesn't help, ask a pharmacist.
• Don't rely on antibiotics. They can stop an infection spreading, but they don't treat its cause, and in South Africa they are only available on prescription.
• Don't ignore the tooth because the pain eases. A tooth abscess doesn't go away on its own.

When to go to a hospital tonight

A few signs mean an infection may be spreading beyond the tooth. If you have any of these, go to a hospital emergency department now; don't wait for the practice to open:

• swelling spreading towards your eye or down your neck;
• a fever with a swollen face;
• trouble breathing or swallowing;
• feeling confused, or a racing heart, with a swollen face.

Why teeth ache

The common causes of toothache are:

• decay that has reached the nerve (the pulp) inside the tooth, which can become infected;
• a cracked or broken tooth;
• an abscess: an infection at the root of the tooth or in the gum;
• a wisdom tooth coming through, with the gum over it swollen or infected.

You can't tell which of these it is from the pain alone. An examination, often with an X-ray, shows the cause, and the cause decides the treatment. If you think it's a wisdom tooth, mention it when you call: a wisdom tooth that has fully come through can be taken out at the practice.

If the tooth was treated or damaged recently:

• after a filling, soreness usually settles within one to two weeks, so call us if it gets worse instead of better;
• after an extraction, pain that starts or gets worse two or three days later can be dry socket, which we treat at the practice (read after an extraction);
• after a break or a lost filling, read chipped or broken tooth or a filling that fell out.

When we can see you

Durban Dental Care is open Monday to Friday 9am to 4pm and Saturday 9am to 12pm, and closed on Sundays and public holidays. Call 031 563 2473 or 031 564 6771 as soon as we open, and tell us you're in pain.

When you call, tell us which tooth hurts, how long it has hurt, and whether your face or gum is swollen. If you're pregnant or take any medicines, say so too. We're at North Coast Road Medical Centre, 490 Chris Hani Road, Park Hill, Durban North.

What happens at your appointment

We examine the tooth, with an X-ray if it needs one, and talk you through what is wrong and your options before anything starts. Depending on the cause, the tooth may be repaired with a tooth-coloured filling or, if it can't be saved, taken out (see tooth extraction).

For a filling, the area is numbed with local anaesthetic, the decay is removed and the tooth is rebuilt in composite, which is set hard with a curing light at the same appointment. If the tooth has to come out, it is numbed in the same way, loosened and lifted out, and you go home with gauze and advice on looking after the socket.

We take medical aid, card and cash. For how we see urgent problems at the practice, read toothache and broken teeth.

Toothache in pregnancy

Tell us you're pregnant when you call. Needed dental treatment, including local anaesthetic and X-rays, can be done during pregnancy, so toothache doesn't have to wait until after the baby is born.

Your questions about toothache at night