We're here when you need us most.
Dental emergencies are stressful and often painful. At Gateway Smiles, we make urgent appointments available the same day during office hours so you don't have to suffer through severe pain or worsening damage.
What counts as a dental emergency?
Severe toothache
Throbbing pain that doesn't respond to over-the-counter pain relievers, or pain severe enough to wake you at night.
Knocked-out tooth
An adult tooth that has been completely knocked out. Time is critical — call us immediately.
Broken or fractured tooth
A visible crack, chip, or fracture, especially with pain, sensitivity, or sharp edges that cut your tongue or cheek.
Lost filling or crown
Especially when causing pain, sensitivity, or exposing a vulnerable tooth surface.
Facial or gum swelling
Swelling can indicate a dental infection, which can become serious if untreated.
Persistent bleeding
Bleeding from a tooth or gum injury that doesn't stop with gentle pressure within 10–15 minutes.
Trauma to the mouth
Any injury to the face, jaw, or mouth — even if no teeth appear damaged, internal injuries are possible.
Loose adult tooth
An adult tooth that has become loose, whether from injury or other causes, requires prompt evaluation.
What to do right now
For severe pain
While you wait for your appointment, take ibuprofen and acetaminophen together — they work better in combination than either alone. Apply an ice pack to the outside of your cheek if there is swelling. Rinse gently with warm salt water. Do not place aspirin directly on the gum or tooth (it can burn the tissue). Avoid very hot or cold foods and drinks.
For a knocked-out tooth
If it is a permanent (adult) tooth, time is critical. Pick the tooth up by the crown (the white part), never by the root. Rinse it gently with milk or saliva — do not scrub or remove any tissue still attached. If possible, place it back in the socket and bite down on a clean cloth or gauze to hold it in place. If you cannot reinsert it, store it in a small container of milk (the proteins help preserve the cells). Get to our office within 30 minutes if at all possible — the chance of saving the tooth drops significantly with each passing minute.
For a knocked-out baby tooth, do NOT try to reinsert it. Reinserting baby teeth can damage the developing permanent tooth underneath. Call us for guidance.
For a broken or chipped tooth
Save any pieces of the tooth if possible — rinse them and store in milk. Rinse your mouth with warm water. If there is bleeding, apply gentle pressure with a clean cloth. If a piece of the tooth has a sharp edge that is cutting your tongue or cheek, you can cover it temporarily with dental wax or even a piece of sugar-free gum. Call us as soon as possible.
For a lost filling or crown
If you find the crown, rinse it and bring it with you — we may be able to recement it. In the meantime, you can use over-the-counter dental cement (available at pharmacies) or a small piece of sugar-free gum to temporarily cover the exposed tooth and protect it from sensitivity. Avoid chewing on that side until you can be seen.
For facial swelling
Facial swelling typically indicates a dental infection that needs prompt treatment. Apply ice to the outside of your face for 20 minutes at a time, and call us immediately. If swelling extends to your eye or down to your neck, if you have difficulty breathing or swallowing, or if you have a fever, this is a medical emergency — go to the emergency room (Mary Washington Hospital, 540-741-1100).
For trauma to the mouth
For any significant facial trauma — especially involving loss of consciousness, possible broken jaw, severe bleeding, or extensive injury — go to the emergency room first to rule out serious injury. We will follow up the next business day with definitive dental treatment.
What to expect at an emergency visit
When you arrive for an emergency appointment, our priority is to relieve your pain and stabilize your situation. We will examine the affected area, take any necessary X-rays, and provide immediate treatment to address the urgent problem — whether that means an emergency root canal, an extraction, a temporary filling, antibiotics for an infection, or repair of a broken tooth.
Definitive long-term treatment may sometimes require a follow-up appointment once the urgent situation is resolved. For example, an emergency root canal might be completed first, with the final crown placed at a follow-up visit. We will explain the plan and the timeline at your emergency visit.
After-hours and weekend emergencies
Our office is open Monday through Saturday, 9 AM to 5 PM. For dental emergencies during these hours, call (540) 299-5721 and we will see you the same day.
For dental emergencies on Sundays, after hours, or holidays, please go to the emergency room at Mary Washington Hospital (1001 Sam Perry Blvd, Fredericksburg) for any condition involving severe swelling, difficulty breathing or swallowing, uncontrolled bleeding, or significant trauma. They will stabilize you, and we will see you the next business day for definitive dental care.
For minor after-hours dental concerns that can wait until morning, call our main number; our voicemail provides guidance and we return calls promptly when the office reopens.
Frequently asked questions
Severe tooth pain, a knocked-out tooth, a broken or fractured tooth with pain, swelling of the face or gums, a lost crown or filling causing pain, persistent bleeding from a tooth or gum injury, and any oral injury from trauma all qualify as dental emergencies. When in doubt, call us — we can help you decide whether you need urgent care.
Time is critical. If the tooth is permanent (adult), pick it up by the crown (the white part), not the root. Rinse it gently with milk or saliva — do not scrub. If possible, place it back in the socket and bite down on a clean cloth. If you cannot reinsert it, store it in milk (not water) and get to our office or an emergency dentist within 30 minutes for the best chance of saving the tooth. Call us immediately.
Severe tooth pain usually indicates an infected nerve or abscess and should not be ignored. While waiting for your appointment, take ibuprofen and acetaminophen together (they work synergistically), apply ice to the outside of your face if there is swelling, and rinse with warm salt water. Call us for the earliest available appointment — typically same-day for true emergencies.
Save any pieces if possible (rinse them and store in milk). Rinse your mouth with warm water. If there is bleeding, apply gentle pressure with a clean cloth. Cover any sharp edges with dental wax or sugar-free gum if available. Call us immediately — we will see you the same day for treatment that may include a filling, crown, or in some cases extraction.
Treat children's dental emergencies the same as adults', but with extra urgency for any serious injury. Knocked-out baby teeth should NOT be reinserted (it can damage the developing permanent tooth) — but knocked-out permanent teeth in children should be handled the same as in adults. Call us right away for any pediatric dental emergency.
For dental emergencies during office hours, call us at (540) 299-5721 and we will see you the same day. For severe emergencies after hours, weekends, or holidays, please go to your local emergency room (Mary Washington Hospital, 540-741-1100) for any condition involving severe swelling, difficulty breathing or swallowing, uncontrolled bleeding, or significant trauma. The ER can stabilize you and we will provide definitive dental care the next business day.
Please come in anyway. We will treat the emergency to relieve your pain and stabilize the situation, and we will work out a payment plan that fits your budget. We accept CareCredit and other financing, and we offer in-house payment plans for established patients. Untreated dental emergencies can become serious medical emergencies — never let cost stop you from getting urgent care.