Usually, no. Hospital emergency rooms in the San Fernando Valley treat infections that are spreading, facial injuries and uncontrolled bleeding, and they can prescribe antibiotics and pain relief, but they rarely have a dentist on hand to extract a tooth. For the tooth itself, call an emergency dentist: in Reseda, (323) 433-6458 gets you a same-day appointment.
It's a fair question at 11 PM with a molar throbbing and every dental office closed. The ER is lit, open and staffed. It just isn't set up for teeth, and knowing that ahead of time saves a long wait and a bill for a visit that ends with "see a dentist."
What the emergency room can do for a tooth problem
Quite a bit, for the right problem. An ER physician can examine facial swelling, order imaging of the jaw if a fracture is suspected, start IV antibiotics for an infection that's spreading, control bleeding, and treat pain. If a tooth infection has reached the point where breathing or swallowing is affected, the ER is exactly where you should be, and fast.
What the ER doesn't generally do is treat the tooth. Extractions, root canals, fillings and drainage through the tooth need dental instruments, a dental X-ray and a dentist, and most hospitals don't keep those in the emergency department. You'll usually leave with a prescription and instructions to see a dentist.
Why antibiotics from the ER don't finish the job
Antibiotics quiet the infection around a tooth. They can't reach the dead tissue inside it, so once the course ends the infection tends to return, sometimes worse. Think of the prescription as a bridge to the dental visit, not a substitute for it. If the ER gave you one, take it as directed and get the tooth treated within a day or two. The abscess treatment page explains what that visit involves.
When to go to the ER first, before any dentist
- Swelling that makes it hard to breathe or swallow, or that's closing your eye
- A high fever along with a swollen face
- Bleeding from the mouth that steady pressure hasn't slowed after 20 minutes
- A blow to the face with a possible broken jaw, or any loss of consciousness
- A deep cut to the lip, tongue or face that may need stitches
For most of our patients the nearest hospitals are Northridge Hospital Medical Center on Roscoe Boulevard and Providence Cedars-Sinai Tarzana Medical Center off Ventura Boulevard. Go, get the dangerous part handled, then call us for the tooth.
When a dentist is the right first stop
Everything else. A toothache, even a severe one, without the warning signs above. A broken or chipped tooth. A lost filling or crown. A knocked-out tooth, where the clock matters and a dentist can replant it. A gum abscess with a bump on the gum but no facial swelling. Wisdom tooth pain. A denture that broke. In each case the ER would send you to a dentist anyway; going straight to one skips the middle step.
Our office in Reseda sees these the same day, Monday through Friday, with evening appointments until 7:00 PM on Tuesday and Thursday. At night and on weekends the phone is still answered by a real person, and the first opening is held for you. The weekend and after-hours page covers what to do until then.
What about urgent care?
Urgent care centers sit between the two. Like the ER, they can prescribe antibiotics and pain relief and check for an infection that's spreading, and they're often quicker and cheaper for that. Like the ER, they don't extract teeth. If it's the middle of the night and you need a prescription to get through until morning, urgent care may be the practical stop; the tooth still needs a dentist.
Getting through the night until the dental visit
- Ibuprofen or acetaminophen, exactly as the label directs; ask a pharmacist before combining them.
- A cold compress on the cheek for swelling, 15 minutes on and 15 off. No heat.
- Warm salt-water rinses to keep the area clean.
- Sleep with your head propped up; lying flat makes a throbbing tooth worse.
- Call the dentist now, not in the morning, so the first chair is yours.
When to call a dentist today
Call (323) 433-6458 as soon as the problem starts. During office hours you get a same-day time at our office on Saticoy Street in Reseda; after hours a real person takes your details and holds the first opening. The visit starts with the $99 exam and X-rays for patients paying without insurance, then a written price before any treatment. The $99 covers the emergency exam and diagnostic X-rays for patients paying without insurance. Treatment is priced separately and quoted to you in writing before any work starts.
Frequently asked questions
Will the ER at least give me something for the pain?
Usually, along with antibiotics if there's an infection. That helps for a night. It doesn't treat the tooth, and the pain returns when the medication wears off, so the dental visit still has to happen within a day or two.
Can urgent care pull a tooth?
No. Urgent care can prescribe and can check whether an infection is spreading, but extractions need a dentist. Some urgent care centers will tell you that at the front desk before you're seen; it's worth asking.
I went to the ER and they told me to see a dentist. How fast?
Within a day or two, sooner if you're still in pain. Call (323) 433-6458 and mention you were seen at the hospital; bring any paperwork and the prescription so our dentist knows what you've already been given.
Further reading: the American Dental Association on dental emergencies and the Mayo Clinic on tooth abscess symptoms and causes.
This article is for general education and is not a substitute for an exam by a licensed dentist.