What to do when a tooth breaks on a Friday night in Spokane

The worst possible time

Dental emergencies don't keep business hours. Most of the broken teeth, knocked-out crowns, and sudden bursts of pain we see arrive on a Friday afternoon, a holiday weekend, or — somehow always — the night before a big trip.

If you're reading this in the middle of one, here's what to do.

The first 30 minutes

The first half hour matters more than people realize.

If a tooth is fully knocked out (avulsed): Find the tooth. Pick it up by the crown — the white part — not the root. Rinse it gently with milk or saline if it's dirty. Do not scrub it. If you can place it back in the socket, do so. If not, store it in milk (best), saline, or saliva (held in your cheek without swallowing). Get to a dentist within 30–60 minutes if possible. Time is the single biggest factor in whether the tooth survives.

If a tooth has cracked or chipped but is still in place: Save any pieces you can find. Rinse your mouth with warm water. Apply a cold compress to the outside of the cheek to manage swelling. Take ibuprofen — assuming you tolerate it — for pain.

If a crown or filling has come out: Save the crown if you can. The exposed tooth underneath may be sensitive. You can buy temporary dental cement at most pharmacies (Dentemp is a common brand) to hold it in place until you can be seen.

If you have severe pain without obvious cause: Take ibuprofen 600mg if you tolerate NSAIDs and aren't on blood thinners. Avoid heat on the cheek; heat can worsen an infection. Cold compress on the outside is safer. Pain that wakes you from sleep, throbs, or is accompanied by facial swelling needs to be seen the same day.

"We'd rather have a 90-second phone call to triage your situation than have you spend a weekend in pain."

When to call urgent care vs. wait until morning

Call an urgent care, ER, or a dentist's emergency line immediately if the face is swollen — especially if the swelling is below the jaw or in the neck — if you can't open your mouth, breathe normally, or swallow, if there's uncontrolled bleeding for more than 15–20 minutes, if the pain is severe enough that ibuprofen and Tylenol together aren't touching it, or if a tooth has been knocked completely out (the 30–60 minute window matters).

You can usually wait until morning if you have a chipped tooth without major pain or sharp edges that are cutting your tongue, if a filling fell out but pain is manageable, if a crown came off but the underlying tooth isn't in active pain, or if you have intermittent sensitivity that's manageable with over-the-counter pain meds.

Spokane-specific options

The greater Spokane area has multiple options for after-hours dental emergencies. Some practices, including ours, have emergency lines that route to an on-call provider. Spokane also has urgent care centers and emergency rooms that can manage acute pain and infection until you can see a dentist for definitive treatment.

For our patients, the same number — (509) 467-0755 — reaches our office during business hours, and our after-hours protocol is detailed in the voicemail. We make every effort to see urgent cases the same day or, at the latest, the next business morning.

What we'd want you to know

The two biggest mistakes we see in dental emergencies are waiting too long when something is genuinely serious, and panicking when something can wait. The list above is meant to help you tell the difference.

If you're not sure, call. We'd rather have a 90-second phone call to triage your situation than have you spend a weekend in pain that could have been managed.