Springfield Dental Emergency: Dentist or ER?

When a tooth breaks or your face starts to swell, the hardest part is often deciding where to go. In Springfield you have three realistic choices: a dentist, an urgent care clinic or a hospital emergency room. Each is right for some problems and wrong for others, and the answer also depends on what time it is. This guide works through the decision for Springfield residents, with the local options named, so you can make the call quickly.

First: is this a 911 or ER situation?

Some dental problems are medical emergencies. Call 911 or go straight to an emergency room if you have any of the following:

• Facial swelling that is spreading toward your eye, down your neck or under your jaw
• Trouble breathing or swallowing
• A high fever with tooth pain or swelling
• Bleeding from the mouth that will not stop with firm pressure
• A suspected broken jaw or facial bones, or a head injury, after a fall, crash or sports collision

These are not problems to wait out until the dental office opens. A spreading infection in the face or neck can affect the airway, and a facial fracture needs imaging and a medical team first. The dental repair comes afterwards.

The emergency rooms closest to Springfield

Springfield's own option is the Inova Emergency Room at the Franconia–Springfield HealthPlex, a freestanding ER at 6355 Walker Lane near the Franconia–Springfield Metro station. Inova lists it as open 24 hours a day, every day. For major trauma, Inova Fairfax Hospital on Gallows Road in Falls Church is Northern Virginia's Level I trauma center. If you are not sure which to choose and the situation is serious, call 911 and let the dispatcher decide.

Be prepared for what an ER can and cannot do. Emergency physicians can control bleeding, manage pain, treat a spreading infection with antibiotics, drain some abscesses and handle fractures. They generally cannot fill, crown, splint or root-canal a tooth, so you will still need a dentist within a day or two.

What urgent care can do for a dental problem

Urgent care clinics are useful for many minor illnesses, but they are rarely the right stop for a tooth. They usually have no dentist and no dental x-ray. At best they can assess you, prescribe pain relief or antibiotics and tell you to see a dentist. If your problem is not severe enough for the ER, it is almost always better to call a dentist directly than to add an urgent care visit in between.

When a dentist is the right first call

Most dental emergencies belong with a dentist, who can diagnose the cause and fix it rather than just treat the symptoms. That includes:

• Severe or throbbing toothache, including pain that wakes you up
• A cracked, chipped or broken tooth
• A knocked-out or loosened adult tooth
• A lost filling or crown, or a crown that has come loose
• A gum swelling or "pimple" near a tooth, without the red-flag signs above
• Pain or swelling around a wisdom tooth

Shield Dental Care offers same-day emergency appointments where possible and accepts walk-ins when the schedule allows. Our page on the emergency dentist for Springfield patients explains what happens when you arrive.

A Springfield decision guide by time of day

Our office in Burke is open Monday to Thursday 8 AM to 5 PM and Friday and Saturday 8 AM to 2 PM, and closed on Sunday. Here is how that maps onto the choices.

Weekday or Saturday morning

Call the dental office as soon as it opens and describe what happened. From West Springfield the office is about 5 minutes away outside rush hour; from Springfield Town Center about 11 minutes; from Newington and North Springfield about 15 to 16 minutes.

Weekday evening, Friday or Saturday afternoon

If none of the red-flag signs apply, manage the problem at home overnight and call first thing the next morning the office is open. If the red-flag signs are present, go to the ER now rather than waiting.

Saturday afternoon and Sunday

This is the longest gap, from Saturday at 2 PM until Monday at 8 AM. A broken tooth without pain, a lost crown or a mild ache can usually wait until Monday with sensible care at home. Swelling that is getting worse over the weekend should not wait: go to the ER, and then call the dentist on Monday for definitive treatment.

What to do while you wait

• Knocked-out tooth: pick it up by the crown, not the root. If you can, put it gently back in the socket; if not, keep it in milk or between your cheek and gum, and get to a dentist right away. The American Dental Association gives the same advice on its dental emergencies page. Time matters more here than in almost any other dental problem.
• Broken tooth: rinse with warm water, save any pieces and use a cold compress on the cheek for swelling.
• Lost crown: keep it safe and bring it with you. Dental cement from a pharmacy can hold it temporarily, but do not use household glue.
• Toothache: rinse, floss gently around the tooth in case food is trapped, and use an over-the-counter pain reliever as directed on the label. Do not put aspirin directly on the gum.
• Bleeding after an extraction: bite firmly on folded gauze for 30 minutes. If it will not stop, call the dentist who did the extraction or go to the ER.

What to bring to an emergency dental visit

Bring a list of your medications, your dental insurance card, any tooth or crown pieces in a small container, and the paperwork from any ER or urgent care visit you have already had. If you were given antibiotics, keep taking them as prescribed. They calm an infection but do not remove its source, which is why a dentist still needs to see the tooth. Depending on what is found, that may mean root canal treatment for Springfield patients or a tooth extraction near Springfield.

Children and teenagers

The same red-flag rules apply to children. A knocked-out baby tooth is different from an adult one: it should not be put back in, but the child should still be seen to check the area. Teenagers who play contact sports are at higher risk of broken and knocked-out teeth, and a properly fitted mouthguard is the simplest prevention. Our guide to mouthguards for Springfield student athletes covers the options.

For everything else we treat, see our hub for dental care for Springfield, VA patients. If you have a dental problem now and none of the red-flag signs apply, call (703) 250-5072 or request an appointment online.