Dental emergencies usually need prompt dental care when there is severe pain, swelling, bleeding, a broken tooth, or a dental injury. Dental emergency treatment can be as simple as repairing a damaged filling, but some cases require a root canal or crown. The right treatment depends on what is happening inside and around the tooth.

A tooth can hurt for several reasons. A deep cavity, cracked tooth, infected pulp, or dental abscess can all cause pain, but they don't all need the same treatment. That's why trying to decide between a filling, root canal, or crown based on pain alone can be misleading. An examination gives the dentist a much better picture of what's going on.

What qualifies as a dental emergency treatment?

Quick dental care can help prevent the dental problem from becoming more serious and may help save the affected tooth. 

A few common examples are:

• A permanent tooth has been knocked out
• A tooth is badly cracked or broken
• Pain is severe or keeps coming back
• The face or gums are noticeably swollen
• There is a suspected dental abscess
• A tooth hurts sharply when you bite
• Bleeding continues after a dental injury
• A filling or other restoration breaks and leaves the tooth exposed

A knocked-out permanent tooth is a particularly urgent situation. Pick it up by the crown, not the root, and keep it moist while heading to a dentist. If it can be placed back into the socket without force, that may be possible. If not, milk can be used to keep it moist until dental care is reached.

Don't wait for a dental appointment if swelling is making it difficult to breathe or swallow. Severe swelling that moves toward the neck can also require emergency medical attention.

Pain isn't always a good measure of how serious a dental problem is. A tooth can have significant damage before symptoms become severe. On the other hand, a small area of irritation can sometimes hurt a lot. That's one reason an examination matters.

How do I know if I need a root canal?

A root canal may be needed when the pulp inside a tooth becomes inflamed or infected. Strong tooth pain, lingering sensitivity to hot or cold, pain when biting, swelling, or an abscess can point to a problem with the pulp.

Some signs are more telling than others. If cold sensitivity disappears almost immediately after the cold food or drink is gone, the cause may be different from pain that continues for quite a while afterward.

Possible signs of pulp damage include:

• Pain that is severe or doesn't settle down
• Pain when chewing or biting
• Hot or cold sensitivity that lingers
• Swelling around the tooth
• A pimple or drainage on the gums
• Deep decay
• A cracked or fractured tooth
• A tooth that becomes darker after an injury
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During a root canal, the dentist removes the damaged pulp from inside the tooth. The space is cleaned and disinfected, then filled and sealed. The tooth is still there. That's the point. Root canal treatment is used to treat the inside of the tooth while preserving the natural tooth whenever possible.

A toothache doesn't automatically mean a root canal is necessary. Cavities, worn enamel, exposed roots, loose fillings, and other problems can cause tooth pain too. The only way to know which problem is responsible is to have the tooth examined.

Are root canals painful?

Root canals are performed under local anesthesia, so most patients should not feel significant pain during the procedure. The tooth is numbed before treatment starts. Some soreness afterward is possible, particularly when biting down, but it usually settles as the area heals.

A lot of the fear around root canals comes from the toothache that brought the patient to the dentist in the first place. An inflamed or infected pulp can be extremely uncomfortable. Treating the source of that pain is one reason a root canal may be recommended.

During the procedure, the dentist accesses the inside of the tooth and removes the affected pulp. The canals are cleaned, disinfected, filled, and sealed.

Afterward, the tooth may feel different for a few days. Mild tenderness isn't unusual. Severe pain or increasing swelling is another matter and should be reported to the dentist.

There's also a practical reason not to put off a recommended root canal just because the pain has eased. Pain can change. That doesn't necessarily mean the problem has gone away.

When do I need a dental crown?

A dental crown may be needed when a tooth has lost enough structure that a filling can't provide the support or coverage it needs. This can happen after extensive decay, a major fracture, a large filling, or certain root canal treatments.

The amount of tooth left matters a lot.

A crown may be considered when:

• A large portion of the tooth has broken
• Decay has weakened much of the tooth
• A large filling has left little natural tooth structure
• A root canal has left the tooth needing added protection
• An older crown is damaged or no longer fits properly

Back teeth often need more protection because they take heavy chewing forces. A molar that's already weakened can be more vulnerable to another fracture. That's one reason crowns are commonly used for heavily damaged back teeth.

A crown isn't automatically required after every root canal, though. Some front teeth can be restored without a crown when enough healthy tooth structure remains. The dentist looks at the tooth itself before deciding.

And a crown isn't the same thing as a cap that simply hides a cosmetic problem. It has a restorative purpose. It covers the prepared tooth and helps protect the structure that's left.

What is the difference between a dental crown and a filling?

A filling repairs a smaller area of damaged tooth structure, while a crown covers much more of the visible tooth when the tooth needs greater protection. The dentist chooses between them based on the amount of healthy tooth remaining and the condition of the tooth.

A filling is commonly used after decay is removed. The dentist fills the resulting space with a restorative material and shapes the tooth so it can work normally again.

A crown involves more preparation because it fits over the tooth. It may be recommended when there isn't enough strong tooth structure left for a filling to do the job safely.