12 signs you need to see a dentist right away

If you have pain, bleeding, swelling or other unusual symptoms in your mouth, it’s best to seek urgent dental care before the underlying problem becomes worse, says American Dental Association (ADA) spokesperson Ana Paula Ferraz-Dougherty. Ideally, though, “prevention is key,” she says. “Instead of waiting until you’re in pain, brushing, flossing, eating a balanced diet, and getting regular check-ups at the dentist are things that are going to help prevent dental issues.” Even so, dental problems that require an urgent visit to the dentist do happen. Here’s what to look for.

Don’t ignore the early signs of gum disease: get in to see the dentist as soon as possible. “The most common cause of bleeding gums is gum disease,” Dr Ferraz-Dougherty says. “If you have any signs of swollen gums or bleeding when you brush or eat, it’s important to see the dentist to get that gum disease treated before it progresses.” The early stages of gum disease, called gingivitis, can often be treated in the dental surgery with cleaning, whereas more advanced stages may require surgery, she says.

In addition, other diseases in the body may reveal themselves through gum problems, so it’s important to get them checked out right away. “Underlying systemic disease can manifest initially as bleeding gums; this includes diabetes, leukaemia and [other] cancers,” says John L. Pfail, chairman of the Department of Dentistry for The Mount Sinai Health System in New York. Because of high glucose in saliva, people with diabetes are also at higher risk of gum disease.

If your gums are receding and exposing more of your teeth, “that’s a sign of a more advanced stage of gum disease,” Dr Ferraz-Dougherty says. “If uncontrolled, gum disease puts you at higher risk for other health issues as well. There are links between gum diseases and cardiovascular disease and diabetes so it’s important to see your dentist so that the gum disease can be treated before it progresses or affects your health in another way.”

Losing teeth is only normal for children – not adults. If you feel like your teeth are shifting, moving around in your mouth, or any actually fall out, see a dentist pronto. Besides a blow to the mouth, what can cause teeth to come loose? “If left untreated, gingivitis can progress to disease which involves the bone surrounding the teeth, which in turn leads to loose teeth, pain, and the eventual loss of teeth,” Dr Pfail says. “Teeth are secured into the mouth by bone and a thin muscle attachment called a periodontal ligament to the bone. Any damage to these structures surrounding your teeth can cause mobility of the teeth.”

In addition, the National Institutes of Health (NIH) reports that osteoporosis, bone loss that is common in older people, may also cause teeth to become loose through a weakening of the jaw bone. Women with osteoporosis are three times more likely to have tooth loss than those who don’t have it, says the NIH.

A cracked tooth requires an emergency visit to a dentist because if left untreated, not only can it cause pain and sensitivity, but it also creates a pathway for bacteria to enter the tooth, possibly leading to infection. The sooner you see a dentist the better if you feel like you cracked your tooth, Dr Ferraz-Dougherty says. “If it’s just a small crack we can fix it with a filling; if it’s a bigger crack it may need a root canal. Sometimes we cannot even save the tooth – if it’s cracked too far down the tooth may need to be extracted.” A potential cause of cracked teeth, she says, is teeth grinding, so if you grind your teeth, “it’s important to get evaluated, as you may need a nightguard to help protect your teeth when you sleep, which is when the majority of people grind them.”

Yes, gross: if you notice any pus in your mouth, call your dentist right away. “Pus collection in a spot in the mouth can be a dental or gum abscess and should be addressed immediately,” says Uchenna Akosa, director of Rutgers Health University Dental Associates. “It is a sign of infection and can spread if not treated and cause more serious medical problems.” In the most extreme cases, she says, “bacteria from an abscessed tooth can spread to the brain and can be fatal.” Untreated dental infections can also lead to sepsis. Antibiotics, draining the infection, and a root canal are possible treatment options to help prevent these complications.

Don’t suffer with this annoying dental symptom: get help to reduce the pain of tooth sensitivity and get to the root of the problem as soon as possible. “Causes can include tooth decay, which can involve exposure of the nerve tissue inside the tooth,” Dr Pfail says. “Teeth that are fractured can also cause extreme tooth sensitivity. Gum recession, which exposes the dentin covering the root surface can cause sensitivity due to changes in the microscopic tubules, or tiny channels, which can transmit pain to the nerve. Extreme tooth grinding, or bruxism, can also lead to internal inflammation of the nerve tissue in the tooth.”

In addition to treating the underlying problem, “we could put you on a sensitive toothpaste, we could do a filling to cover that area, or we could do a gum procedure to recover that area,” Dr. Ferraz-Dougherty says.

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Along with too much sensation, a lack of sensation in your tooth is also a sign you should have your mouth checked out now. “If your tooth feels numb that could be an indication that your tooth might need a root canal,” Dr Ferraz-Dougherty says. “If a tooth is cracked or has a big cavity and the nerve dies that can give you a numb feeling.”

In addition, “injury or trauma to a tooth, biting into something hard, teeth grinding, or a dying tooth from chronic tooth decay can all cause a tooth to be numb,” Dr Akosa says. “They all cause the tooth to lose access to nutrients and blood flow, resulting in numbness.”

It’s not just the teeth that can have oral emergencies: jaw issues should be seen to ASAP. “When it comes to any issues with the jaw or any changes in the way it usually functions, you should be on high alert,” Dr Pfail says. “If your jaw becomes locked, open or closed, see your dentist immediately because they can reset it.”

Swelling around your jaw area could be a sign of an infected tooth, or a type of growth such as a cyst or even a tumour, “so that’s another major reason to get it checked out,” Dr Ferraz-Dougherty says. “Difficulty opening or closing, or clicking or popping could be a sign of TMJ disorder, or temporomandibular disorder, caused by many different things, including an uneven bite.” Addressing TMJ issues earlier rather than later can result in easier treatment such as a night guard or braces; more advanced cases may require surgery, she says.

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Everyone has a mouth sore once in a while, but if one sticks around, get in to see the dentist right away, as it could be a sign of oral cancer. “If the sore does not disappear within seven to 14 days, see a dentist immediately for an oral exam and cancer screening,” Dr Akosa says. “A biopsy may be performed to determine the cause of the sore.” In addition, any strange bumps or even colour changes in your mouth that last more than a week should also be evaluated immediately, Dr Ferraz-Dougherty says.

It’s not just embarrassing: bad breath could be caused by a serious health issue, so don’t wait to see your dentist to determine the source. According to Dr Akosa, a persistent bad odour could be a sign of underlying disease, anything from an infection to metabolic disorders (including diabetes), acid reflux, and even cancer. “It’s important that you go see a dentist so that we can rule out all of these things and figure out what’s causing it,” Dr Ferraz-Dougherty says.