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1. Is there swelling?

If yes: go to 2. Is the swelling rapidly increasing, likely to obstruct the airway, closing the eye or is the patient generally unwell?

If no: go to 3. Is the patient in pain, has the patient suffered trauma to the teeth or is there bleeding following an extraction?

2. Is the swelling rapidly increasing (worsened in the last hour) or likely to obstruct the airway (e.g. difficulty breathing or swallowing) or closing the eye, or is the patient generally unwell?

If yes: provide Emergency Care.

• • Provide immediate contact with a clinician, ideally within 60 minutes, and subsequent treatment within a timescale appropriate to the severity of the condition.
  • If the dental problem is resulting in severe or life-threatening symptoms (e.g. severe dehydration, signs of airway compromise or sepsis) or is secondary to a more significant problem (e.g. a significant facial injury), advise the patient to contact NHS 24/NHS 111 (Telephone 111) or call 999.

If no: provide self care advice on pain relief if required and Urgent Dental Care

• • Provide dental care at the next available clinic, within 24 hours or as soon as practicable, unless the condition worsens.
  • Treatment should not be delayed if the patient can be seen sooner than 24 hours.

3. Is the patient in pain or has the patient suffered trauma to the teeth or is there bleeding following an extraction?

If yes: provide self care advice on pain relief or dental trauma or post-extraction bleeding as appropriate to the condition and go to 4. What is the severity of the condition?

If no: provide Non-urgent Dental Care.

• • Provide access to an appropriate service within 7 days if required.
  • Advise the patient to call back if their condition worsens.

4. What is the severity of the condition? 

If the patient has a permanent tooth that has been knocked out or has uncontrolled bleeding following an extraction: provide Emergency Care.

• • Provide immediate contact with a clinician, ideally within 60 minutes, and subsequent treatment within a timescale appropriate to the severity of the condition.
  • If the dental problem is resulting in severe or life-threatening symptoms (e.g. severe dehydration, signs of airway compromise or sepsis) or is secondary to a more significant problem (e.g. a significant facial injury), advise the patient to contact NHS 24/NHS 111 (Telephone 111) or call 999.

If the patient has severe pain, teeth have moved, or pulp or dentine has been exposed by trauma: provide Urgent Dental Care.

• • Provide dental care at the next available clinic, within 24 hours or as soon as practicable, unless the condition worsens.
  • Treatment should not be delayed if the patient can be seen sooner than 24 hours.

If the patient has mild or moderate pain or has sustained minor dental trauma: provide Non-urgent Dental Care.

• • Provide access to an appropriate service within 7 days if required.
  • Advise the patient to call back if their condition worsens.