Your Tooth Hurts and You Have No Money. What Now

By Ross Seymour of Free Dentist Office, a directory of dentists who take Medi-Cal, built from the state's public provider data. It is not run by any state agency.

A hospital emergency room will treat the pain and the infection. It will not fix the tooth. That is the single most useful thing to know at two in the morning, because it decides whether you are still in pain next week.

Swelling in your face or neck. Go to an emergency room now. That is not a dental problem any more
Pain with no swelling. A dental office, urgent care or a community clinic
No coverage. Community health centers charge by what you earn
Cost. An emergency room visit for a tooth is the most expensive way to get the least done

First, the Part That Is Actually an Emergency

Some of this is not a dental problem. If the swelling has moved into your face, under your jaw or down your neck, if you have a fever with it, if swallowing or breathing is getting harder, stop reading and get to an emergency room. An infection that has left the tooth can become serious quickly.

That is rare. Most toothache is not that. But it is the one case where waiting for an appointment is the wrong call.

What an Emergency Room Will and Will Not Do

An emergency room can give you antibiotics for the infection and something for the pain. Most do not have a dentist and cannot drill, fill or pull the tooth.

So you leave feeling better with the same broken tooth you arrived with, and in a few days the pain comes back. People end up going three or four times for the same tooth. Use the emergency room for the emergency, then get to a dentist for the tooth.

If You Have Medi-Cal

You are covered for the dental work itself, including having the tooth out if that is what it comes to. The job is finding an office that takes the coverage and can see you soon.

Call and use the word emergency. Offices keep slots for pain. Say what is happening, how long it has been going on and whether there is swelling. Ask if they have anything today and if not, ask who they would send you to.

If You Have No Coverage at All

Start with community health centers. They see people without insurance and charge on a sliding scale based on what you earn, which for some people means very little. Ask what a visit costs before you go.

Dental schools are the other option worth knowing. Treatment costs less because students do the work with an instructor watching. Appointments take longer and there is often a wait to get in, so this is better for a problem that is not urgent.

It is also worth finding out whether you qualify for Medi-Cal. Plenty of people who qualify have never applied.

What to Do Tonight

Rinse with warm salty water. Take the painkiller you would normally take for a headache and follow the packet. Keep your head raised when you lie down, because flat makes the throbbing worse.

Do not put an aspirin against the gum. It burns the tissue and does not help the tooth. Do not wait for it to settle on its own either. Toothache that stops often means the nerve has died, and the infection is still there.

Before You Spend a Dime

Will a dentist pull the tooth the same day?

Sometimes. If there is a lot of infection they may treat that first and take the tooth out once it has calmed down. Ask them to explain the plan so you know what is happening and when.

Can I be turned away for owing money?

A private office can refuse to book you over an unpaid balance. A community health center is a better call in that situation.

I have no ID. Can I still be seen?

Call and ask before you travel. Requirements differ by clinic, and community health centers are usually the most flexible.

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