Toothache in Hong Kong: A&E Tonight, a Dentist Tomorrow or a DH Emergency Session? The 2026 Triage Guide

Need a dentist at night or on a public holiday? Hong Kong's 24-hour and same-day options and fees are in night-time and 24-hour dental options; this page covers urgent toothache triage: when to go now, when to use a DH session and when to go to A&E.

Toothache in Hong Kong: where to go? Swelling reaching the eye or neck, trouble breathing or swallowing, fever with swelling, unstoppable bleeding or jaw injury: A&E now. Severe pain, broken tooth, lost filling or abscess without those red flags: a dentist within 24 hours. Bearable pain needing only relief or extraction: a Department of Health emergency dental session. Verified 2026-09-26.

"Toothache is worse than a serious illness", as the Cantonese saying goes, and pain that starts at midnight or on a public holiday tends to send people to the wrong place. This Hong Kong triage guide sets out which situations belong in a public hospital A&E, which need a dentist within 24 hours, and which can wait for the Department of Health (DH) emergency dental service, with every scope, fee and registration step cited to a government or hospital source. Fees change, so confirm before you set off.

Three-tier toothache triage

Match your situation to the table first. Anything that could compromise your airway, eyesight or whole body is an emergency; severe pain on its own is a dental problem, and A&E will not fill or root-treat the tooth.

Tier	Typical situation	Where to go	Fee (eligible persons)
Go now (red flags)	Facial swelling spreading to the eye or neck; difficulty breathing, swallowing or speaking; swelling with fever; bleeding from the mouth that will not stop; injury to the face or jaw14–16	Public hospital A&E; call 999 if needed	A&E $400 per attendance; triage categories I (critical) and II (emergency) are free5,6
Dentist within 24 hours	Spontaneous severe pain or pain that wakes you (pulpitis); broken tooth with pain; lost filling; abscess without the red flags above; swollen gum over a wisdom tooth10–12	Private dentist; at night or on holidays, a private hospital with a published emergency dental service	Clinic check-up $100–300, X-rays $100–400, treatment extra26,27; private hospital out-of-hours emergency $6,000–8,00024,25
Can wait: DH emergency session	Pain you can tolerate, you only need pain relief or an extraction, and you can wait until the next working-day morning1	DH emergency dental service at 11 government dental clinics2,3	Free for eligible persons; non-eligible $850 plus $90 per drug item1,4

Go to A&E now (red flags)

Once a tooth infection spreads into the deeper tissues of the face it can threaten the airway within hours, and that cannot wait for morning. The NHS toothache, dental abscess and emergency dentist pages say to go to A&E or call an ambulance if any of the following applies^14–16:

• swelling around the eye or the neck, or an eye that is suddenly painful or swollen, or a change in your eyesight;
• swelling of the mouth, lips, throat or neck that makes it hard to breathe, swallow or speak;
• a lot of swelling in the mouth, or you cannot open your mouth;
• heavy bleeding from the mouth that will not stop;
• a serious injury to the face or jaw, or a head or face injury that has caused you to lose consciousness, vomit or see double.

A high temperature together with facial swelling is also a sign that an abscess is spreading¹⁵. This is what the previous version of this article called "dental abscess and cellulitis": a bacterial infection around the root tip that causes obvious facial swelling and fever^12,15.

What a public hospital A&E will and will not do

Many people head straight for A&E when the pain becomes unbearable, but A&E practises emergency medicine, not dentistry. The only dental service the Government provides to the public is the DH emergency dental service, which covers "pain relief and extraction"⁹. Hospital oral and maxillofacial surgery and dental units (from 6 February 2026 the DH hospital dental service has merged with the Hospital Authority's oral and maxillofacial surgery service) mainly serve inpatients, patients with special oral-care needs and dental emergency cases, normally on referral within the hospital⁸. In practice, an A&E doctor can assess whether an infection threatens your airway, prescribe painkillers or antibiotics, deal with bleeding and trauma, and refer a serious case to the hospital's oral and maxillofacial team; A&E will not do a filling, a root canal or any routine dental treatment, so you still need a dentist afterwards.

On fees, the public healthcare fee reform took effect on 1 January 2026: the A&E fee for eligible persons rose from $180 to $400 per attendance, and patients triaged as category I (critical) or II (emergency) are exempt^5,6. A&E triage has five categories: critical, emergency, urgent, semi-urgent and non-urgent³⁰; a plain toothache usually lands in the lower categories, which means a longer wait. Non-eligible persons pay $2,100 per A&E attendance⁷.

See a dentist within 24 hours

These are not life-threatening, but leaving the cause untreated makes the pain worse and can turn a tooth that root canal treatment could have saved into one that has to come out. The DH Oral Health Education Unit (toothclub) explains each kind of pain^10–12:

• Pulpitis (inflamed pulp): decay has reached the pulp; "the tooth has an obvious cavity and produces severe pain", and the treatment is root canal treatment or extraction¹¹. The pain often worsens at night when you lie down and can radiate to the head, ear or neck: the classic "woken up by toothache".
• Cracked or broken tooth: "a fracture can expose the dentine or the pulp, leaving the pulp nerve open to outside stimuli"¹⁰. Keep any broken fragment in milk or saliva and take it to the dentist¹⁹.
• Lost filling: with the dentine exposed, cold, hot, sweet or sour food stimulates the pulp nerve and causes sharp pain¹⁰, so the tooth needs to be refilled promptly.
• Abscess without red flags: after the pulp dies, bacteria spread through the root tip into the surrounding periodontal tissue, "causing inflammation and a build-up of pus"; the dentist will cut and drain the abscess, root-treat the tooth or extract a badly damaged one¹².
• Pericoronitis (wisdom tooth gum infection): food debris and bacteria trapped between the wisdom tooth crown and the gum flap inflame the tissue, which turns red and swollen; treatment is cleaning, antibiotics or extraction¹⁰. If the swelling makes it hard to swallow or open your mouth, it becomes a red flag¹⁵.

The NHS also advises seeing a dentist for toothache that lasts more than two days, does not ease with painkillers, or comes with a high temperature, pain on biting, red gums, a bad taste, or a swollen cheek or jaw¹⁴.

Finding a same-day, night or holiday dentist

• Private dental clinics: most Hong Kong clinics work daytime hours, and some run evening or holiday sessions. Phone first to ask whether they can fit you in today and what the consultation and X-ray fees are (published clinic price lists show check-ups at $100–300 and X-rays at $100–400^26,27). This site does not recommend clinics; before booking, see how to check a dentist's registration.
• Private hospital emergency dental services: Union Hospital's dental centre states that it provides a "24-hour emergency dental treatment service" with a dedicated hotline²³, and its fee schedule lists an emergency dental consultation outside office hours at $7,000–8,000²⁴; the HKSH Dental Centre fee schedule lists an emergency charge of $6,000 outside service hours and on public holidays, on top of consultation and treatment fees²⁵. These are figures from published fee schedules, not recommendations.
• Public: DH emergency dental sessions run only on working-day mornings and must be booked online the day before^1,2, so there is no public same-day dental option for severe pain at night or on a holiday; go to A&E only if you have a red flag.

For getting through the night, see the night-time toothache guide; for a tooth knocked out in an accident, see the knocked-out tooth guide.

Can wait: the DH emergency dental service

The DH emergency dental service is the dental care the Government provides to the general public. Its scope is "pain relief or extraction"; it does not include fillings, scaling, dentures or removal of bridges, and it does not extract teeth for orthodontic purposes^1,9. In other words, if you want to keep the tooth (root canal treatment or a filling), the service cannot help; it can only relieve the pain or take the tooth out.

Item	Arrangement published by the DH
Scope	"Pain relief or extraction"; no fillings, scaling, dentures or bridge removal1
Clinics	11 government dental clinics, each on set working-day mornings only: Kennedy Town, Kowloon City, Kwun Tong, Tsuen Wan, Yan Oi (Tuen Mun), Yuen Long, Fanling, Tai Po Wong Siu Ching, Mona Fong (Sai Kung), Cheung Chau and Tai O2,3
How to register	Online registration since 30 December 2024: between 6:00 and 11:30 each day, via the eHealth or iAM Smart mobile app or the DH webpage, you register for the next working day; one registration per person per day1,3
Allocation	Computer ballot; half the quota is reserved for a priority ballot for people aged 65 or above; results can be checked in the system from 12:30 the same day, and successful applicants receive an SMS from "#DH-DENT GP"1,3
Leftover places	Under the arrangement announced in December 2024, any places left after the ballot can be claimed first-come-first-served by phoning the leftover-quota hotline 2892 2577 between 2 pm and 5 pm the same day, and the hotline can also be called on the morning of the service day for any places still left3; general enquiries 2892 2111 during office hours1,2
Fees (from 1 January 2026)	Free for eligible persons (Hong Kong ID card holders and Hong Kong-resident children under 11); non-eligible persons pay an $850 consultation fee plus $90 per prescription item (up to four weeks), X-rays extra1,4

Registration is "register today, be seen the next working day"; there are no sessions at weekends or on public holidays^1,2. If you are eligible for the Community Dental Support Programme (for example Old Age Living Allowance recipients or Hospital Authority medical fee waiver holders), extractions and fillings are fully subsidised for Category A and $50 per tooth for Category B, and the programme also covers pain-relief medication and root canal treatment²⁹. Other public and subsidised routes are on the dental subsidies overview.

Symptom-to-cause table

The table maps common symptoms to the likely cause, urgency, what the dentist usually does, and the general private-clinic range from this site's benchmark pages (the same figures as the /fees hub).

Symptom	Likely cause	Urgency	What the dentist usually does	Private clinic range and benchmark page
Short sharp pain with cold or sweet things that stops when the trigger is removed	Decay into the dentine, exposed dentine10,11	Book an appointment; do not put it off	Filling or high-concentration fluoride; a crown if the cavity is large11	Filling $600–1,50026,27, see filling costs
Spontaneous severe pain, pain that wakes you, pain radiating to the head, ear or neck	Pulpitis (decay into the pulp)11	Within 24 hours	Root canal treatment or extraction11,13	Root canal $4,000–8,00026,27, see root canal cost
Pus-filled lump on the gum, bad taste, pain on biting	Abscess (dead pulp or gum disease)12	Within 24 hours; A&E immediately if the face swells or you have a fever	Drainage, root canal treatment or extraction12	As above; extraction $600–1,50026,27
Swollen, painful gum at the back, hard to open the mouth	Pericoronitis around a wisdom tooth10	Within 24 hours; A&E immediately if swallowing is difficult	Cleaning, antibiotics or extraction10	See wisdom tooth removal cost
Bleeding on brushing, red swollen gums, loose teeth	Periodontal disease10	Book an appointment	Scaling, root planing, periodontal surgery10	See deep cleaning cost
Sudden sharp pain biting on something hard, a corner has chipped off	Cracked or broken tooth10	Within 24 hours	Filling, crown, root canal treatment or extraction10	Depends on treatment, see the fee hub

Managing the pain while you wait for the dentist

NHS and American Dental Association (ADA) self-care steps, meant to get you to the dentist, not to replace treatment^14,15,20:

1. Painkillers: adults can take paracetamol or ibuprofen as directed on the pack. NHS adult guidance: paracetamol 500 mg, one or two tablets per dose, at least four hours between doses, no more than eight tablets in 24 hours; check with a pharmacist first if you have a liver or kidney condition or drink heavily¹⁷. Ibuprofen 200 mg, one or two tablets per dose, up to three times a day (no more than six tablets in 24 hours), ideally with or after food; check first if you have had a stomach ulcer, or have asthma, heart, liver or kidney problems, blood-clotting problems, or are pregnant or breastfeeding¹⁸. Children under 16 must not take aspirin¹⁴.
2. Warm salt-water rinse: helps clean the area (not for children)¹⁴; the ADA suggests rinsing with warm water and gently flossing out any food trapped between the teeth²⁰.
3. Cold compress: for a broken tooth or a swollen face, hold an ice pack wrapped in a towel against the outside of the cheek to limit swelling²⁰.
4. Keep your head raised: lying flat raises the relative blood pressure in the head and the pressure inside an inflamed pulp chamber, so an extra pillow at night is a common way to take the edge off.
5. Soft food, no triggers: avoid very hot, very cold or sweet food and drink, and do not smoke¹⁴.

What not to do

• Do not put a painkiller or aspirin tablet on the gum: the ADA says plainly not to put aspirin on the aching tooth or gum tissues²⁰, and the old article warned that it causes a chemical burn.
• Do not exceed the recommended dose of any painkiller¹⁵.
• Do not pull the tooth or lance the abscess yourself: an abscess needs to be drained by a dentist and the cause treated¹².
• Do not take antibiotics without a diagnosis: the Centre for Health Protection says to "use only antibiotics prescribed by a doctor" and never share them²¹. Antibiotics bought across the border or online without a dentist's diagnosis are still misuse; the Consumer Council also notes that the mainland has no independent statutory body regulating dentists, so understand the local oversight and follow-up arrangements before any cross-border treatment²².

If the pain suddenly stops, is it better?

Not necessarily. Decay that reaches the pulp causes severe pain, and the pulp may then die; a dead nerve does not hurt, but bacteria can still pass through the root tip into the surrounding tissue and bone and form an abscess^10,13. Pain that "goes away on its own" is often the disease moving on, not healing, so the tooth still needs examining. See why a toothache that stops has not necessarily healed.

Children's toothache

Hong Kong-resident children under 11 are eligible persons for the DH emergency dental service, so pain relief or extraction is free¹. Primary 1 to 6 pupils can join the DH School Dental Care Service, with an annual fee of $45 for eligible pupils and $970 for non-eligible pupils, covering scaling, fillings, extractions and oral health education^9,28; for acute pain, contact the child's assigned school dental clinic. The NHS reminds parents that children under 16 must not take aspirin and that salt-water rinses are not advised for children¹⁴; facial swelling, fever or difficulty swallowing in a child are red flags too¹⁵. For choosing a dentist, see how to choose a children's dentist.

Frequently asked questions

Can I go to A&E for a toothache?

Only with red flags: swelling reaching the eye or neck, trouble breathing or swallowing, bleeding that will not stop, or a jaw injury. A&E gives pain relief and antibiotics and manages spreading infection; it will not fill or root-treat the tooth. Eligible persons pay $400 per visit^5,6,15.

What should I do about a toothache in the middle of the night?

Take paracetamol or ibuprofen at the pack dose, rinse with warm salt water and keep your head raised^14,17,18; call a dentist first thing in the morning. Without red flags, A&E is not needed; if you cannot wait, a private hospital with a published 24-hour emergency dental service is an option²³.

How do I register for a DH emergency dental session?

Between 6:00 and 11:30 each day, register for the next working day via the eHealth or iAM Smart app or the DH webpage. Places are allocated by computer ballot, results are available from 12:30, and eligible persons are treated free^1,3.

Which painkiller works for toothache?

Adults can take paracetamol (one or two 500 mg tablets, four hours apart, up to eight a day) or ibuprofen (one or two 200 mg tablets, up to three times a day, with food); ask a pharmacist first if you have stomach, liver, kidney or asthma problems or are pregnant^17,18.

What should I do about a swollen gum?

A swollen gum is usually an abscess, gum disease or pericoronitis around a wisdom tooth, and needs a dentist to drain, clean or extract^10,12. If the swelling spreads to the face, eye or neck, or you have a fever or trouble swallowing, go to A&E immediately¹⁵.

How long should a toothache last before I see a dentist?

The NHS says to see a dentist if toothache lasts more than two days, does not ease with painkillers, or comes with fever or facial swelling¹⁴. Spontaneous severe pain or pain that wakes you points to pulpitis and warrants a visit within 24 hours¹¹.

Related guides

• Night-time toothache guide: getting through the night and what to arrange in the morning.
• Knocked-out tooth guide: how to store and replant a tooth within the golden hour.
• Why a toothache that stops has not healed: pulp death and abscesses.
• Root canal cost benchmark: what the usual treatment for pulpitis costs.
• How to check a dentist's registration: a one-minute check before an urgent booking.
• Dental subsidies overview: DH emergency sessions, the Community Dental Support Programme and vouchers.

Sources

1. Department of Health, Dental Services (emergency dental service scope, registration, fees) dh.gov.hk, page revised 2026-07-30, verified 2026-09-26.
2. Department of Health, list of emergency dental service clinics (pain relief and extraction only) dh.gov.hk, page revised 2025-05-01, verified 2026-09-26.
3. Government press release, DH reminds public of online registration system for emergency dental service, 2024-12-23 info.gov.hk, verified 2026-09-26.
4. Department of Health, Fees for Dental Services dh.gov.hk, page revised 2026-02-06, verified 2026-09-26.
5. Hospital Authority, Public Healthcare Fees and Charges Reform FAQ (A&E fee from $180 to $400, categories I and II exempt, effective 2026-01-01) ha.org.hk, verified 2026-09-26.
6. HA Connect, Public Charges for Eligible Persons (A&E $400 per attendance, categories I and II exempt) ha.org.hk, verified 2026-09-26.
7. HA Connect, Public Charges for Non-eligible Persons (A&E $2,100 per attendance) ha.org.hk, verified 2026-09-26.
8. Government press release, DH hospital dental services integrated into the Hospital Authority, 2025-12-15 info.gov.hk, verified 2026-09-26.
9. DH Oral Health Education Unit, FAQ (government dental service limited to emergency care; School Dental Care Service scope) toothclub.gov.hk, verified 2026-09-26.
10. DH Oral Health Education Unit, Tooth pain and gum pain toothclub.gov.hk, verified 2026-09-26.
11. DH Oral Health Education Unit, Symptoms and treatment of tooth decay toothclub.gov.hk, verified 2026-09-26.
12. DH Oral Health Education Unit, Dental abscess toothclub.gov.hk, verified 2026-09-26.
13. DH Oral Health Education Unit, Pulp treatment / root canal treatment toothclub.gov.hk, verified 2026-09-26.
14. NHS, Toothache nhs.uk, page reviewed 2024-07-01, verified 2026-09-26.
15. NHS, Dental abscess nhs.uk, page reviewed 2026-03-18, verified 2026-09-26.
16. NHS, How to find an NHS dentist in an emergency nhs.uk, page reviewed 2025-05-14, verified 2026-09-26.
17. NHS, Paracetamol for adults nhs.uk, page reviewed 2026-03-24, verified 2026-09-26.
18. NHS, Ibuprofen for adults nhs.uk, page reviewed 2025-08-27, verified 2026-09-26.
19. NHS, Chipped, broken or cracked tooth nhs.uk, page reviewed 2025-01-09, verified 2026-09-26.
20. American Dental Association MouthHealthy, Dental Emergencies mouthhealthy.org, verified 2026-09-26.
21. DH Centre for Health Protection, Beware of antibiotic resistance: use antibiotics properly chp.gov.hk, verified 2026-09-26.
22. Consumer Council, CHOICE issue 572 complaint digest on dental services (2024-06) consumer.org.hk, verified 2026-09-26.
23. Union Hospital Dental Centre (Tsim Sha Tsui) service page (24-hour emergency dental treatment service) union.org, verified 2026-09-26.
24. Union Hospital, Dental Charges (emergency dental consultation during non-office hours $7,000–8,000; effective 2026-05-01) union.org, verified 2026-09-26.
25. HKSH Dental Centre fee schedule (emergency charge outside service hours and on public holidays $6,000; effective 2026-08-01) hksh.com, verified 2026-09-26.
26. Private clinic market reference: Bowtie (insurer): 2026 Hong Kong dentist fee comparison (Chinese) (updated 24 Jul 2026; private clinic reference prices for fillings, extractions, scaling); this site also checked two private clinics' published price lists in Sep 2026 (not named or linked, to stay neutral). checked 5 Oct 2026.
27. Private clinic check-up and X-ray fees: taken from private clinics' published price lists checked by this site in Sep 2026 (not named or linked, to stay neutral); market reference only, no neutral published figure found yet. checked 5 Oct 2026.
28. Department of Health, School Dental Care Service fees dh.gov.hk, page revised 2026-09-01, verified 2026-09-26.
29. Community Dental Support Programme, Introduction communitydental.gov.hk, verified 2026-09-26.
30. Legislative Council Panel on Health Services, paper on Hospital Authority A&E services, 2019-06-17 (five triage categories) legco.gov.hk, verified 2026-09-26.

※ Actual fees depend on case difficulty.