Dr. Jay Holthus
134 Hospital Dr.
Lewisburg, PA 17837

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Emergency Info

In the event your child has a dental concern in which emergent care is required, we ask that you contact our office as soon as possible at 570-522-7070. Every attempt will be made to see your child in a timely manner depending on the severity of the condition. If we are unable to return your call immediately because our office is closed, please contact the nearest emergency department for further instruction (Evangelical Community Hospital Operator # 570-522-2000). Dr. Holthus has a variable "on-call" schedule and may be available to consult with afterhours via the Evangelical Community Hospital ER. If your child has just undergone dental surgery either at the office or in a hospital setting, and is exhibiting persistent vomiting beyond 4 hours, a temperature elevation above 101ºF beyond 24 hours, or any difficulty breathing, please seek immediate advice from our office or the nearest ER.

The following represent a listing of the some of the scenarios in which emergent care is recommended:

Facial swelling

More often than not, a facial swelling exists because of the presence of an infected or abscessed tooth. This is a situation in which immediate action must be taken. In the event our office is closed, please contact the nearest emergency room (Evangelical Community Hospital Operator # 570-522-2000) as soon as possible. A swelling is particularly dangerous because it means an infection that originated in a tooth has spread to surrounding tissues and will continue to do so until treatment is received. This often includes immediate antibiotic treatment, likely in the form of IV therapy, as well as dental surgery to remove the source of infection. In some cases, an infection may be so severe that it becomes necessary to perform an "incision and drainage" (I & D) procedure to ensure proper drainage for the site. The areas of swelling will differ depending on the location of the affected tooth. An infection of the upper jaw teeth will often produce a swelling to the cheek area and under the eye. Because some of the veins in this area do not have valves, blood can flow backward and spread an infection to an area under the brain known as the cavernous sinus. An infection of the lower jaw teeth will consequently lead to a swelling of the lower jaw. This infection can spread down to the throat perhaps affecting the ability to breathe, and even spread as far as the sac around the heart. We provide this information to you specifically to inform you of the severity of the situation. Please call us immediately at (570) 522-7070.


Begin by cleaning around the sore tooth meticulously. Using warm saltwater, rinse the mouth to dislodge any food trapped between the teeth. UNDER NO CIRCUMSTANCES should you use aspirin on the aching tooth or on the gums. In the event of facial swelling, apply a cold compress to the area. (Do not apply ice directly to the skin.) For temporary pain relief, acetaminophen (Tylenol) is recommended. See us as soon as possible.

Broken tooth

Rinse the area with warm water. Put a cold compress over the facial area of the injury. (Do not apply ice directly to the skin.) Recover any broken tooth fragments and see us as soon as possible.

Knocked Out Permanent Tooth

First of all, remain calm. If possible, find the tooth and hold it by the crown rather than the root. Rinse with plain water to remove any visible debris, but do not scrub the tooth. (Successful re-implantation of the tooth relies on the presence of mature tissue on the tooth and quick action.) Replace the tooth in the socket and hold it there with clean gauze or a washcloth. If you can't put the tooth back in the socket, place the tooth in a clean container with milk and take your child and the glass with the tooth immediately to your pediatric dentist or nearest emergency room. The faster you act, the better your chances are of saving the tooth.

Possible Broken Jaw

In the event of jaw injury, tie the mouth closed with a towel, necktie, or handkerchief. Go immediately to an emergency room.

"Through and through" lacerations of the lip

Lip lacerations are wounds that are created by the tearing of the soft tissue in the lip area, often as a result of a fall or other traumatic incident. In many cases, either the teeth or a foreign object penetrates the entire thickness of the skin creating a "hole" that extends from the outside of the face to the oral cavity. This type of laceration is known as a "through and through". This particular sort of laceration can easily become infected – if your child has suffered from this form of injury, please call us immediately at 570-522-7070, or visit the nearest ER immediately. Antibiotic treatment may be started and it may be necessary to suture the wound. The area must be thoroughly cleaned and evaluated by a medical professional.

Cut or Bitten Tongue, Lip or Cheek

Cool compress can be applied to any bruised areas. (Do not apply ice directly to the skin.) For bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the bleeding does not stop with pressure or continues after 15 minutes, go to the emergency room. Follow-up with us here at Pediatric Dentistry of Lewisburg or your general practitioner.

Broken Braces or Wires

Remove a broken appliance only if it comes out easily. If it is lodged or painful to remove, cover any protruding edges with wax, cotton balls, gauze or chewing gum. DO NOT REMOVE any wire caught in the gums, cheek or tongue; see us as soon as possible. Emergency attention is usually not required for loose or broken appliances that cause no discomfort.