Act fast: the first 30 minutes matter most
If an adult tooth is knocked out, pick it up by the crown, rinse it gently if it is dirty and try to put it back in the socket. If you cannot, keep it moist in milk and get to a dentist right away. Time is the biggest factor in saving the tooth.
Dental sources, including Cleveland Clinic and Mayo Clinic, stress the same thing: a tooth that is put back within about 30 minutes has a better chance of surviving, and the chances drop as time passes. Do not wait until morning or until the pain settles. Call the dentist now.
Mayo Clinic suggests this order: pick up the tooth by the crown, rinse it briefly if it is dirty, try to put it back, and get to a dentist right away. It also says that if you cannot put it back, a container of cow's milk or your own saliva will keep the root cells alive. Many pharmacies also sell a tooth-saving kit, so it can help to keep one in a first-aid kit for a child who plays sports.
If you are with a child, stay calm. Children pick up on your tone. Say that you are going to help and that the dentist will take care of the tooth.
Step by step, what to do
Stay calm and follow these steps in order:
- Find the tooth. Pick it up by the crown, the white part you chew with. Do not touch the root.
- If it is dirty, rinse it briefly with milk or your own saliva. Do not scrub it. Do not use tap water for long and do not wipe it with a towel.
- Try to put it back in the socket, facing the right way. Push it in gently with your finger. Then bite down softly on gauze or a clean damp cloth to hold it in place.
- If you cannot put it back, place it in a small cup of cold milk. Spit works if there is no milk. Do not let it dry out.
- Call your dentist and go in right away. If the office is closed and you cannot reach a dentist, go to an ER.
What not to do
A few common mistakes can kill the tiny cells on the root that help the tooth reattach.
Do not scrub the root or remove the pink or white tissue on it. Do not store the tooth in water or wrap it in a tissue or a cloth, because it can dry out. Do not put the tooth in mouthwash or alcohol. And do not try to put back a baby tooth. Baby teeth that get knocked out are not replanted, because it can hurt the adult tooth growing underneath. Still see a dentist, though, to check the area.
If the tooth goes back in, it may feel strange, and it may bleed a little. That is normal. Hold gauze on the area and keep gentle pressure. Do not wiggle it, and do not eat until you have seen the dentist. If you cannot get the tooth in all the way, stop. Do not force it. Put it in milk and go.
Another common mistake is waiting to see if the pain settles before calling. A knocked-out tooth does not hurt the way a cavity does. The injury can be numb, and people sometimes feel fine for an hour. That hour is the one that decides whether the tooth survives, so call first.
What the dentist does
Your dentist will check the socket, take X-rays and look for broken bone or other injured teeth. If the tooth was out for a short time, it is usually put back and held in place with a thin splint for a couple of weeks. You might need antibiotics and a tetanus shot, depending on the injury.
Many replanted teeth need a root canal later. The nerve inside usually does not survive an injury like this. Your dentist will watch the tooth over the following weeks and months and tell you when to start treatment.
Healing takes time. You will probably eat soft foods for a week or two, avoid biting into hard foods with that tooth, and brush gently around it. Your dentist may check it again after a few weeks, and again after a few months, to see whether the root is healing or whether the tooth needs a root canal.
Cleveland Clinic also stresses that how fast you get care matters more than almost anything else. So if you are choosing between cleaning up the blood and calling the dentist, call first.
Tell the dentist exactly how long the tooth was out and how it was stored. Those two facts help the dentist estimate how likely the tooth is to heal.
If the tooth cannot be saved
Sometimes the tooth is too damaged, or too much time has passed. That is not the end of the story. There are good ways to replace a missing tooth.
A dental implant is a titanium post that acts like a new root, with a crown on top. It takes a few months to heal, and it does not need the teeth next to it to be filed down. A bridge or a partial denture are other options. Your dentist will explain what fits your mouth, your health and your budget.
In the meantime, a temporary tooth can fill the gap so you can smile and eat while you decide.
If the tooth could not be replanted, do not wait long to talk about replacement. The bone where the tooth was starts to shrink without a root to hold it up. Replacing the tooth, or at least having a plan, protects the bone and keeps the nearby teeth from shifting into the gap.
Other injuries to check
For a child, call the dentist for any hit to the mouth, even if no tooth came out. A tooth that is pushed in or loose can be hard to see and can cause trouble later. Also call your doctor if there is a head injury, loss of consciousness, vomiting or a headache that gets worse.
A hard hit to the mouth can do more than loosen a tooth. Look for these signs:
- A tooth that is loose, pushed in or sticking out
- Chipped or cracked teeth
- Cuts on the lips, tongue or cheeks
- Pain in your jaw or trouble closing your mouth normally
Where to go in Kendall
A knocked-out tooth is one of the true dental emergencies. The ADA lists a knocked-out tooth as a reason for urgent dental care.
KDA lists emergency care 24/7. If you are in pain, call us at 305-271-1421 and tell us what is going on. Our regular office hours are Monday to Friday, 8:00 AM to 5:00 PM, and we are closed Saturday and Sunday.
You will find us at 8833 SW 107th Ave, Miami, FL 33176, in the Kendall Mall. We have served South Florida since 1973. We take digital X-rays and 3D scans in the office, so we can see what is wrong the same visit. We accept most dental insurances and most Medicare supplemental plans, and financing is available.
If it happens at night or on a weekend, call anyway. A dental office with emergency care will tell you where to go and how to keep the tooth safe on the way. Put the number in your phone now, and save it where your family can find it.
Free X-ray, exam and consultation. New Patient Special. New patients only.
The patient and any other person responsible for payment has the right to refuse to pay, cancel payment or be reimbursed for payment for any other service, examination or treatment that is performed as a result of and within 72 hours of responding to any advertisement for the free, discounted fee or reduced fee service, examination or treatment. D0191, C6182
Common questions
Can a knocked-out tooth be saved?
Often yes, especially if it is put back within about 30 minutes. The longer it is out, the lower the chance.
What do I put a knocked-out tooth in?
If you cannot put it back in the socket, put it in cold milk. If you have no milk, keep it in your own saliva. Do not use plain water for long.
Should I clean the tooth?
Only rinse it briefly with milk or saliva if it is dirty. Do not scrub it or touch the root.
What if it is a baby tooth?
Do not put it back. It can damage the adult tooth underneath. Still call a dentist to check your child.
Do I need to go to the ER?
Call your dentist first. Go to an ER if you cannot reach one, if the bleeding will not stop, or if you may have other injuries like a broken jaw or a head injury.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: mayoclinic.org, health.clevelandclinic.org, dentalcompare.com.