Knocked-Out Tooth: What to Do in the First 30 Minutes

What should I do first if a tooth is knocked out?

If it is an adult tooth, act within minutes. Find the tooth, pick it up by the crown (the white chewing surface), and rinse it gently. Cleveland Clinic says avulsed teeth are dental emergencies and require immediate treatment, and that teeth treated within 30 minutes to one hour are the most likely to be saved.

HealthyChildren.org, from the American Academy of Pediatrics, gives a tighter window: an adult tooth is most likely to be saved when it is placed back in the socket within 15 minutes, and it may still be saved within the first hour if you act quickly and carefully. Faster is better, so do not wait to see if the pain settles.

What are the steps for the first 30 minutes?

Follow these steps in order. They combine advice from Cleveland Clinic and HealthyChildren.org.

The word for a tooth knocked out of its socket is avulsed. Cleveland Clinic calls putting it back reinsertion or replantation. Pushing it into the empty tooth socket yourself can feel scary, so move calmly.

What if I cannot put the tooth back?

Keep it moist, and keep going. Cleveland Clinic says that if you cannot put the tooth back, keep it moist and contact your dentist for an emergency appointment or go to an emergency room. It says milk gives the tooth the most protection. You can also keep the tooth in your cheek, tucked against the gum, or under your tongue, where saliva keeps it wet.

HealthyChildren.org lists milk, a saline solution, or your child’s own saliva, and says not to store the tooth in tap water. The American Dental Association says to keep a knocked-out adult tooth moist at all times.

What if I only found part of the tooth?

Do not try to put a piece back. Cleveland Clinic says never to try to put only part of a tooth back into the socket. See a dentist as soon as you can.

What if I cannot find the tooth at all?

Tell the provider who treats you. Cleveland Clinic says you may have swallowed or breathed in the tooth. It says swallowed teeth are usually harmless, but breathing one in may cause lung infections like aspiration pneumonia, so tell your provider you may have inhaled it. If you have trouble breathing, call 911.

Should I put a baby tooth back in?

No. Cleveland Clinic says it is not a good idea to reinsert a baby tooth, and HealthyChildren.org says there is no need to try to replace one lost early. Still call your dentist so the mouth can be checked. Our post on when baby teeth fall out explains the normal schedule.

What will the dentist do?

The dentist checks the tooth and the mouth, then treats the tooth. Cleveland Clinic says that if the tooth goes back in its socket, the dentist makes sure it sits in the right position and places a splint to anchor it to the neighboring teeth. If infection reaches the tooth pulp, a root canal may be needed.

After treatment, Cleveland Clinic suggests eating only soft food and liquids for two weeks, avoiding very hot or cold foods, and brushing gently with a soft toothbrush. Expect follow-up visits so your dentist can check that the tooth is stable. Your dentist will explain the plan for your own case.

Who is most at risk, and how can I help prevent it?

Falls, bike accidents and contact sports are common causes. Cleveland Clinic lists falls, bicycle accidents, contact sports like football and hockey, traffic accidents and assaults. It says this injury mostly occurs in kids ages 7 to 11. It also says wearing a mouth guard during contact sports may protect your teeth.

A custom mouth guard is one option to ask your dentist about. Our post on boil-and-bite mouth guards compares the choices.

Who do I call, and when is the office open?

Call a dentist first, during office hours. Town Center Dental is open Monday to Wednesday from 8am to 5pm and Thursday from 8am to 4pm. The office is closed Friday to Sunday. Call (636) 273-5866 right away during open hours, tell the team you have a knocked-out tooth, and say how long ago it happened.

If it happens when the office is closed, do not wait for Monday. The American Dental Association says to get to your dentist’s office right away or visit an emergency room. Cleveland Clinic says if you cannot put the tooth back, contact a dentist or go to an emergency room. After hours and on weekends, that means an emergency room. For serious injuries, such as broken facial bones, Cleveland Clinic says to go directly to the emergency room. If someone has trouble breathing, call 911.

See emergency dentist, urgent care or ER for how to choose, and our dental emergency guide for other injuries.

What should I do on the way to the dentist or ER?

Keep the tooth moist and keep moving. If you put the tooth back, keep biting gently on gauze or cloth. If you could not put it back, keep it in milk or in your cheek against the gum. The American Dental Association says to call your dentist and give as much detail as you can. HealthyChildren.org says to let them know you are coming and that your child has a knocked-out adult tooth.

Calling ahead lets the team prepare. Say your child’s age or yours, how long ago it happened, how you have stored the tooth, and whether there are other injuries.

Next step

Save our number in your phone now: (636) 273-5866. Read about emergency dentistry at Town Center Dental, then call during office hours or request an appointment for follow-up care.