Knocked-Out Tooth: What to Do in the First Few Minutes
A knocked-out tooth is genuinely one of the most time-sensitive dental emergencies there is. More than five million teeth are knocked out every year in children and adults, according to the American Association of Endodontists, and how you handle the first few minutes has a real impact on whether that tooth can be saved.
Act Fast: Every Minute Matters
Permanent teeth have the best chance of successful reimplantation when they’re placed back in the socket within 15 to 30 minutes. Beyond about 60 minutes outside the mouth, the survival rate of the delicate ligament cells on the tooth’s root drops off sharply, though it’s still sometimes possible to save a tooth even after an hour.
Here’s exactly what to do, step by step.
Step 1: Find the Tooth and Handle It Correctly
Locate the tooth right away. When you pick it up, hold it only by the crown, the white chewing surface, never the root. The root is covered in fragile cells that are essential for the tooth to reattach successfully, and touching or rubbing them can damage those cells within seconds.
Step 2: Rinse Gently, If Needed
If the tooth is visibly dirty, rinse it gently with plain water for about 10 seconds. Don’t scrub it, don’t use soap or any cleaning chemicals, and don’t dry it or wrap it in a tissue or cloth.
Step 3: Try to Reposition It in the Socket
If you can do this safely, gently push the tooth back into its socket, making sure it’s facing the right direction. Bite down gently on a piece of clean gauze or a soft cloth to help hold it in place. This step gives the tooth the best possible chance, since keeping it in its natural environment is better than any storage method.
If you can’t get it back in, or you’re not comfortable trying, don’t force it. Move to the next step instead.
Step 4: Keep It Moist
If the tooth can’t go back in the socket, it needs to stay moist at all times. In order of preference:
- Tuck it between your cheek and gum (adults only; never do this with a young child who might swallow it)
- Submerge it in a small container of cold whole milk, which has a pH and protein content that helps preserve the root’s cells
- Use an ADA-recognized tooth preservation product like Save-A-Tooth if you happen to have one on hand
- As a last resort, use your own saliva in a clean container
Never store the tooth in plain tap water. Water actually damages the delicate root cells faster than leaving the tooth dry.
Step 5: Get to a Dentist Immediately
Call your dentist right away and let them know you’re on your way with a knocked-out tooth so they can prepare for emergency care. Bring the tooth with you, even if you were able to reposition it in the socket. If you can’t reach your dentist, go to an emergency room or an emergency dental clinic.
A Note About Baby Teeth
If a child’s baby (primary) tooth gets knocked out, the approach is different. Dentists generally don’t attempt to reimplant a baby tooth, since doing so can risk damaging the permanent tooth developing underneath. Still, call your pediatric dentist to have it evaluated.
What Happens at the Dental Visit
Your dentist or an endodontist will examine the tooth and the socket, may take an X-ray to check for other injuries, and will typically splint the tooth to the neighboring teeth to hold it steady while it reattaches. Depending on how long the tooth was out of the mouth and the type of injury, a root canal may be needed, sometimes right away and sometimes after the tooth has had time to stabilize.
Preventing This in the First Place
- Wear a properly fitted mouthguard during contact sports
- Avoid chewing on ice or extremely hard foods
- Never use your teeth as a tool to open packaging
FAQ
How long can a knocked-out tooth survive outside the mouth?
The best outcomes happen when the tooth is replanted within 15 to 30 minutes, though reimplantation can sometimes succeed even after an hour. After 60 minutes, the ligament cells on the root deteriorate quickly, lowering the odds of success.
Should I try to put the tooth back in myself?
Yes, if you can do it gently and the person is calm enough to cooperate. Getting the tooth back into the socket, even imperfectly, gives it the best chance until a dentist can properly reposition and splint it.
What should I store a knocked-out tooth in if I can’t reinsert it?
Cold whole milk is the best common household option. Saliva (tucked in your cheek) or an ADA-recognized preservation product also work. Never use plain tap water.
Will a knocked-out tooth need a root canal?
Often, yes, though the timing depends on the specific injury and how the tooth responds after reimplantation. Your dentist or endodontist will determine the right approach for the specific tooth.
Do baby teeth get reimplanted the same way as adult teeth?
No. Dentists generally don’t reimplant a knocked-out baby tooth, to avoid damaging the permanent tooth developing beneath it. Still, have it evaluated by a pediatric dentist right away.
Every Minute Counts
If you’re dealing with a knocked-out tooth right now, don’t wait, call Dr. Heidi Finkelstein and our team at My Plantation Dentist immediately for guidance and to get seen as quickly as possible. Contact us right away.
Dr. Heidi Finkelstein, My Plantation Dentist
