Knocked-out tooth: the first 60 minutes

A knocked-out tooth is one of the few true emergencies in dentistry. The good news: what you do in the first few minutes can make a real difference, and it is simpler than it sounds.

First: baby tooth or adult tooth?

Baby (primary) teeth should not be put back in. Replanting them can damage the adult tooth developing underneath. Keep the tooth if you like, comfort your child, control bleeding with gentle pressure on clean gauze, and call us so we can examine the area.

Adult (permanent) front teeth usually arrive around ages 6 to 8. If your child is older than that, assume it may be permanent and act quickly.

For a permanent tooth: step by step

1. Find the tooth and pick it up by the crown (the white part you chew with). Do not touch the root.
2. If it is dirty, rinse it briefly with milk or saline. Do not scrub it or use soap.
3. If your child is old enough to cooperate, gently push it back into the socket and have them bite on a clean cloth to hold it.
4. If you cannot put it back, keep it moist: in a cup of milk, in saline, or in the child’s own saliva. Do not store it in water and do not let it dry out.
5. Call us immediately and head in. If there are other injuries, go to the emergency room first.

Why the clock matters

The root is covered in delicate living cells that help the tooth reattach. International dental trauma guidelines (IADT) note that once a tooth has been dry for 60 minutes or more, those cells are no longer viable. Even then, a dentist will usually still try to replant a permanent tooth, but the long-term outlook is better the faster it is handled.

Pack a small “tooth-saver” in your sports bag: a lidded cup and a small carton of shelf-stable milk. Mouthguards prevent many of these injuries in the first place.