A knocked-out (avulsed) permanent tooth is one of the few true dental emergencies where minutes genuinely matter. Acting quickly and correctly can be the difference between saving and losing the tooth. Here is exactly what to do.
First, stay calm and find the tooth
Pick the tooth up by the crown (the white chewing part). Never touch the root, the part that was in the gum, because the delicate cells on the root surface are what allow the tooth to reattach.
Gently rinse, do not scrub
If the tooth is dirty, rinse it briefly with milk or clean water. Do not scrub it, use soap, or dry it, and do not wrap it in a tissue. Those cells on the root need to stay intact and moist.
Try to reinsert it
If you can, gently place the tooth back into its socket, facing the right way, and bite down softly on a clean cloth to hold it in place. A reinserted tooth kept in its natural environment has the best chance.
If you can’t reinsert it, keep it moist
Do not let the tooth dry out. In order of preference, store it in:
- A tooth-preservation medium, such as Hank’s Balanced Salt Solution, if one is available
- Milk, which is the most practical option for most people
- Saliva, held in the mouth beside the cheek, and only for an older child or adult where there is no risk of swallowing the tooth
Plain water is a last resort, because it is not ideal for the root cells.
Call us immediately
Call our office right away so we can see you as quickly as possible. The best outcomes happen when a tooth is reimplanted within about 30 to 60 minutes, so treat this like the emergency it is. If it is after hours, our emergency care page and voicemail will guide you.
Never replant a baby tooth
These steps are for permanent teeth. A knocked-out primary (baby) tooth should not be replanted, because putting it back can damage the developing permanent tooth underneath. Keep your child comfortable, control any bleeding with gentle pressure on clean gauze, and call us or your child’s dentist for guidance.
For chipped or loosened teeth
Not every injury is an avulsion. A chipped, loosened, or pushed-out tooth also benefits from prompt care, we can often stabilize it and monitor the nerve over time. Learn more about dental trauma management.
When it’s a 911 situation
Call 911 or go to the nearest emergency room for any injury involving difficulty breathing or swallowing, uncontrolled bleeding, a possible jaw fracture, or a head injury. Your overall safety comes first.
This article is for general education and is not a substitute for professional care. If you are experiencing a medical emergency, call 911.
