Emergency Dentist: What to Do When You Knock Out a Tooth
A knocked-out tooth is one of the most alarming dental emergencies you can face. Whether it happens during a weekend footy match, a bike ride, or an accidental fall at home, the shock of it can make it hard to know what to do next.
The good news is that with the right first aid steps and prompt access to an emergency dentist, your knocked-out tooth can sometimes be saved, but time is absolutely critical. So, what do you do when you knock out a tooth?
Read through to know the first aid steps when you get into an accident and knock out your tooth.
What Happens When a Tooth Is Knocked Out?
When a tooth is completely displaced from its socket, it’s referred to clinically as an avulsed tooth. What makes this type of dental emergency particularly time-sensitive is the condition of the periodontal ligament (PDL), which are the tiny fibres that attach the tooth root to the surrounding bone. These fibres need to stay alive for successful reimplantation to be possible, and they begin to deteriorate quickly once the tooth is out of the mouth.
According to the International Association of Dental Traumatology (IADT), PDL cells start to become non-viable after around 30 minutes of dry time outside the mouth. After 60 minutes, the prospects for long-term success decrease considerably.
This is why knowing what to do in those first few minutes matters so much.
What Should You Do If You Knock Out a Tooth?
Acting quickly and carefully can make a real difference to the outcome. Here’s what to do:
1. Pick up the tooth by the crown, not the root
The crown is the white part you can see when you smile. Avoid touching the root, as the PDL fibres that cling to it are delicate and easily damaged by handling.
2. If it’s dirty, rinse it gently.
Hold it briefly under cold running water or rinse it in milk to remove visible debris. Do not scrub it, dry it, or wrap it in tissue.
3. Try to put it back in the socket.
If you can, gently reinsert the tooth into the socket and bite down softly on a clean cloth to hold it in place. This is the best environment for keeping the PDL cells alive. Even if it goes back in slightly crooked, that’s okay. The priority is keeping it moist and in contact with the socket.
4. If you can’t reinsert it, store it in milk.
Milk has the right pH and nutrients to help keep PDL cells alive for a period of time. Saliva (under the tongue or in a small container) is the next best option to keep the tooth moist. Avoid storing the tooth in water. It’s too dilute and can cause the delicate cells on the tooth root to swell and die rapidly.
5. Get to an emergency dentist immediately.
Call ahead so the clinic can prepare for your arrival. The sooner you’re seen, the better the chances of a positive outcome.
Does It Matter Whether It’s an Adult or Baby Tooth?
Yes, and this is an important distinction. A knocked-out adult tooth should always be treated as an urgent emergency, and reimplantation attempted where possible. A knocked-out baby tooth, however, should not be reimplanted.
Putting a baby tooth back into the socket carries a risk of damaging the developing adult tooth underneath. If your child knocks out a baby tooth, keep them calm, manage any bleeding with gentle pressure, and still see a dentist promptly so the area can be assessed.
What Is the Time Limit for Reimplanting a Knocked Out Tooth?
The window for successful reimplantation is narrow. Teeth that are reimplanted within 30 minutes tend to have the best outcomes. Between 30 and 60 minutes, success rates decline, though reimplantation is still absolutely worth attempting. Beyond 60 minutes of dry time, PDL cell viability is significantly compromised.
However, even then, the IADT guidelines note that attempting reimplantation is almost always still the right decision, as it keeps future treatment options open.
The key takeaway from this is don’t wait and see. Treat a knocked out tooth as an emergency from the moment it happens.
Tooth Trauma After a Sports Injury
Sporting activities are one of the most common causes of tooth trauma, particularly contact sports like AFL, rugby, basketball, and martial arts. If you or your child plays a contact sport, a custom-fitted mouthguard is one of the most effective ways to reduce the risk of dental trauma, including tooth avulsion.
Over-the-counter mouthguards offer some protection, but custom mouthguards made by a dentist provide a far better fit and level of coverage.
If a tooth is knocked out during sport, the same first aid steps apply. And if another player or teammate is nearby, having someone call the dental clinic while you manage the tooth can save valuable minutes.
What Will the Emergency Dentist Do?
When you arrive at the clinic, the dentist will assess the tooth and the socket, reposition and splint the tooth if reimplantation is possible, and discuss follow-up care.
Depending on the situation, a root canal may be needed in the weeks following reimplantation, as the nerve and blood supply to the tooth is typically disrupted by the trauma. Regular monitoring is important to check for complications, such as root resorption.
If reimplantation is not possible, your dentist will discuss options for replacing the tooth in the longer term, such as a dental implant or bridge. Regardless if it’s a fully or partially knocked out tooth, it’s still best to visit an emergency dentist.
Don’t Wait — Every Minute Counts
When a tooth gets knocked out, staying calm and acting fast gives you the best possible chance of saving it. Pick it up by the crown, keep it moist, try to put it back in, and get to an emergency dentist straight away.
At Whitehorse Dental in Blackburn, we do our best to see emergency patients on the same day, wherever possible. Whether it’s a knocked out tooth, a sports injury, or any other sudden dental concern, our team is here to help with prompt, gentle care.
Contact us or book an appointment online, or call us at (03) 8838 8820 to speak with our team.
Frequently Asked Questions
- What should I do first if a tooth is knocked out?
Pick it up by the crown (not the root), rinse it gently if needed, and try to reinsert it into the socket straight away. If that’s not possible, store it in milk and get to an emergency dentist immediately.
- Can a knocked out tooth be saved?
In many cases, yes, particularly if you act quickly. The best outcomes occur when the tooth is reimplanted within 30 minutes. A dentist can assess whether reimplantation is still viable even beyond that window.
- Should I put a knocked out baby tooth back in?
No. Baby teeth should not be reimplanted, as doing so may damage the developing adult tooth underneath. See a dentist promptly for an assessment.
- What’s the best way to store a knocked out tooth?
Milk is the most practical and recommended storage medium. Saliva (under the tongue or in a small container) also works. Avoid water and avoid letting the tooth dry out.
- How long do I have to reimplant a knocked out tooth?
Ideally, within 30 minutes for the best outcomes. Reimplantation may still be attempted after 60 minutes, though success rates are lower. Seek emergency dental care as fast as possible, regardless of how much time has passed.
- Is a knocked out tooth a dental emergency? Yes, absolutely. A knocked out tooth is one of the most time-critical dental emergencies. Contact an emergency dentist the moment it happens.
