What to Do When a Tooth Gets Knocked Out: A Step-by-Step Survival Guide
This is a time-sensitive emergency.
If you or your child has had a permanent tooth knocked out (avulsed), you have a critical window of roughly 30 to 60 minutes to re-implant the tooth for the highest chance of long-term survival. Do not panic. Take a deep breath, follow the steps below exactly, and call Higher Ground Dentistry at (909) 946-9090 immediately. We will guide you through this.
The 5-Minute Protocol: Do This Immediately
- Find the Tooth: Locate the tooth immediately. Pick it up by the crown (the white part used for chewing). Never touch the root. The root is covered in delicate periodontal ligament cells that are vital for the tooth to reattach to the bone. If you touch them, they can die.
- Rinse Gently (If Dirty): If the tooth fell in dirt, rinse it briefly (10 seconds max) with cold water or milk. Do not scrub the tooth. Do not use soap, alcohol, or chemicals. Do not dry it with a towel.
- Reinsert the Tooth (The Best Option): The best transport container for a tooth is its own socket. Gently guide the tooth back into the hole it came from. It should slip in relatively easily. Once it is in, bite down softly on a clean cloth or piece of gauze to hold it in place.
- Note: Only do this for permanent (adult) teeth. Never re-implant a baby tooth, as it can damage the developing adult tooth underneath.
Store Properly (If You Can't Reinsert): If you cannot get the tooth back in, or if there is too much swelling/pain, you must keep the tooth moist. The storage medium you choose can determine if the tooth lives or dies.
The "Save-a-Tooth" Storage Hierarchy
Not all liquids are created equal when it comes to saving a tooth. Here is what you should use, in order of preference:
|
Storage Medium |
Effectiveness |
Why? |
|
Hank's Balanced Salt Solution (HBSS) |
Best |
Contains the perfect pH and nutrients to keep cells alive for up to 24 hours. Found in some first aid kits (Save-A-Tooth). |
|
Cold Milk |
Excellent |
Milk contains proteins and sugars that maintain cell fluid pressure and is free of bacteria. It keeps cells vital for about 3-6 hours. |
|
Saliva (Cheek Pouch) |
Good |
Placing the tooth inside the patient's cheek keeps it moist and at body temperature. Be careful not to swallow it! |
|
Saliva (Cup) |
Okay |
Spitting into a cup is safer than the cheek (no swallowing risk) but bacteria can grow quickly. |
|
Tap Water |
Avoid |
Water is hypotonic. It will cause the root cells to swell and burst within minutes, killing the tooth. Only use for a 10-second rinse. |
🚨 Emergency Checklist — Call Immediately If:
• A tooth is completely knocked out
• The tooth is cracked, bleeding, or extremely loose
• The socket is filling with blood
• You are in severe pain or cannot bite down
• You cannot reinsert the tooth safely
• You are unsure whether it is a baby tooth or permanent tooth
📞 Emergency Line: (909) 946-9090
⏱ Fastest care available in Upland for dental trauma and avulsed teeth
Why Time Matters: The Science of Avulsion
You might be wondering why speed is so important. Your tooth is held in your jaw by the Periodontal Ligament (PDL). When a tooth is knocked out, this ligament is torn. However, thousands of tiny PDL cells remain attached to the root.
If these cells stay alive (hydrated and nourished), they can reattach to the bone when the tooth is put back. If they dry out—which happens in less than 60 minutes in open air—the cells die. Once the cells die, the body will view the re-implanted tooth as a foreign object and eventually reject it (resorption).
For the highest chance of saving the tooth, bring it to our Upland emergency dental clinic within 30–60 minutes. We specialize in trauma-based dentistry and re-implantation.
What Happens at the Dentist's Office?
When you arrive at Higher Ground Dentistry with a knocked-out tooth, here is what you can expect:
- Stabilization: Dr. Sikka will ensure the tooth is positioned correctly and then "splint" it. This involves bonding a thin wire or composite material to the knocked-out tooth and its neighbors to hold it steady, like a cast for a broken arm.
- X-Rays: We will take digital images to check for root fractures and ensure the tooth is seated properly in the socket.
- Root Canal Therapy: In almost all cases of avulsed mature teeth, the nerve inside the tooth is severed and will die. To prevent infection and root resorption, a root canal is usually necessary. Depending on the situation, Dr. Sikka may start this immediately or wait 7-10 days.
Healing Period: The splint usually stays on for about 2 weeks. During this time, you will need to eat soft foods and maintain meticulous oral hygiene.