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A knocked-out tooth (also called an avulsed tooth) is a dental emergency. If it is a permanent (adult) tooth, acting quickly gives the best chance of saving it.
If possible:
Pick the tooth up by the crown (the white chewing surface), not the root.
- If dirty, gently rinse it with milk, saline, or saliva. Do not scrub it.
- Carefully place it back into its socket if possible.
- Bite gently on clean gauze or a cloth to hold it in place.
- If you cannot reinsert it, keep it in milk or your own saliva.
- Contact an emergency dentist immediately within 30-60 mins.
Never try to reinsert a baby tooth, as this may damage the developing adult tooth beneath it.
What Is a Knocked-Out Tooth?
A knocked-out tooth occurs when a tooth is completely displaced from its socket due to dental trauma. Unlike a chipped or broken tooth, the entire tooth, including the root, is forced out of the mouth. This type of injury commonly results from sports injuries, falls, road traffic collisions, workplace accidents, or other significant impacts to the face or mouth.
A knocked-out permanent tooth is one of the few true dental emergencies because the tissues attached to the root begin to deteriorate as soon as the tooth is outside the mouth. According to the International Association of Dental Traumatology (IADT), immediate replantation offers the best chance of saving the tooth, with treatment ideally started within 30 - 60 minutes. The longer the tooth remains out of the socket, especially if it dries out, the lower the likelihood of successful replantation.
What to Do If You Knock Out a Tooth, Step-by-Step Guide
Step 1: Stay Calm and Find the Tooth
Try to stay calm and locate the tooth as quickly as possible. Pick it up carefully to avoid damaging the delicate tissues needed for successful reattachment.
Step 2: Hold the Tooth by the Crown
Always hold the tooth by the crown (the visible white part), not the root. Touching the root can damage the cells that help the tooth heal after replantation.
Step 3: Rinse the Tooth Gently (If Dirty)
If the tooth is dirty, rinse it gently with milk, sterile saline, or saliva. Do not scrub it or use soap, toothpaste, alcohol, or disinfectants, as these can damage the root surface.
Step 4: Try to Reinsert the Tooth
If it is a permanent tooth and you feel confident, gently place it back into its socket in the correct position. Bite softly on clean gauze or a folded cloth to hold it in place, but never force the tooth if it does not fit easily.
Step 5: Store the Tooth Properly
If you cannot reinsert the tooth, keep it moist by storing it in milk, sterile saline, or your own saliva. Avoid wrapping it in tissue or leaving it dry, as this can reduce the chances of saving the tooth.
Step 6: Contact an Emergency Dentist Immediately
Seek emergency dental care as soon as possible, ideally within 30–60 minutes. If you're in Didsbury, Manchester, contact R&G Dental straight away so our team can assess the injury and advise you on the next steps. If you're elsewhere or your dental practice is closed, contact your local emergency dental service.
Baby Tooth vs Permanent Tooth - What Should You Do?
Knowing whether the knocked-out tooth is a baby (primary) tooth or a permanent (adult) tooth is essential, as the recommended treatment is different for each. Attempting the wrong first-aid step could affect the long-term health of the developing permanent teeth.
Not sure whether it's a baby or permanent tooth? Avoid trying to reinsert it and contact an emergency dentist immediately. A dentist can identify the tooth and recommend the safest course of action. This is especially important for children aged 5–12 years, when both baby and permanent teeth may be present.
What Will an Emergency Dentist Do for a Knocked-Out Tooth?
After a knocked-out tooth (avulsed tooth), an emergency dentist's first priority is to determine whether the tooth can be saved and to protect your long-term oral health. The treatment you receive will depend on several factors, including how long the tooth has been out of the mouth, how it was stored, whether it is a permanent or baby tooth, and the extent of any damage to the tooth and surrounding tissues.
Your dentist will also ask how the injury occurred, as a significant impact to the face or head may be associated with other injuries, such as a jaw fracture, facial trauma, or concussion, which may require further medical assessment.
Emergency Dental Assessment
During your appointment, the dentist will carry out a thorough examination to assess the injury and determine the most appropriate treatment.
What Happens If My Knocked-Out Tooth Cannot Be Saved?
Unfortunately, not every knocked-out (avulsed) tooth can be successfully replanted. A tooth may not be salvageable if it has remained dry for too long, the root is severely damaged, there is significant infection, the supporting bone or tissues have been badly injured, or the tooth has fractured below the gum line.
If your tooth cannot be saved, your dentist will discuss the most suitable replacement options based on your oral health, age, jawbone condition, and personal preferences. Common treatments include:
- Dental Implant: Ideal for replacing a single missing tooth, as it closely mimics the look, feel, and function of a natural tooth while helping to preserve the jawbone.
- Dental Bridge: Suitable for replacing one or more missing teeth by using neighbouring teeth or dental implants for support, providing a fixed and natural-looking restoration.
- Denture: Recommended when multiple teeth are missing, offering a removable and cost-effective solution that restores your smile and improves chewing ability.
At R&G Dental, we provide personalised advice on dental implants, bridges, and dentures to help restore your smile after tooth loss. Contact our team today to discuss the best tooth replacement option for your needs.
Recovery After a Knocked-Out Tooth
Healing varies between individuals and depends on the severity of the injury.
In general:
Recovery timelines differ from patient to patient, so your dentist will advise you based on your specific injury.
Possible Complications After a Knocked-Out Tooth
Many knocked-out teeth heal successfully, particularly when treated promptly. However, dental trauma can sometimes lead to complications, which is why regular follow-up appointments and dental X-rays are important after treatment.
Root Resorption
Root resorption is a condition in which the body gradually breaks down the tooth root following trauma. It may develop months or even years after the injury, often without causing symptoms at first, so regular clinical reviews and X-rays are essential for early detection.
Ankylosis
Ankylosis occurs when the tooth fuses directly to the surrounding jawbone instead of healing through its normal supporting ligament. This complication is more likely after severe trauma and, in growing children, can affect normal jaw growth and the position of developing teeth.
Infection
The dental pulp (the soft tissue inside the tooth) may become infected after a traumatic injury, particularly if its blood supply has been damaged. If an infection develops, root canal treatment is often recommended to remove the infected tissue and help preserve the tooth.
Tooth Discolouration
A tooth that has experienced trauma may gradually become grey, yellow, or darker over time. While discolouration does not always mean the tooth is infected, it can indicate changes inside the tooth and should be assessed by your dentist during follow-up appointments.
Frequently Asked Questions
Is a Knocked-Out Tooth Considered a Dental Emergency?
Yes. A knocked-out permanent tooth is one of the few true dental emergencies because prompt treatment offers the best chance of saving the tooth. For the best possible outcome, you should seek emergency dental care immediately.
Can a knocked-out tooth be saved?
Yes, a knocked-out permanent tooth can often be saved if it is replanted or treated quickly. The best chance of success is when the tooth is replanted as soon as possible after the injury and handled correctly. Even if immediate replantation is not possible, storing the tooth properly and seeking urgent dental care may improve the prognosis.
What is an avulsed tooth?
An avulsed tooth is a tooth that has been completely knocked out of its socket due to trauma. Unlike a chipped or cracked tooth, the entire tooth, including the root, comes out of the mouth.
How Long Can a Knocked-Out Tooth Survive Outside the Mouth?
According to the International Association of Dental Traumatology (IADT), a knocked-out permanent tooth has the best chance of being saved if it is replanted immediately, ideally within 15 minutes. If this isn't possible, keeping the tooth moist and seeing an emergency dentist within 30 - 60 minutes offers the best prognosis. Even after 60 minutes, you should still seek urgent dental care, as treatment may still be beneficial.
What Is the Best Way to Store a Knocked-Out Tooth?
If you cannot replant the tooth immediately, keep it moist by storing it in milk, sterile saline, or your own saliva (such as inside your cheek, if it is safe to do so). Do not let the tooth dry out or store it in tissue, as this can reduce the chances of successfully saving it.
Conclusion
A knocked-out tooth can be alarming, but knowing what to do immediately can make a significant difference. Acting quickly, handling the tooth correctly, and seeking emergency dental care without delay give a permanent tooth the best chance of successful replantation.
Remember to hold the tooth by the crown, keep it moist if it cannot be replanted straight away, and never attempt to reinsert a baby tooth. Even if you are unsure whether the tooth can be saved, prompt assessment by a dentist is always recommended.
With the right first aid and professional treatment, many patients can achieve a positive outcome and protect their long-term oral health.
