Knocked-Out Tooth: What to Do in the First 30 Minutes

A knocked out tooth is one of the few dental problems where minutes really count. If it’s an adult tooth, pick it up by the crown, rinse it briefly, push it gently back into the socket and see a dentist straight away, ideally within 30 minutes. If it’s a baby tooth, never put it back in.

The steps below take you from the moment the tooth comes out to the dental chair. For other urgent problems, see our dental emergency guide, or call our emergency dentist in North Sydney on the way.

First, check for more serious injuries

Teeth are often knocked out by a fall, a sporting collision or a blow to the face, so check the person as well as the tooth. Call 000 or go to your nearest hospital emergency department if there is:

• a knock to the head with loss of consciousness, vomiting, confusion or a bad headache
• difficulty breathing or swallowing, or a chance the tooth or a fragment has been inhaled
• bleeding that won’t stop after 15–20 minutes of firm pressure
• a possible broken jaw, or teeth that suddenly don’t meet properly
• swelling spreading to the eye, neck or floor of the mouth

If the injury happens out of hours and you’re unsure where to go, healthdirect on 1800 022 222 offers nurse advice 24 hours a day. A dentist can still treat the tooth once any serious injury has been checked.

What to do with a knocked out tooth, step by step

1. Find the tooth. Pick it up by the crown, the white part you chew with. Don’t touch the root, which has a thin layer of living cells that help the tooth reattach.
2. Rinse it only if it’s dirty. Rinse briefly in milk or saline. If you only have water, a rinse of a few seconds is enough. Don’t scrub it, use soap or wrap it in tissue.
3. Put an adult tooth back in the socket. Check it’s the right way round by comparing it with the tooth next to it, then press it gently into place.
4. Hold it there. Bite gently on a clean cloth or handkerchief to keep the tooth steady while you travel.
5. If you can’t put it back, keep it moist. Place it in a small container of milk or saline. An adult can also hold it inside the cheek so it stays in saliva. Don’t ask a child to do this, as they may swallow it.
6. Get to a dentist straight away. Call ahead if you can.

Why the first 30 minutes matter

The root surface is covered with delicate cells that attach the tooth to the bone. Once those cells dry out, they start to die, and the chance of the tooth reattaching drops quickly. Keeping the tooth in the socket, or in milk or saliva, protects those cells until a dentist can reposition it.

Don’t store the tooth in water for the trip. Plain water can damage the root cells over time, whereas milk is a better short-term option.

Children and baby teeth

Never put a baby tooth back into the socket. Doing so can damage the adult tooth that is developing underneath. Instead, comfort your child, control any bleeding with a folded cloth and gentle pressure, and bring them in to be checked.

Front baby teeth are usually lost naturally from around six or seven years of age, so it isn’t always easy to tell whether a knocked-out tooth is a baby tooth or an adult one. If you’re not sure, don’t put it back. Keep it in milk and call a dentist straight away for advice.

It’s still worth seeing a dentist even when a baby tooth can’t be replaced. They can check for broken fragments, injuries to the lips and gums, and any damage to the adult tooth below. If you can’t find the tooth at all, it may have been pushed up into the gum, swallowed or inhaled, which needs to be checked. Our children’s dentistry team can check injuries like these.

What happens when you reach the dentist

At our North Sydney practice, we aim to see urgent problems as soon as possible, often on the same day, and a knocked-out tooth is a priority. Your dentist will usually:

1. gently clean the tooth and socket, and reposition the tooth if it’s been replanted at home
2. take X-rays to check the position of the tooth and look for fractures
3. attach a thin, flexible splint to the neighbouring teeth, usually for about two weeks, so the tooth can settle
4. check whether you need a tetanus booster, particularly if the tooth touched soil, and prescribe medication only if it’s needed
5. arrange follow-up visits to monitor healing

In adults, the nerve inside a replanted tooth usually doesn’t survive, so root canal treatment is often started within a couple of weeks. The tooth is then reviewed over the following months and years, because the root can slowly be replaced by bone in some cases.

Caring for the tooth at home

• Eat soft foods for the first week or two and avoid biting directly on the tooth.
• Brush gently with a soft brush after every meal and use any mouthwash your dentist recommends.
• Avoid contact sport until your dentist says the tooth has settled.

If the tooth can’t be saved

Sometimes a tooth can’t be replanted, or it doesn’t hold in the long run. There are several ways to replace a missing front tooth, including a removable denture, a bridge or dental implants. Your dentist will talk you through the pros, cons, risks and costs of each.

Implants aren’t usually placed until the jaw has finished growing, so teenagers and young adults may need a temporary option first.

How to lower the risk

Most knocked-out teeth happen during sport, play or falls. A custom-fitted mouthguard worn for all contact sports and training can reduce the risk of injury to the teeth and jaw.

Frequently asked questions

Need help now?

North Sydney Dentistry is at Level 1, Suite 102/71 Walker St, North Sydney, a two-minute walk from North Sydney station. We’re open Monday to Friday, 9am to 6pm, and keep time aside for urgent problems where we can. Call (02) 8090 1108 or book online.

This article is general information only and is not a substitute for advice from your own dentist or doctor. Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.