What should I do if a tooth is knocked out?

A knocked-out adult tooth is a genuine dental emergency. Pick it up by the crown, not the root, and try to put it back in its socket straight away if you can, then get to a dentist urgently. If you cannot reinsert it, keep it in milk and go immediately. Never try to reinsert a baby tooth.

In short

• Only a permanent (adult) tooth should ever be put back in its socket. Never reinsert a baby tooth.
• Pick the tooth up by the crown, which is the white part you normally bite with, and avoid touching or scrubbing the root.
• If it is dirty, rinse it gently for a few seconds in milk, saline or your own saliva, then try to put it back into its socket and bite gently on a clean cloth to hold it there.
• If you cannot put it back in, keep it moist in milk, in an adult’s own cheek, or in saline. Do not let it dry out.
• Every minute matters. Go straight to a dentist. SADA and NHS guidance both point to about an hour as the window that gives an adult tooth the best chance of survival, and the sooner you act within that, the better.

This article is part of the dental emergency guidance on this site for patients in Cape Town.

What should I do right now?

Find the tooth and pick it up by the crown only, never the root, since touching the root can damage the cells the tooth needs to reattach to the bone. If it is dirty, rinse it gently for a few seconds in milk, saline or your own saliva rather than scrubbing it or running it under a tap. If you can manage it, push the tooth firmly back into its socket facing the right way round, then bite down gently on a clean cloth or handkerchief to hold it in place. Then get to a dentist immediately, even if the practice is not yet open.

What if I cannot put the tooth back in?

If you cannot reinsert the tooth yourself, the most important thing is to keep it moist. Milk is the storage option most consistently recommended. An adult can also keep the tooth in their own mouth, held between the cheek and the gum, or you can use a saline solution such as the type used for contact lenses. Wrap it in a clean, damp cloth or gauze if you are placing it in milk or saline to travel. Do not let the tooth dry out, and do not store it loose in a tissue or paper. For a young child, it is usually easier and safer to carry the tooth in a small container of milk rather than in their mouth.

Does this apply to baby teeth too?

No. A baby (primary) tooth should never be put back in its socket. Reinserting it can damage the permanent tooth developing underneath the gum. If your child has lost a baby tooth in a knock, they still need to see a dentist urgently, so that the dentist can check that no broken pieces of tooth remain in the gum and that nothing else has been injured.

How much does timing matter?

Timing matters a great deal. Research summarised in the International Association of Dental Traumatology’s guidelines shows that the chances of a replanted tooth surviving fall the longer it spends outside the mouth, and every extra minute counts. SADA’s own patient guidance and NHS emergency dental standards both point to around one hour from the injury as the window that gives an adult tooth the best chance, so this is not something to leave until the next day, or even until the pain settles. Go straight to a dentist rather than stopping to manage pain or clean up first.

What if the tooth is loose or pushed out of place, but not fully knocked out?

Call a dentist right away to arrange an emergency appointment. You can gently try to guide the tooth back towards its normal position using light finger pressure, but never force it. This still needs the same urgency as a fully knocked-out tooth.

When should I go to a hospital emergency unit instead of a dentist?

Go to a hospital emergency unit, not a dentist, if there is bleeding from the mouth that will not stop, if the injury involved a blow to the head and there is any loss of consciousness, vomiting or confusion, or if swelling is spreading towards the eye or neck, or making it hard to breathe, swallow or speak. These signs need urgent medical attention alongside, or instead of, dental care. Call an ambulance or have someone drive you there without delay.

How do I reach Dr Davies?

Call straight away. On weekdays from 8:30 to 17:00, call the practice and ask for Dr Davies, and at any other time, including Saturdays, call her own mobile. This page always shows the right number for the time of day. Call as soon as the injury happens rather than waiting, since with this injury every minute affects the outcome, and this page cannot replace the examination and X-ray a dentist will need to do.