First Aid for Tooth Loss
When a tooth is knocked out, quick action can make a big difference—especially if it’s a permanent tooth. Acting within minutes may give you the best chance of saving the tooth and avoiding long-term dental complications. While a dentist should handle the final care, what you do right after the injury matters greatly.
Why Timing Is Critical
Replanting a knocked-out adult tooth as soon as possible increases the odds that it will take root again and function normally. The cells on the tooth’s root are very sensitive, and they can begin to die off if the tooth is left out of the mouth too long or if handled the wrong way. Ideally, a permanent tooth should be returned to its socket within 30 minutes.
Baby teeth (also called primary teeth) are never reinserted once they come out. Dentists avoid placing them back because they could interfere with the healthy development of the permanent teeth underneath.
Table: Differences Between Adult and Child Tooth Loss
| Type of Tooth | Replantation Attempted? | Reason |
|---|---|---|
| Permanent tooth | Yes | Best chance for saving the tooth |
| Baby tooth | No | Can harm developing adult tooth |
What To Do If a Tooth Is Knocked Out
Staying calm and acting fast is key. Whether it’s a fall, sports accident, or other injury, follow these steps if someone loses a permanent tooth:
1. Hold the Tooth by the Crown
Pick up the tooth carefully and only touch the crown (the top part you normally see in the mouth). Avoid touching the root, as this part contains important cells needed for reattachment.
2. Check the Tooth for Damage
Look to see if the tooth is intact. If parts are missing, save any broken pieces and tell the dentist. Even partial fragments may help with treatment.
3. Rinse the Tooth Gently (If Needed)
If the tooth is dirty, gently rinse it with cold milk or the person’s own saliva. Avoid tap water and never scrub, brush, or wipe the root. Using water or rubbing the tooth can damage living tissue, making it harder for the tooth to heal.
4. Do Not Wrap the Tooth
Avoid wrapping the tooth in a napkin, tissue, or cloth. This can dry out the root and significantly lower the chance of successful replanting. Keeping the root moist is essential.
5. Try to Reinsert the Tooth
If possible, gently place the tooth back into its original socket. Line it up properly and press it in with light pressure. Have the person bite down gently on a clean gauze pad, handkerchief, or soft cloth to hold it in place.
6. If Replanting Is Not Possible
If you can’t put the tooth back into the mouth, store it safely in a proper solution. The best options for temporary storage are:
- Milk (preferably cold)
- Saliva (have the person spit into a clean container)
- ADA-approved tooth preservation solution (if available)
Never use plain water, as it can damage the cells needed for the tooth to heal.
Step-by-Step Summary for Managing a Knocked-Out Tooth
- Handle the tooth by the crown, not the root.
- Rinse briefly with milk or saliva only if the tooth is dirty.
- Do not scrub or wrap the tooth.
- If possible, reinsert the tooth into its socket and hold it in place.
- If replanting isn’t possible, store it in milk, saliva, or a special tooth-saving solution.
- Seek emergency dental care immediately—do not delay.
Tip: Time is crucial. The longer the tooth is out of the socket, the lower the chances of successful reattachment. Ideally, get to a dentist within 30–60 minutes.
Storage Options and What to Avoid
Best Options for Short-Term Storage
- Cold cow’s milk
- Tooth preservation kits (available at pharmacies or sports facilities)
- Person’s own saliva (spit into a clean cup)
What to Avoid
- Tap water
- Wrapping in cloth or tissue
- Rinsing with alcohol or hydrogen peroxide
- Drying out the tooth
Signs of Complications or Lower Success
Not all knocked-out teeth can be saved. Your chances of success decrease if:
- The tooth has been out of the mouth for more than an hour.
- The root is visibly broken or missing.
- The injury damaged surrounding gums or bone.
- The tooth was stored incorrectly (dried out or cleaned too aggressively).
Even if the tooth appears too damaged, a dentist can assess it and may still recommend treatment options such as a splint or root canal to restore function or appearance.
