By Dr. Zack Mekouar, DDS

As a dentist with over a decade of experience treating dental emergencies, I’ve seen plenty of cases where someone walks into my dental office holding a knocked-out tooth. Whether it’s the result of contact sports, bicycle accidents, or even a simple fall, losing a tooth can feel like a dental nightmare. The good news is that a knocked-out permanent tooth can often be saved, but fast action and the right steps are crucial for the best outcomes.

This article will guide you through what to do if a permanent tooth gets knocked out, how to care for it until you can get professional help, and the treatment options available if replantation isn’t possible.

Can a Knocked-Out Tooth Be Saved?

The short answer is yes—under the right circumstances. A knocked-out tooth, or avulsed tooth, can often be replanted if handled and stored correctly. However, the best chance of survival depends on how quickly you act, the condition of the tooth, and proper dental care.

When an avulsed tooth is knocked out, the blood vessels and nerves connecting it to the gum tissue are severed. Although these cannot be repaired, preserving the living cells on the root surface is essential for successful replantation. Acting within the first hour significantly increases the chances of saving the tooth. That’s why it’s imperative that you don’t panic when a dental emergency occurs – stay calm, and call your emergency dentist.

Step-by-Step Guide: What to Do When a Tooth Is Knocked Out

1. Stay Calm and Assess the Situation

The first thing to do is take a deep breath and assess the injury. If there are serious injuries, such as significant bleeding, loss of consciousness, or head trauma, seek medical care at the emergency room before addressing the tooth. Your overall health always takes priority.

2. Locate the Tooth and Handle It Properly

Find the tooth immediately, being careful not to touch the root of the tooth. Instead, hold it by the visible white bit, also known as the crown.

If the tooth is dirty, rinse it with clean water, such as tap water, but avoid scrubbing the root surface, as this can damage the delicate living cells necessary for replantation.

3. Storage: Keeping the Tooth Alive

The best thing you can do is attempt to place the tooth back in its correct position in the socket. Have the person bite down gently on a clean cloth or clean gauze to hold it in place.

If replantation isn’t possible—due to mouth injuries, unconsciousness, or a young child being involved—store the tooth properly:

1. Glass of milk: This is ideal because it helps maintain the tooth’s root surface cells.
2. Saline solution: If available, use it to keep the tooth moist.
3. The person’s saliva: For older children or adults, holding the tooth in their cheek is an option, but be cautious to avoid swallowing it.
4. Cold water: As a last resort, place the tooth in cold water, but avoid prolonged exposure to tap water, which can damage the cells.

4. Get Immediate Treatment and Professional Help

Once the tooth is stored, contact a general dentist or dental clinic for an emergency appointment. Let them know you’re dealing with a knocked-out tooth to ensure they prioritize your visit. If you can’t reach a dentist, visit an urgent care center or, if necessary, the emergency department.

At the dental office, your dentist will assess the dental injury, often using x-ray pictures to check for damage to adjacent teeth or the jawbone. They’ll clean the socket and determine whether the tooth is viable for replantation.

What Happens if Replantation Is Possible?

If the tooth can be replanted, the dentist will carefully place it back into the socket and stabilize it with a flexible splint attached to adjacent teeth. This splint helps the tooth stay in place while the gum tissue heals.

You’ll likely need root canal treatment within a few weeks to remove the damaged blood vessels and nerves inside the tooth, preventing infection and pain. With proper care, a replanted tooth can function normally for years.

What If Replantation Isn’t Possible?

Unfortunately, not all knocked-out teeth can be saved. If the avulsed tooth has been out too long, dried out, or sustained too much damage, your dentist will discuss treatment options to replace it.

1. Dental Implants: These are often the best strategy for replacing a single tooth. A dental implant involves placing a titanium post into the jawbone, which supports a crown that looks and functions like a natural tooth.
2. Dental Bridge: A dental bridge uses adjacent teeth to support a false tooth, making it a quicker solution than an implant.
3. Partial Dentures: For multiple missing teeth, a removable partial denture may be a good idea, especially for patients unable to undergo dental surgery.

Special Considerations for Young Children

When dealing with a knocked-out baby tooth, the approach differs. Unlike adult teeth, primary teeth are usually not replanted, as doing so can damage the developing permanent tooth underneath. Instead, a pediatric dentist will monitor the child’s mouth to ensure proper healing and development.

If you’re concerned about your child’s oral development, you can always contact a pediatric dentist for guidance.

Prevention: Simple Steps to Protect Your Teeth

While accidents like car accidents and bicycle accidents are sometimes unavoidable, there are steps you can take to prevent dental trauma and protect your oral health:

• Wear a mouth guard during contact sports or activities with a high risk of sports injuries.
• Avoid chewing on hard objects like ice or hard candy, which can damage adjacent teeth or cause a dental injury.
• Use seatbelts to reduce the risk of mouth injuries during car accidents.
• Practice good oral hygiene to strengthen your teeth and gums.

Conclusion

A knocked-out tooth may feel like a disaster, but with quick action and proper care, there’s often a good chance of saving it. And when replantation isn’t an option, modern treatment options like dental implants or a dental bridge ensure you can restore your smile and maintain your oral health.

Accidents happen, but knowing the best strategy for handling a dental emergency can make all the difference. Always consult a dentist or pediatric dentist to protect your overall health and achieve the best outcomes for your smile.