A knocked-out tooth is one of the few dental situations where the clock is genuinely running from the moment it happens.
Time matters enormously with avulsed teeth, the dental term for teeth that have been completely dislodged from their socket. The longer the tooth is out of the mouth, the lower the chance of successful reimplantation. If this has happened to you or someone nearby, contacting an emergency dental practice should be your first call, but what you do in the minutes before you arrive can make a real difference to the outcome.
The First 60 Seconds After It Happens
Speed and calm are both essential. Here’s what to do immediately.
- Pick the tooth up by the crown, the white visible part, and not by the root
- Do not scrub or scrape the root surface; any tissue attached to it is important for reimplantation
- If the tooth is dirty, rinse it briefly under cold running water for no more than ten seconds
- Do not dry it, wrap it in tissue, or leave it exposed to the air
And if the person is conscious and cooperative, the best storage option is actually to place the tooth back into its socket immediately. Hold it in place gently by biting on a clean cloth or gauze.
Keeping the Tooth Alive
If reimplanting immediately isn’t possible, for example because the patient is a young child, is in shock, or the socket is heavily bleeding, the tooth must be kept moist in an appropriate storage medium.
| Storage Option | Suitability | Notes |
|---|---|---|
| Back in the socket | Best option | Only if patient is alert and not at risk of swallowing |
| Milk | Very good | Full-fat or semi-skimmed; widely available |
| Saline (salt water) | Acceptable | Use if milk is unavailable |
| The patient’s saliva | Acceptable | Hold in the cheek pouch if other options aren’t available |
| Tap water | Last resort only | Poor osmolarity; damages cells over time |
| Dry or in tissue | Avoid | Causes rapid cell death on the root surface |
Most patients we see with knocked-out teeth have used tap water or simply wrapped the tooth in tissue. Both options damage the periodontal ligament cells that are essential for the tooth to reattach. Milk is almost always available and is far superior.
Why Root Handling Matters
The root of a tooth is coated in a thin layer of periodontal ligament fibres. These fibres are what allow the tooth to bond back to the bone when reimplanted. Touching, scrubbing, or drying the root damages these cells and significantly reduces the chance of a successful outcome.
In our experience, even when a tooth is brought in quickly, cases where the root has been scrubbed or dried for more than a few minutes have much lower success rates than those where the root has been handled carefully and kept moist throughout.
This is why our first advice is always the same: don’t touch the root, don’t clean it aggressively, and get to us as fast as possible.
What Happens When You Arrive
Once you reach us, our dentist will assess the tooth, the socket, and any associated soft tissue injury. If reimplantation is clinically viable, the tooth will be repositioned and stabilised with a temporary splint that bonds to the neighbouring teeth. This splint is typically left in place for one to two weeks while the bone begins to reattach.
X-rays will be taken to assess the socket and confirm correct positioning- A course of antibiotics is usually prescribed to reduce the risk of infection
- Follow-up appointments will be arranged to monitor healing and assess whether root canal treatment is needed
X-rays will be taken to assess the socket and confirm correct positioningBut it’s worth being realistic: not all knocked-out teeth can be saved, and even those that are successfully reimplanted may not survive long-term. The outcome depends heavily on the type of tooth, the patient’s age, how the tooth was stored, and how quickly treatment was provided.
What About Children’s Teeth?
If a primary (baby) tooth is knocked out, it should generally not be reimplanted. Attempting to do so can damage the developing permanent tooth underneath. The British Dental Association advises that children with knocked-out baby teeth should still be seen by a dentist promptly, both to assess the socket and to reassure the child and parent.
We see children for emergency appointments here at Coniston, and our team is experienced in keeping young patients calm during what can be a frightening situation for everyone involved.
Preventing Knocked-Out Teeth
For patients who play contact sports, a custom-fitted mouthguard is one of the most effective and cost-efficient preventive measures available. Stock mouthguards bought in sports shops offer some protection, but custom-made guards that fit precisely over your teeth provide significantly better coverage and are more comfortable to wear.
And while accidents can’t always be predicted, wearing appropriate protection during sport dramatically reduces the risk of this kind of traumatic dental injury.
Call Us Immediately
If you’ve knocked out a tooth near West Byfleet, please call Coniston Dental Practice immediately on 01932 343 675. We’ll guide you through what to do on the phone and get you seen as quickly as possible. Every minute counts, and we’re here to give your tooth the best possible chance.
