What to do with a knocked-out tooth
If only part of the tooth has come away, see what to do for a broken tooth instead. For a whole adult tooth, in this order:
- Pick the tooth up by the crown, the white part you chew with. Do not touch the root.
- If it is dirty, rinse it for a few seconds in milk or saline. Do not scrub it, dry it or wrap it in a tissue, and leave anything attached to the root where it is.
- Put it back in the socket if you can, facing the right way, and bite gently on a clean cloth to hold it there.
- If it will not go back in, keep it moist: in a cup of milk, or inside the cheek if the person is old enough not to swallow it. Plain water is not good for it, and neither is letting it dry out.
- Call 540-921-3323 straight away, and bring the tooth with you.
Why the first hour matters
The root of a tooth is covered in living cells that hold it in the bone. Out of the mouth, those cells begin to dry out and die, and once they are gone the tooth is far less likely to reattach. Putting it back in the socket, or keeping it in milk, helps keep those cells alive until we can see it.
Putting the tooth back is something you can do yourself, wherever you are, and it is the most useful thing anyone can do for it in that first hour. Do not wait to see whether the bleeding stops, and do not finish the game first. Deal with the tooth, then call.
Baby teeth are not put back
If a young child knocks out a baby tooth, do not try to put it back. Pushing it into the socket can damage the adult tooth forming underneath. Press a clean cloth on the gum to stop the bleeding, bring the tooth with you anyway, and call so we can check the area and the teeth around it. We see children, and children's dentistry explains how we look after them.
If you are not sure whether it is a baby tooth or an adult tooth, keep it in milk rather than putting it back, and call.
When to go to the emergency room first
A blow hard enough to knock out a tooth can do other damage. Go to a hospital emergency room first for a head injury, a suspected broken jaw, difficulty breathing or swallowing, swelling that is closing an eye or spreading down the neck, or bleeding that will not stop after firm pressure. Keep the tooth in milk and take it with you, then call us afterward and we will take care of the dental side.
What happens next
When you call, tell whoever answers what has happened and they will get you seen. The office is at 300 Tazewell Street in Pearisburg, and you can park at the door.
At the appointment we take a digital X-ray and numb the area. If the tooth arrived in milk, we put it back in the socket, and if you managed to put it back yourself, we check its position and adjust it if needed. The tooth is then held steady with a splint, a thin support bonded to the teeth on either side, while it reattaches.
After that, we keep an eye on it with check-ups and X-rays for some time. A knocked-out adult tooth often needs a root canal later, because the nerve inside it does not usually survive the injury. If the tooth does not reattach, we will talk through replacing it, for example with a dental implant.
Questions patients ask
Can a knocked-out tooth be saved?
Sometimes. The chances are best if it goes back into the socket quickly, ideally within the first hour, and if the root is kept moist in the meantime. Whether it reattaches for good depends on the injury, and we will be straight with you about that.
Should I put a knocked-out tooth in water?
No. Plain water damages the living cells on the root. Milk is better, or saline, or holding it inside the cheek if the person is old enough not to swallow it. Back in the socket is best of all.
Should a knocked-out baby tooth be put back?
No. Pushing a baby tooth back into the socket can damage the adult tooth developing underneath. Stop the bleeding with a clean cloth, bring the tooth with you, and call so we can check the area.
What if I cannot get the tooth back in?
Do not force it. Keep it in milk, or inside the cheek if that is safe, and call straight away. Bring the tooth with you.
Will a knocked-out tooth need a root canal?
Often, yes, usually some time after it has been put back, because the nerve inside the tooth does not usually survive the injury. We watch the tooth with check-ups and X-rays and tell you if and when it is needed.