Definition
First Aid Advice For Knocked-Out Permanent Tooth
- To save the tooth, it must be reimplanted ASAP (2 hours is the outer limit for survival). Right away is best. If > 30 minutes away from dental or medical care, encourage the caller to replace the tooth in the socket before coming in. Use the following technique:
- Rinse off the tooth with saliva or water (do not scrub it).
- Replace it in the socket facing the correct way.
- Press down on the tooth with your thumb until the crown is level with the adjacent tooth.
- Have your child bite down on a wad of cloth to stabilize the tooth until you can reach your dentist.
- Note: Baby teeth can't be re-implanted.
Types of Tooth Injuries
- Loosened tooth - may bleed a little from the gums. Usually tightens up on its own.
- Displaced tooth (usually pushed inward)
- Chipped or fractured tooth
- Avulsed (knocked out) tooth - a dental emergency for permanent teeth
Transporting a Knocked-Out Permanent Tooth
- If unable to put the tooth back in its socket, follow these instructions:
- It is very important to keep the tooth moist. Do not let it dry out.
- Transport the tooth in milk or saliva (Milk is best per ADA 2003)
- MILK TRANSPORT OPTION 1 (best): Place tooth in a small plastic bag with some milk. Put the plastic bag in a cup of ice.
- MILK TRANSPORT OPTION 2: Place tooth in a cup of cold milk.
- SALIVA TRANSPORT OPTION 1: Put the tooth inside the child's mouth. (Be careful not to swallow it) (EXCEPTION: Age < 12 years)
- SALIVA TRANSPORT OPTION 2: Put the tooth in a cup and keep tooth moist with child's saliva (spit).
When to Call Your Doctor for Tooth Injury
Call Your Dentist or Doctor Now (night or day) If
- You think your child has a serious injury
- Permanent tooth knocked out (Reason: needs reimplantation ASAP; 2 hours is the deadline for tooth survival) --See FIRST AID
- Permanent tooth is almost falling out
- Baby tooth is almost falling out
- Bleeding won't stop after 10 minutes of direct pressure
- Tooth is greatly pushed out of its normal position
- Tooth that's pushed out of its normal position interferes with normal bite
- Severe pain
- Age under 1 year old
Call Your Dentist Within 24 Hours (between 9 am and 4 pm) If
- You think your child needs to be seen
- Baby tooth knocked out by injury (Reason: can't be reimplanted but dentist will check for damage to permanent tooth)
- Tooth is slightly pushed out of its normal position
- Can see a chip or fracture line (crack) in the tooth
- Tooth feels very loose when you try to move it
Call Your Dentist During Weekday Office Hours If
- Tooth sensitive to cold fluids
- Tooth becomes a darker color
- You have other questions or concerns
Parent Care at Home If
- Minor tooth injury and you don't think your child needs to be seen
Home Care Advice for Minor Dental Injuries
- Local Cold: For pain, apply a piece of ice or a popsicle to the injured gum area for 20 minutes.
- Pain Medicine: If it still hurts, give acetaminophen (e.g., Tylenol) or ibuprofen.
- Soft Diet: For any loose teeth, offer a soft diet for 3 days. By then, it should be tightened up.
- Call Your Dentist If:
- Pain becomes severe
- Tooth becomes sensitive to hot or cold fluids
- Tooth becomes a darker color
- Your child becomes worse
And remember, contact your doctor if your child develops any of the "When to Call Your Doctor" symptoms.
Disclaimer: This information is not intended be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.
Author and Senior Reviewer: Barton D. Schmitt, M.D.
Last Reviewed: 1/19/2009
Last Revised: 6/27/2008
Copyright 1994-2009 Barton D. Schmitt, M.D.