Seeing a tooth get knocked out is a startling and often distressing experience. The most important thing to know is that quick, correct action can make all the difference. In many cases, a knocked-out permanent tooth can be successfully saved and replanted, but the clock starts ticking the moment the injury occurs.
Your response within the first hour is absolutely critical. This brief window of time is when the cells on the root of the tooth are still viable. Taking the right steps can preserve these cells and give your endodontist the best possible chance of saving your natural tooth. This guide is here to walk you through exactly what to do, step by step, to help you feel prepared and in control during a stressful situation.
Handle the Tooth with Care
When a tooth is knocked out, your first instinct might be to grab it quickly. It’s essential to do this carefully and correctly to avoid causing further damage. The root of the tooth is covered in delicate periodontal ligament cells, which are vital for reattachment. Touching the root can easily damage these cells, significantly reducing the chances of successful replantation.
Always pick up the tooth by the crown—the smooth, white part you normally see when you smile. Never touch the root, which is the longer, more pointed part that sits below the gum line. Think of the crown as the safe "handle" for the tooth.
If the tooth is dirty, you can gently rinse it with milk or a sterile saline solution. It’s very important that you do not use tap water, as the chlorine and other substances in it can harm the delicate root cells. Do not scrub, wipe, or wrap the tooth in a tissue or cloth. The goal is simply to rinse away debris without disturbing the sensitive root surface. A gentle rinse for no more than 10 seconds is all that is needed. Handling the tooth properly from the very beginning is the first and most crucial step in saving it.
Keep the Tooth Moist to Preserve It
Once you have carefully picked up the tooth by the crown and rinsed it if necessary, the next priority is to keep it moist. The cells on the root surface cannot survive if they dry out. A dry tooth has a much lower chance of being successfully reimplanted. This is why you must never store it in a tissue, paper towel, or leave it exposed to the air.
The best place to store the tooth is back in its socket. If possible, after a gentle rinse, you can try to carefully place the tooth back into the empty socket. Gently bite down on a clean cloth or piece of gauze to hold it in place. We understand this might not always be possible, especially if there is significant pain or swelling.
If you cannot place the tooth back in the socket, the next best option is to submerge it in a suitable liquid. Milk is an excellent choice because its chemical composition is compatible with the tooth’s root cells, and it is readily available in most homes. Placing the tooth in a small container of milk will keep it hydrated and preserve the cells. A balanced salt solution, like one found in a first-aid kit, is another great option. If neither is available, you can have the person hold the tooth inside their cheek, where their saliva will keep it moist. However, this should only be done with older children or adults who are conscious and calm enough not to swallow it.
Seek Professional Care Within the Hour
With the tooth properly handled and preserved, the final and most urgent step is to see an endodontist or dentist immediately. The 60-minute window following the injury is often called the "golden hour" for a reason. The sooner the tooth can be professionally reimplanted, the higher the likelihood of a successful outcome. After about an hour, the viability of the root cells begins to decline rapidly, making reattachment much more difficult.
An endodontist is a specialist in saving teeth, particularly those affected by complex issues like traumatic dental injuries. At your emergency appointment, the endodontist will examine the tooth and the socket, clean the area, and carefully splint the tooth back into place. A splint acts like a cast, holding the tooth steady while the periodontal ligament fibers reattach to the jawbone. This process is critical for healing and gives your natural tooth the best chance for long-term survival. Remember, acting quickly is your greatest advantage.
Frequently Asked Questions
What is an endodontist?
An endodontist is a highly specialized dentist who focuses on diagnosing and treating issues inside the tooth. After completing dental school, they undergo an additional two to three years of advanced training centered on the tooth's pulp—the soft inner tissue containing nerves and blood vessels.
Why was I referred to an endodontist?
Your general dentist may refer you to an endodontist when a tooth problem is particularly complex or requires specialized care to save the tooth. Common reasons for a referral include a tooth with a severe infection, a complicated root canal system (such as curved or narrow canals), or a tooth that has undergone a previous root canal and requires retreatment.
At Modern Micro Endodontics, we are dedicated to providing gentle and effective care to relieve your pain and save your natural teeth. We know that dental emergencies can be distressing, and our team is here to support you with expert treatment and a compassionate approach. If you are experiencing a dental injury or tooth pain, please do not hesitate to schedule an appointment with us.