Pick the tooth up by the crown — never the root. Do not scrub it. Put it straight back in the socket if you can. If you cannot, keep it in milk.
Call (203) 372-0881 now. A tooth kept moist has a real chance of being saved. A tooth left dry for an hour usually does not.
Read the rest while someone else drives.
Do this, in this order
1. Find the tooth. Hold it by the crown. The crown is the white part you chew with. The root must not be touched — it is covered in living cells, and those cells are the only reason a re-implanted tooth ever re-attaches. Wiping them off with your fingers destroys them.
2. If it is dirty, rinse it briefly. In milk, saline, or the patient's own saliva. Ten seconds, no more. Not tap water — water kills the root cells. Never soap, never disinfectant, never a scrubbing brush or a cloth.
3. Put it back in the socket. This is the best storage medium there is, by a wide margin. Line it up the right way round — it goes in the way it came out — and push it gently but firmly until it is level with its neighbours. Then bite on a clean cloth or a piece of gauze to hold it there.
It will feel wrong. Do it anyway.
4. If you cannot put it back — and many people cannot — keep it wet. In order of preference:
- Milk. Any milk, from any fridge. It is close to the right chemistry for the root cells and it is nearly always available.
- Saline, or a proper tooth-preservation solution if a first-aid kit has one.
- Inside the patient's own cheek, held between cheek and gum. Only for someone old enough not to swallow it.
- Not water. Not a dry tissue. Not kitchen roll. These are the two most common mistakes, and they are the ones that lose the tooth.
5. Get to a dentist immediately. Call ahead so we can be ready.
Why thirty minutes
The cells on the root surface begin to die within minutes of drying out. Re-implanted quickly, they can re-attach the tooth to the bone and it can last for decades.
Under 30 minutes: a genuinely good chance. Under 60 minutes, kept moist: still worth doing. Several hours, kept dry: the tooth can sometimes still be replaced, but the odds fall sharply.
Come in regardless. Even a tooth with a poor prognosis is often worth re-implanting in a child or teenager, because it preserves the bone while a long-term plan is made — and in a growing jaw, an implant cannot be placed for years.
If it is a child's baby tooth
Do not put it back. Re-implanting a baby tooth can damage the adult tooth developing in the bone above it.
Still call us. The socket needs to be looked at, and the adult tooth underneath needs to be checked.
If you are not sure whether it is a baby tooth or an adult tooth — bring it, and bring the child, and we will tell you.
After it is back in
Expect the tooth to be splinted to its neighbours for a couple of weeks while the ligament reattaches.
Expect it to need a [root canal](/root-canal-bridgeport). In an adult, the nerve inside a knocked-out tooth almost always dies, and treating it before it becomes infected is what keeps the tooth. That is not a complication; it is part of the plan.
Expect it to be watched for years. Re-implanted teeth can slowly resorb, and the tooth may darken. Both are manageable, and both are far better than a gap.
What not to do
- Do not scrub the root. This is the single most damaging thing, and it is the instinct almost everyone has.
- Do not store it in water.
- Do not wrap it in a dry tissue and drive around with it in the cup holder.
- Do not wait to see whether it settles down. There is no version of this that improves with time.
- Do not go home and call in the morning.
Prevention, since it is nearly always avoidable
NEEDS SIGN-OFF K-18 Claims about the practice — Custom mouthguards / night guards from a scan. Approve as written, or give the correction.
Most knocked-out teeth in this city come from sport, and most of those come from sports nobody thinks of as dangerous — basketball above all, because elbows are at exactly face height.
A custom mouthguard is scanned in ninety seconds and it costs a small fraction of one crown. A knocked-out adult front tooth on a fourteen-year-old is a five-figure lifetime cost: root canal, crown, and eventually an implant that cannot even be placed until the jaw has finished growing.
If your child plays anything, get the guard.
Questions people ask
The tooth is broken as well as knocked out. Still bring it?
Yes. Bring every piece.
It has been three hours. Is there any point?
Call. Yes, often — particularly in a child.
Should I take a painkiller?
Yes, one you normally tolerate. Do not put aspirin against the gum; it burns the tissue.
We are closed — Wednesday, Saturday or Sunday?
Call (203) 372-0881 anyway. This is exactly the situation the message is for, and it is worth seeking an urgent dental clinic rather than waiting for the next open day.
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Call (203) 372-0881 now. Emergency dentistry in Bridgeport.
Educational, not a diagnosis. If there is facial swelling with fever, or difficulty breathing or swallowing, or a serious head injury — go to a hospital emergency room.
