How to deal with a knocked out tooth

One of the amazing things about kids is that they have absolutely no fear. However, this fearlessness becomes distinctly less amazing when they courageously leap off something, land on their face and knock out a tooth! Not to worry, if this happens a knocked out tooth is a situation that a prepared parent can easily deal with by taking the following steps:

See a dentist as soon as possible

The most important thing for you to do is to take your child to see a dentist. Dentists can very often save teeth that have been knocked out, but their job becomes more and more difficult the longer you leave it before seeing them. Even if you can’t find the tooth, it’s still imperative that your child sees a dentist, as the tooth can sometimes be knocked back up into the gums. If your regular dentist isn’t open, or you don’t have one, then contact the Emergency Dental Service who offer a dentist emergency 24 hours service. For the best outcome you should see a dentist within one hour of the tooth being knocked out.

First Aid

If you are carrying out first aid you should make sure that you are wearing medical gloves to avoid transmission of any bacteria into your child's mouth. Then you need to follow these steps:
  • Control any bleeding, making sure that you position your child in such a way that any bleeding does not cause choking.
  • Try to find the tooth. If you find it, do not handle the tooth by the root. If it is dirty you can gently rinse it with water, but don’t use any antiseptic or soap as this may damage it.
  • If it is a permanent tooth then you can try to reinsert it, which is the best way to protect the root of the tooth and allow it to reattach. Do not reinsert the tooth if it is a primary, or baby, tooth.
  • If you are reinserting the tooth then gently get it into position in the socket, and press it into place with your thumb so that it is level with the crown of the adjacent tooth. Then get your child to bite down on a wad of gauze or similar to keep the tooth in place until you get to the dentist.

Preservation of the tooth

If you are unable to re-insert the tooth then you need to preserve it until you get to the dentist's office. Place the tooth in a small plastic bag with some milk, and place the bag in ice. If you don’t have any milk then you can wrap the tooth in a damp cloth, or you can keep it damp with your child's saliva. You can do this either by placing it in the child's mouth and asking them to hold it there (this is only recommended if they are over 12 years old in case they swallow it) or by asking them to spit into the cup with the tooth.

The reason that milk is used for tooth transport is that cells from the surface of the root won’t swell up and burst in milk as they do in water. Milk also helps to maintain the correct acid to alkali balance and allows the root cells to keep growing so that they don’t die off. Saliva has the same effect but to a lesser extent.

But it’s just a baby tooth, it would have come out anyway!

Even if it is a baby tooth it’s important that you visit the dentist. Baby teeth act as space maintainers for the adult teeth growing behind them. If a baby tooth is lost unexpectedly this can cause the adult teeth to come through in the wrong place, which in turn can cause crooked teeth and problems eating.