Your first task is to find the tooth! In many cases, a permanent tooth that is knocked out (avulsed) can be replanted back in the same space. In many cases where parents think a tooth has been knocked out, it was actually pushed up or intruded into gums. Ideally, gently rinse the debris off the tooth and try to put the tooth back in the space. Have your child gently bite down on a cloth to help it stay in place.

If that is not an option, store the tooth in some type of solution. Milk is the best alternative, however, if that is not available, saliva or water will also work. It is important to keep the tooth moist and tissue fibers in place, so no washing, scrubbing or drying the tooth. Call your dentist—this is a true dental emergency! Time is of the essence and the quicker the tooth can be replanted, the greater the chances are for success in maintaining the tooth. The best chance for success is if the tooth is replanted within 60 minutes.

If the knocked-out tooth is a primary tooth DO NOT try to put the tooth back into the space. Call your dentist and take the tooth to the appointment. The actual tooth gives us good information about the injury. It can tell us if the entire tooth came out or if some of the roots is still in the space. If bone fragments are attached to the tooth, there may be more fractured bone around the adjacent teeth. The permanent teeth are growing and developing right above the roots of the baby teeth. So trying to put the tooth back in the space can damage or move the permanent tooth bud. A “kiddy denture”, like the ones seen in child pageants on television, can be safely worn until the permanent tooth comes in.