Can a knocked-out tooth be put back in?

With a permanent tooth it is usually attempted. Two things decide the outcome: how long the tooth spent out of the mouth, and whether it spent that time dry or in a suitable liquid. A tooth brought in quickly and in a suitable medium such as milk has a better chance of taking hold. It cannot be said that this will work in every case, and even if the tooth does take hold it needs long-term follow-up. Replanting is not done with baby teeth.

What should I bring the tooth in?

Milk, saline or your own saliva are suitable; carrying the tooth inside your cheek also works, although this route is not chosen for young children because of the risk of swallowing it. Tap water is not suitable, as it damages the cells on the root surface. Wrapping the tooth in a dry tissue or a plastic bag does the same. Bring any broken-off piece in wet in the same way.

The tooth is broken but it does not hurt, should I still hurry?

It would be sensible to hurry. A lack of pain does not show that the damage is only on the surface; a tooth nerve shaken by a blow can fail to respond in the first few days. A broken surface leaves an exposed tooth nerve open to bacteria, and in some cases the piece that snapped off can be bonded back on. On top of that, whether the root or the surrounding bone was affected by the same blow can only be worked out with an examination and X-rays.

Tooth knocked out or broken: what to do

What does this mean?

A tooth is not stuck straight onto the bone; it hangs in its socket by a thin layer of ligament that wraps around the root. When a tooth comes out completely, the cells of that layer stay alive on the root for a while. Once they dry out they die, and the chance of a replanted tooth taking hold drops. This is why how you hold the tooth and what you keep it in come before everything else you do here.

What separates this from teeth that wear down over time or chip away bit by bit is that it happens suddenly and once. Three situations that take different paths sit under the same heading: the tooth coming right out of its socket, the tooth breaking and a piece snapping off, and the tooth being knocked loose or pushed up into the gum without breaking. With a break, what matters is how deep it goes; if you can see a pink spot or bleeding in the middle of the broken surface, the tooth nerve has been reached.

Age changes the path too. A baby tooth that has been knocked out is not put back; there is a risk of harming the permanent tooth developing underneath it. With a permanent tooth, putting it back is usually attempted. If you look for the tooth or the broken piece and cannot find it, that is information in itself: the piece may have been swallowed, gone into the airway or become buried inside the lip.

The cause of this symptom is usually obvious: a blow, a fall or biting on something hard. The real question is how far the blow reached. The headings below show what your dentist looks at when assessing the bone, the gum and the neighbouring teeth alongside the tooth itself.

Likely causes

Cracked Tooth Syndrome Dental trauma (a broken, knocked-out or loosened tooth)

What helps at home?

Hold the tooth only by the crown, the part that shows in the mouth; do not touch, rub or brush the surface of the root.
If soil or sand has got on it, rinse the tooth gently for a few seconds with milk or saline; do not leave it sitting in tap water and do not wrap it in a tissue and let it dry out.
If it is a permanent tooth and you are able to, ease it back into its own socket and bite on a clean cloth; if you cannot, carry it in a container of milk or in your own saliva inside your cheek. Do not throw the broken piece away either, bring it in the same way.
Put something cold on the outside of the cheek for swelling and do not chew on that side; do not be reassured by a lack of pain, as a tooth that has been knocked loose may not hurt on the first day.

When not to wait

If there was loss of consciousness, vomiting, dizziness or no memory of what happened after the blow, go to hospital first
If the bleeding does not stop within twenty minutes despite pressure
If your jaw does not close properly, or your lip and chin feel numb
If the tooth or the broken piece cannot be found
If the tooth has been driven up into the gum instead of coming out

Frequently asked questions

Can a knocked-out tooth be put back in?: With a permanent tooth it is usually attempted. Two things decide the outcome: how long the tooth spent out of the mouth, and whether it spent that time dry or in a suitable liquid. A tooth brought in quickly and in a suitable medium such as milk has a better chance of taking hold. It cannot be said that this will work in every case, and even if the tooth does take hold it needs long-term follow-up. Replanting is not done with baby teeth.
What should I bring the tooth in?: Milk, saline or your own saliva are suitable; carrying the tooth inside your cheek also works, although this route is not chosen for young children because of the risk of swallowing it. Tap water is not suitable, as it damages the cells on the root surface. Wrapping the tooth in a dry tissue or a plastic bag does the same. Bring any broken-off piece in wet in the same way.
The tooth is broken but it does not hurt, should I still hurry?: It would be sensible to hurry. A lack of pain does not show that the damage is only on the surface; a tooth nerve shaken by a blow can fail to respond in the first few days. A broken surface leaves an exposed tooth nerve open to bacteria, and in some cases the piece that snapped off can be bonded back on. On top of that, whether the root or the surrounding bone was affected by the same blow can only be worked out with an examination and X-rays.

This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.

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