What Patients Should Do After Tooth Gets Knocked Out
If a tooth has been completely knocked out, forget the intro and proceed to the steps first. You can come back to the details later.
At South Pasadena Dental in South Pasadena, our team acts quickly to help you find the right solution for missing teeth after a dental emergency like a knocked-out tooth. We provide immediate guidance and personalized treatment options to protect your oral health and restore your smile.
This guide covers two different situations: a tooth that’s fully out of the mouth and a tooth that’s been knocked loose but is still partly attached. The response window and treatment approach are different for each, so identifying the injury correctly matters.
We see these situations all the time at South Pasadena Dental. A child gets hit in the face during basketball practice in South Pasadena, CA or gets hit in the mouth during a soccer game, and suddenly someone is standing there holding a tooth with no idea what to do next. In cases like these, the first 30 minutes can make the difference between saving the tooth and losing it.
The Critical Difference Between a Knocked-Out and a Dislodged Tooth
A knocked-out tooth, known clinically as an avulsed tooth, has come completely out of the socket. The entire root is no longer connected to the surrounding tissue or bone. The supporting ligament fibers that normally hold the tooth in place have been separated from the socket, leaving the tooth fully detached.
A dislodged tooth, referred to as a luxated tooth, remains partially attached but has been forced out of its normal position. It may move forward or backward, shift sideways, or get pushed deeper into the gum. Sometimes the change is obvious, while other times the tooth simply feels unstable or misaligned when biting down. The tooth is still connected, but the structures supporting it have been injured.
Both situations require immediate dental care. A completely knocked-out tooth is the more urgent of the two because the living cells on the root surface start to deteriorate quickly once the tooth is exposed to air. A luxated or dislodged tooth still has some blood flow and tissue attachment, which provides a little more time for treatment, but the situation is still urgent.
Why the First 30 Minutes After a Tooth Is Knocked Out Determine Whether It Can Be Saved
The periodontal ligament cells covering the root are living tissue that must stay moist and protected to remain alive. As soon as the tooth comes out of the socket, those cells begin to break down. A dentist can successfully reimplant the tooth when enough of those cells are still healthy enough to reconnect to the surrounding bone. If the cells die off completely, the tooth may still appear undamaged, but the body can no longer properly reattach it.
According to the American Association of Endodontists, the highest success rates occur when a knocked-out tooth is replanted within five minutes. Keeping the tooth in milk or a tooth preservation product such as Save-A-Tooth can help protect the root cells and extend the amount of time the tooth remains viable. The chances of successful reattachment begin to decline significantly once a tooth has been out of the mouth for more than 30 minutes without proper storage. The chances of saving the tooth become low after about an hour and very unlikely after two hours even with treatment.
“The biggest mistake I see is a dry paper towel. People find the tooth, wrap it up carefully, and think they’ve done the right thing. But dry storage destroys the ligament cells in minutes. The tooth looks fine but there’s nothing left to work with biologically. Milk isn’t perfect but it’s almost always nearby and it keeps those cells alive long enough to matter.” — Dr. Arkady Tsibel
Immediate Steps to Take the Moment a Tooth Is Knocked Out or Dislodged
Hold the tooth by the crown, which is the white chewing surface. Avoid touching the root. The root is covered with delicate ligament cells that help the tooth reattach, and touching them can damage those cells.
Gently rinse the tooth with milk or saline solution for a few seconds if the tooth is dirty. Do not use tap water because it can harm the living cells on the root surface. Do not use soap, scrub the tooth, or let it dry out.
If possible, gently place the tooth back into the socket right away. It may sound intimidating, but the socket is the best environment for keeping the tooth alive. Make sure the tooth is facing the correct direction and carefully guide it into place using light, steady pressure. Do not force it. Once it is seated, bite down gently on a clean cloth or gauze to help keep it stable and seek emergency dental care right away.
If you are unable to put it back in place, immerse the tooth in a small container filled with milk. A Save-A-Tooth preservation kit from a pharmacy is even better if available. If neither option is available, hold the tooth inside the mouth between the cheek and gums to keep it moist with saliva. Do not use this method with children because the tooth could be accidentally swallowed.
If the tooth is still attached but has shifted out of place, do not try to reposition it yourself. Leave it as it is, apply gentle pressure to control any bleeding, and seek emergency dental care immediately.
| Situation | Do This | Don’t Do This |
|---|---|---|
| Tooth fully out | Hold by crown, reinsert or put in milk | Touch root, wrap dry, use tap water |
| Tooth still in socket but loose | Leave it, don’t reposition, apply pressure to bleeding | Wiggle it, test it, eat on that side |
| Tooth is dirty | Rinse gently with milk or saline | Scrub, use soap or chemicals |
| Can’t reinsert | Milk or Save-A-Tooth solution | Paper towel, dry container, leaving it dry |
How to Get Emergency Dental Care Fast When a Tooth Is Knocked Out
Call the dental office immediately once you’re ready to go. Early notice gives the team time to prepare for a time-sensitive injury like this. Be clear that the tooth has been completely knocked out and share approximately what time the accident happened.
Call South Pasadena Dental at (626) 788-9700 for any dental emergency. Give the details upfront to help our staff organize emergency care before you arrive.
If you cannot reach a dentist after hours, an emergency room may help with pain and temporary stabilization, but most are not equipped to reimplant a knocked-out tooth. Keep the tooth moist and continue trying to reach an emergency dentist.
Once you arrive at the dental office, the first step is taking an X-ray to evaluate the socket, root, and surrounding bone. The dentist will clean the tooth, place the tooth back into position, and attach it to nearby teeth with a temporary splint for about one to two weeks while healing occurs. A root canal is needed later in most cases because the nerve tissue inside the tooth often does not survive the injury, even when the tooth is successfully saved. That treatment is typically done at a separate follow-up visit.
For a luxated or dislodged tooth that has been pushed out of place but not completely knocked out, the dentist will examine the direction and severity of the movement. Some teeth can be repositioned and stabilized successfully, while others may have too much structural damage to be preserved.
Trusted by Patients Across the Community
“They are always making sure that I’m comfortable and happy with each visit. Parking always available in the back on a busy street is a big plus!”
— Joseph Esquivel
“I had an amazing experience at Dr. Sedghi’s dental practice. From the moment I walked in, the staff was warm, professional, and incredibly welcoming. The office was clean, modern, and well-organized, making me feel comfortable right away.”
Emergency Knocked-Out Tooth Care
If a tooth has been knocked out, call South Pasadena Dental at (626) 788-9700 immediately. Patients throughout Pasadena, San Marino, and Alhambra contact us when dental emergencies happen. Dr. Arkady Tsibel DDS and his team regularly treat urgent dental injuries like these.
How to Choose Between General Dentist and Oral Surgeon for Tooth Extractions | A Dentist’s Guide of Sudden Tooth Pain
