An adult tooth that has been knocked completely out is one of the few dental situations where the next thirty minutes genuinely change the outcome. The ligament cells on the root surface stay viable for a short window, and almost everything that improves the odds happens before you reach a dentist.
This is worth reading before you need it.
The first sixty seconds
- Find the tooth. Handle it by the crown, the white part you normally see. Do not touch the root.
- Do not scrub it. If it is dirty, rinse it briefly in milk, saline or the person’s own saliva. Water for no more than ten seconds if nothing else is available. Do not use soap, disinfectant or a cloth, and do not scrape anything off the root.
- Put it back if you can. For an adult tooth, gently reposition it in the socket the right way round and have the person bite softly on a clean cloth or gauze to hold it. This is the single most effective thing you can do.
- If you cannot reposition it, keep it wet. Milk is the most suitable commonly available storage medium. The person’s own saliva, held in the cheek for an older child or adult who is fully alert, also works. Plain water is the last resort because it damages the root cells.
- Call a dentist immediately. Say that an adult tooth has been avulsed and when it happened. That phrasing tells the practice to prioritise the call.
What not to do
- Do not store the tooth dry, in a tissue, or in a pocket. A dry root is the most common reason a re-implantation fails.
- Do not scrub, sterilise or dry the root surface.
- Do not re-implant a baby tooth. Pushing a primary tooth back into the socket can damage the adult tooth developing underneath it. Keep the child comfortable and see a dentist, but leave the tooth out.
- Do not delay because the tooth is back in place and feels settled. It still needs splinting and review.
Why time matters so much
The root of a tooth is covered in periodontal ligament cells. When the tooth is re-implanted, those cells are what allow it to reattach to the bone. They begin to die once the tooth is out of the socket, and they die much faster in a dry environment than a wet one. A tooth replanted within the first fifteen minutes has a considerably better outlook than one replanted after an hour, and a tooth stored dry for an hour has a poor one. Milk slows the process because its osmolality and pH are closer to what those cells need.
What happens at the practice
The dentist will confirm the tooth is correctly positioned, usually with an x-ray, and check for a fractured socket wall or other injuries. The tooth is then splinted to the neighbouring teeth for a period, typically a couple of weeks, so it can stabilise. Root canal treatment is usually needed afterwards, because the nerve supply is severed when the tooth comes out. You will also be asked about tetanus cover if the injury happened outdoors.
After that, the tooth is reviewed over months rather than weeks, because complications such as root resorption can appear late.
Other dental injuries worth knowing
Not every knock loosens a tooth completely. A tooth that is pushed out of position, loosened, or driven up into the bone still needs same-day attention, because repositioning is easier before the tissues settle. A tooth that is simply chipped is usually less urgent, though it depends on how deep the fracture runs. We cover that distinction in more detail in telling an urgent chipped tooth from a routine one.
If there is a head injury, loss of consciousness, a suspected jaw fracture or bleeding that will not stop, that is a hospital matter first. In Canberra, the emergency department at Canberra Hospital in Garran is the appropriate place to go.
Keeping an emergency plan
Sports are the most common cause of avulsed teeth in adults and older children. A custom-fitted mouthguard is the practical preventive measure, and it is worth arranging before a season starts rather than after an incident. If your household plays contact sport, it is also worth keeping our number saved and knowing that milk in the fridge is your storage medium.
What emergency treatment costs
An emergency appointment at Civic Gentle Dental Care starts from $70 to $110 for the examination, with x-rays at $52 each as needed. Treatment costs depend on what the injury requires and are quoted before anything proceeds. Full details are on our price list, and you can read more about emergency dental appointments in Canberra.
Common questions
The tooth has been out for two hours. Is it worth bringing in?
Yes. The outlook is less favourable, but the decision about whether to attempt re-implantation is a clinical one, and there are other injuries to assess regardless. Keep the tooth in milk and come in.
Can I put the tooth in water?
Only if there is genuinely nothing else, and only briefly. Plain water is hypotonic and causes the root cells to swell and burst. Milk is much better.
My child knocked out a baby tooth. What now?
Do not re-implant it. Control any bleeding with gentle pressure on clean gauze and arrange a dental appointment so the socket and the developing adult tooth can be checked.
Will the tooth need root canal treatment?
For a fully formed adult tooth, almost always. The blood and nerve supply is severed when the tooth is avulsed, so the pulp does not survive even when the tooth reattaches successfully.
Booking an appointment in Canberra City
Civic Gentle Dental Care is at Suite 8, Level 3/161 London Circuit, Canberra City, a short walk from the Canberra Centre. To arrange an appointment, call (02) 6247 0224 or send us a message through our contact page.
This article is general information only and is not a substitute for individual dental advice. Whether a treatment is suitable for you, and what it will involve, can only be determined after an examination by a dentist. Any prices mentioned are estimates drawn from our current price guide and are not a quote.