The first 30 minutes after a tooth is knocked out are the difference between saving it and losing it. We treat avulsion injuries every week at Emergency Dentist Scarsdale, and the patients who get the best outcomes are the ones who follow a small handful of rules.
This is the protocol — written in the order you actually need it.
1. Pick the tooth up by the crown
The crown is the white part you normally see in the mirror. The root is the yellowish part that was inside your gum. Never touch or scrub the root. The cells on the root surface are what allow re-implantation; if they die, the tooth can't be saved.
2. Rinse — gently and briefly
If the tooth is dirty, rinse it for a couple of seconds with milk or saline. Plain water is a last resort because it damages root cells. Don't use soap, alcohol, peroxide, or a brush. Don't dry the tooth or wrap it in a paper towel.
3. Try to put it back
If you can, place the tooth back in its socket the right way around (the bumpy chewing surface up for a top tooth, down for a bottom tooth). Bite gently on a clean cloth to hold it. This is the best storage medium there is.
4. If you can't reinsert, use the right storage
In order of preference: an HBSS "Save-A-Tooth" kit (some pharmacies carry these), cold milk, saliva (tucked between cheek and gum if the patient is alert), or saline. Plain water only as a last resort.
5. Get to a dentist within 30–60 minutes
Re-implantation success drops sharply after the first hour. Book an appointment online on your way — we'll prepare a treatment room before you walk in.
What we do at the office
We examine the socket, take a digital X-ray to check for fractures of the surrounding bone, gently clean the tooth, and re-implant it. The tooth is splinted to neighbouring teeth for one to two weeks while the periodontal ligament heals. A root canal is usually completed within 7–14 days because the nerve does not survive being out of the socket.
Baby teeth
Don't try to re-implant a baby tooth — it can damage the developing permanent tooth underneath. Still bring your child in immediately so we can check the socket and rule out other injuries.
What NOT to do
- Don't scrub the tooth or use soap.
- Don't let it dry out — dried root cells can't be revived.
- Don't store it in tap water for more than a couple of minutes.
- Don't wrap it in tissue or paper towel.
If you're holding a knocked-out tooth right now, stop reading and book an appointment online. Time matters more than information.