Emergency Care
Knocked Out Tooth in Canberra: What to Do in the First 30 Minutes
Hold it by the crown, put it in milk, and call us on the way. Read the first section, then move.
A knocked-out adult tooth is one of the few dental situations where the next half hour genuinely decides the outcome. At Dental Embassy in Braddon these are seen urgently. This page tells you exactly what to do right now, and what not to do.
First 30 minutes count
Act, then call on the way
Hold the crown only
Never touch the root
Milk, not water
Saliva if no milk available
Baby teeth are different
Do not replant them
If a permanent tooth has just been knocked out, do these four things before reading anything else on this page.
One. Pick the tooth up by the crown, the white part you normally see. Do not touch the root. Two. If it is dirty, rinse it briefly in milk or saline. Never scrub it, and do not hold it under a running tap. Three. Put it straight back into the socket if you can, facing the right way, and bite gently on a clean cloth to hold it. If you cannot, put it in a container of cold milk. Four. Call 1300 000 230 and come in. Ring on the way rather than before you have dealt with the tooth.
Do not put it back if it is a child's baby tooth. That single exception is explained further down and it matters.
Why the Root Surface Is Everything
A tooth is not cemented into bone. It is suspended by the periodontal ligament, a thin layer of living cells covering the root that attaches it to the socket. When a tooth is knocked out, some of those cells stay on the root.
If they survive, the tooth can reattach. If they die, the body treats the root as foreign material and gradually resorbs it, which is why some replanted teeth are lost months or years later despite an apparently good start.
Everything in the first-aid list follows from that one fact. Handling the root crushes the cells. Scrubbing removes them. Drying kills them within minutes. Tap water kills them too, because it is not the right salt concentration for cells to survive in.
Storage, Ranked
Back in the socket is best by a wide margin. The socket has the right temperature, moisture and chemistry, and every minute the tooth spends there is a minute it is not deteriorating. If you can manage it, do it, even if the position is not perfect.
Cold milk is the best practical alternative and the reason this advice is worth remembering: milk is in most fridges and every service station. Its composition is close enough to keep ligament cells viable far longer than water does.
Saliva is next. Holding the tooth inside the cheek works for an adult or an older child, though not for a young child who might swallow it. Spitting into a container and putting the tooth in that also works.
Water is a last resort and a poor one. Dry is worst. A tooth carried dry in a tissue for an hour has a poor outlook, and this is the most common way a savable tooth is lost.
Baby Teeth: Do Not Put It Back
This reverses the main advice on this page, which is exactly why it gets its own section.
A knocked-out baby tooth should not be replanted. The permanent tooth is developing in the bone directly above it, and pushing the baby tooth back risks damaging that developing tooth, which is a far worse long-term outcome than an early gap.
Instead, control the bleeding with gentle pressure on clean gauze, keep your child calm, and bring them in promptly so we can check for other damage and make sure no fragment has been left behind. Our children's dentistry page and the guide on knocked-out or broken baby teeth cover this in more detail.
If you are not sure whether the tooth is a baby tooth or an adult one, put it in milk and bring it with you. Milk harms nothing.
Loosened, Pushed In or Pushed Out
Not all trauma knocks a tooth clean out. A tooth can be loosened, driven further into the bone, or pushed out of line, and all three need prompt attention even though the tooth is still there.
Do not try to reposition it yourself. Displaced teeth are repositioned and then splinted to the neighbouring teeth for a period of healing, and forcing one back by hand can worsen damage to the root and the bone. Avoid biting on it, keep to soft food, and get seen the same day.
Cracks and fractures that do not displace the tooth are covered on our broken tooth repair page, and general same-day care on emergency dentistry.
What Happens When You Arrive
If the tooth is already back in the socket, we check the position, then splint it to the neighbouring teeth so it is held still while the ligament heals. If you have brought it in milk, we assess how long it has been out and how it was stored, then clean and replant it where that is appropriate.
We x-ray to check for fractures of the root or the surrounding bone, and to make sure no fragment has been left in the soft tissue. Most replanted teeth need root canal treatment at some point, because the nerve rarely survives being severed, and that is planned rather than rushed.
Then it is follow-up. Replanted teeth are monitored over months to check the ligament is reattaching and the root is not resorbing. We will be straight with you about the prognosis rather than optimistic, and if the tooth is ultimately lost, an implant or bridge is still available.
Sport, and Getting Seen
Most avulsed adult teeth we see come from sport and from falls. A properly fitted mouthguard is worth the cost if you or your kids play contact sport, and a custom one from us fits better and stays in better than a boil-and-bite from a chemist.
We are open Monday to Friday from 7:30am and Saturday from 9am, at Shop 7/104 Northbourne Avenue in Braddon, which is a short trip from the city, Turner, Dickson and Ainslie. Call 1300 000 230 on your way rather than waiting until you arrive, so we are ready for you. If there was a blow to the head with loss of consciousness, confusion or vomiting, go to the emergency department first: the tooth can wait for the head injury, not the other way round.
Common Questions
Frequently Asked Questions
The first 30 minutes matter most, and the odds fall steadily after that. A tooth replanted within about an hour has a reasonable chance; beyond a couple of hours dry, the chance is poor. That is why the priority is getting the tooth back into the socket or into milk immediately, and calling us on the way rather than after you have sorted everything else out.
The crown, which is the white part you normally see. Never touch the root. The root surface carries the periodontal ligament cells that allow the tooth to reattach, and wiping, scrubbing or handling them destroys exactly what you are trying to save.
Only if it is visibly dirty, only briefly, and only in milk or saline. Never scrub it, never use soap or disinfectant, and never rinse under a running tap for any length of time. Tap water is not the right environment for the ligament cells and kills them faster than milk does.
That is common, and it is fine. Put the tooth in a container of cold milk, which is the most effective storage medium easily found in a fridge or a service station. Saliva is next best: hold it in the mouth between the cheek and gum if the person is old enough not to swallow it. Do not store it in water, and do not let it dry out.
No, and this is an important difference. A knocked-out baby tooth should NOT be put back, because replanting it risks damaging the permanent tooth developing above it. Control the bleeding, keep the child calm and see a dentist promptly, but leave the tooth out. Our page on children covers this, and the same rule does not apply to adult teeth.
Do not force it back into place yourself. A tooth that is displaced or partly out still needs repositioning and splinting, and doing it badly can worsen the damage. Avoid biting on it, take an anti-inflammatory if you can safely, and get seen the same day. These have a good prognosis when handled promptly.
No, and it would be dishonest to promise otherwise. Even a well-managed replanted tooth may eventually need root canal treatment, and some are lost to root resorption months or years later. What good first aid does is give the tooth its best chance and buy time. If it is ultimately lost, an implant or bridge remains available.
If the injury involved contact with soil or a dirty surface, or there are cuts to the lips and gums, and your tetanus cover is not up to date, that is worth raising with your doctor. It is also worth mentioning any blow to the head, loss of consciousness, nausea or confusion, which need medical assessment regardless of the tooth.
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