Steps To Save a Knocked-Out Tooth

Wearing a custom-fitted mouthguard while participating in contact sports will help protect against painful and potentially expensive dental injuries. However, if an accident does occur remain calm and act quickly. The following steps should be taken immediately:


  • Do not touch the root of the tooth. Handle the tooth by the crown only.
  • Rinse the tooth off in an milk if there is dirt covering it. Contact lens solution or even an isotonic sports drink can be used as an alternative. If the patient is calm and conscious, then you can ask the patient to suck the tooth clean if there isn’t anything available to rinse it with. As a very last resort, use water, but be very quick (1 second rinse) as water will cause the cells to die.
  • Attempt to reimplant the tooth as soon as possible into the socket with gentle pressure, and hold it in position. Aluminium foil can be used to hold the tooth in position, otherwise have the patient bite down gently on some tissue paper to hold it in place.
  • If unable to reimplant the tooth, place it in a protective transport solution, such as milk, or saline. This will hydrate and nourish the periodontal ligament cells which are still attached to the root. Do not store it in water.
  • The tooth should not be wrapped in tissue or cloth as this will dry out the cells on the roots.
  • Take the patient to a dentist or hospital emergency room for evaluation and treatment

Remember, time is critical to prevent permanent damage.

Extreme care should be taken with a tooth that has been knocked out. Avoid the following:

  • Do not handle the root of the tooth.
  • Do not scrape or rub the surface of the tooth.
  • Do not let the tooth dry out – keep it moist at all times.
  • Do not put the tooth in hot water or ice.
  • Avoid rinsing or storing the tooth in water for more than one or two seconds.
  • Do not remove any soft tissue fragments from the tooth.

Broken or Fractured Teeth

Teeth are remarkably strong, but they can chip, crack (fracture) or break. This can happen in several ways:

  • Biting down on something hard
  • Being hit in the face or mouth
  • Falling
  • Having cavities that weaken the tooth

When a tooth chips or breaks, it may not hurt and you may not even notice the damage right away. Minor tooth fractures usually don’t cause pain, but if a large piece of the tooth breaks off, it can hurt. That’s because the nerve inside the tooth may be damaged, and if it is exposed to air, saliva, or hot or cold foods or drinks, it can be extremely uncomfortable.
Pain from a broken or cracked tooth may be constant or may come and go. Many people feel pain when they chew because chewing puts pressure on the tooth.

Cracked (Fractured) Teeth
There is no way to treat a cracked tooth at home. You need to see your dentist. Sometimes a tooth hurts only when you eat or when the temperature in your mouth changes (because you drank something hot or cold, for example.) If your tooth hurts all the time or you get pain that wakes you up at night, it may have a damaged nerve or blood vessels. This is a serious warning sign.

Broken Teeth
If you have a broken tooth, come in and see us as soon as possible. We can help to figure out how severe the break is, if it was caused by cavities, and if the tooth’s nerve is in danger. Adults with a damaged nerve usually will require root canal treatment. In children, sometimes the damaged nerve can be saved if the dentist is able to treat the problem right away.

Please remember to:

  • Save the pieces. We may be able to cement the tooth back together.
  • Rinse your mouth well with warm water. If you saved the pieces of the tooth, rinse them well.
  • Put gauze on any bleeding areas for about 10 minutes or until the bleeding stops.
  • Apply a cold pack to the cheek or lips over the broken tooth. This will help reduce swelling and relieve pain.
  • Take an over-the-counter pain reliever such as Panadol or Ibuprofen as directed.

Problems with Braces

Braces, bands or wires sometimes break or fall off. More often, one of the parts will come loose. This can cause some discomfort. Here are a few possible problems:

  • Loose braces — The braces (also called brackets) are the metal or ceramic pieces that are glued to your teeth. They’re usually attached using a material called composite resin. It is similar to the tooth-colored material used for some fillings. If you chew something hard or sticky, the resin can weaken or break. When that happens, a bracket can come loose. It may poke into your gums, tongue or cheek. When you first get your braces, your orthodontist will give you a special wax. You can put the wax over the bracket to keep it from poking you. This should provide some comfort until you can see your orthodontist.
  • Loose band — Bands are the metal rings that are cemented around back teeth (and sometimes around front teeth). If a band becomes loose, call for an appointment to have it re-cemented or replaced. If the band comes off completely, do not try to put it back on. Save it and bring it to your appointment.
  • Protruding or broken wire — This is a common problem. If a wire breaks or sticks out, it can hurt your cheek, tongue or gum. You can use the eraser end of a pencil to push the wire into a better position. If that doesn’t work, put a small piece of orthodontic wax over the end of the wire. Do not cut the wire. A cut wire can be accidentally swallowed or inhaled. If the wire has caused a sore, rinse your mouth with warm salt water or an antiseptic rinse. This will keep the area clean and reduce discomfort. You can also use an over-the-counter pain reliever if required. This will temporarily numb the area. If the pain doesn’t get better or the sore seems to be getting worse, call your orthodontist.
  • Loose spacer — Spacers or separators are rubber rings that are put between your teeth. They are left in place usually for a few days. They open a small space between your teeth so that orthodontic bands will slip onto your teeth easily. Sometimes springs or brass wire is used for this purpose. Sometimes, spacers can slip out of position or fall out. If this happens, make an appointment with your orthodontist to have them replaced.