If a permanent tooth (one that grew in after the baby teeth) is knocked out whole, hold it by the crown and rinse it briefly, put it back if you can, and if you can't, soak it in milk and see a dentist right away; don't put a baby tooth back

In a real emergency, call 911 first, then read this.

Cost

Free. Milk and saline are available at home or at a convenience store; the dentist's fee is separate. The hard part is daring to push the fallen tooth back into the socket yourself, and telling on the spot whether it is a baby tooth or a permanent tooth.

What you get

The NHS dental trauma page says: hold the tooth by the crown, the white part that shows above the gum, and don't touch the root. If the tooth is dirty, rinse it gently with milk, saline or saliva. Try to put it back into its original socket. If it goes in, bite gently on a clean cloth to hold it in place and see a dentist as soon as possible. If it can't be put back, soak it in milk or saliva. Don't put a baby tooth back, since it can damage the permanent tooth growing underneath. If a tooth is knocked out and can't be found, still book an emergency dental appointment. The steps on the International Association of Dental Traumatology's "Save Your Tooth" poster are the same: find the tooth, hold the crown, plug the sink and rinse briefly with cold tap water. Then choose one of three: put it back in place, or put it in a glass of milk or saline, or hold it between the cheek and gum. Finally go to a dentist right away. The dental trauma database of the University Hospital of Copenhagen in Denmark picked 145 permanent teeth in 116 people that were replanted after being knocked out, and followed them for 7 months to 23 years. It looked at the risk of the root fusing with the alveolar bone (ankylosis), after which the root is slowly resorbed. For teeth replanted on the spot it was 17.2%, for teeth soaked in saliva or saline before replanting 55.3%, and for teeth left dry for 1 hour or more 85.7%. The same hospital had earlier followed a batch of 400 teeth, reanalyzed in 2020. For teeth of children whose roots were not yet fully formed, the ankylosis risk was 33.9% with under 20 minutes dry and 60.0% with over 60 minutes. For teeth with fully formed roots, it rose from 59.4% to 86.4%. Both groups' figures are estimates at 900 days after replantation. The 1995 study of these 400 teeth also found that teeth soaked in tap water for more than 20 minutes mostly developed root resorption. During follow-up, 30% of these 400 teeth were eventually extracted

Notes

Graded B because the figures come from a single hospital's study that only followed and recorded cases, with no assigned groups. The size of the benefit is set at medium by judgment: what is saved is the tooth, not life, and the outcome looked at is root fusion, not the tooth falling out directly. The researchers also say that a share of teeth left dry for an hour or more still did not fuse, so don't throw the tooth away even if it is late; take it to the dentist all the same. Tap water is only for a quick rinse; don't carry the tooth soaking in water. The beneficiaries are mainly your own children, and adults who bump their mouth falling, playing ball or riding a bike are in the same position. The NHS says a tooth that can't be saved can be covered first by a removable denture, and after the area heals a bridge or implant can be considered. For how to ask about the cost of implants, see §24.12 (before getting an implant, ask for the all-inclusive price).

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. NHS. Knocked-out tooth（2025-02-06 审核）：「Hold the tooth by the white bit that sticks out of the gum (the crown) – do not touch the root」「If the tooth is dirty, rinse it gently in milk, saline or saliva」「Do not put a baby tooth back in as it could damage the tooth growing underneath」「If you cannot put the tooth back in, you can put it in either milk or saliva」. https://www.nhs.uk/conditions/knocked-out-tooth/
2. International Association of Dental Traumatology. Save your tooth（海报）. https://iadt-dentaltrauma.org/guidelines-and-resources/save-a-tooth-poster/
3. Gul A 等 (2024). Risk of ankylosis of avulsed teeth immediately replanted or stored under favorable storage conditions before replantation: A long-term clinical study. Dental Traumatology. https://doi.org/10.1111/edt.12898
4. Lauridsen E 等 (2020). Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage: A re-evaluation of a long-term clinical study. Dental Traumatology. https://doi.org/10.1111/edt.12520
5. Andreasen JO 等 (1995). Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications. Endodontics & Dental Traumatology. https://doi.org/10.1111/j.1600-9657.1995.tb00461.x
6. Andreasen JO 等 (1995). Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Endodontics & Dental Traumatology. https://doi.org/10.1111/j.1600-9657.1995.tb00464.x

Translated from the Chinese original. Original book, section 13, tip 48. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer