If your tooth gets knocked out, you have about 30 minutes to get it back in place for the best chance of saving it. A tooth replanted within that window has roughly a 90% survival rate. After 90 minutes outside the mouth, that drops to just 7%. Every minute counts, so here’s exactly what to do.
Pick Up the Tooth Correctly
Find the tooth and pick it up by the crown, which is the white part you normally see when you smile. Never touch the root. The root is covered in tiny living cells called periodontal ligament cells, and they’re what allow the tooth to reattach to your jawbone. Handling, scrubbing, or drying the root destroys those cells and dramatically lowers your chances of saving the tooth.
If the tooth is dirty, gently rinse it with milk or clean water for no more than 10 seconds. Don’t use soap, don’t wrap it in tissue, and don’t scrub it.
Try to Put It Back In
The single best thing you can do is push the tooth back into its socket yourself. Hold it by the crown, position it facing the right way, and press it in gently with your fingers. Then bite down on a clean cloth or gauze to hold it in place. This feels counterintuitive, and it might hurt, but the socket is the ideal environment for keeping those root cells alive.
If you can’t get it back in (because of pain, swelling, or the tooth won’t seat properly), you need to store it in something that keeps the root cells alive until you reach a dentist.
How to Store the Tooth if You Can’t Replant It
Your storage options, ranked from best to worst:
- Tooth preservation kit (sold as “Save-A-Tooth” or similar): These contain a balanced salt solution specifically designed to keep root cells alive. It’s the gold standard for cell survival and significantly outperforms every other option. If your household is active in contact sports, keeping one of these in your first aid kit is worthwhile.
- Cold milk: Whole milk works well as a short-term option. It won’t nourish the cells long-term, but it keeps them viable for 30 to 60 minutes, which is usually enough time to get to a dentist. This is the most practical choice for most people because it’s almost always available.
- Saliva: If there’s no milk around, place the tooth between your cheek and gum, or have the injured person spit into a clean cup and drop the tooth in. Saliva isn’t ideal, but it’s far better than letting the tooth dry out.
- Saline: Contact lens saline solution works in a pinch but only for a very short period. It lacks the nutrients cells need to survive.
Do not store the tooth in tap water. The difference in salt concentration between water and your cells causes the root cells to swell and burst. Don’t wrap it in a napkin or paper towel either, as the tooth will dry out within minutes.
Get to a Dentist Immediately
Call your dentist or head to an emergency dental clinic right away. If neither is available, go to an emergency room. The success rate tells the whole story: 90% when replanted within 30 minutes, 43% between 30 and 90 minutes, and just 7% after 90 minutes. Even if you’re past that 90-minute window, bring the tooth. Dentists can sometimes still replant it, though the long-term outlook changes.
While you’re on the way, control bleeding by biting down on clean gauze or a damp tea bag placed over the empty socket. You can take an over-the-counter pain reliever, but avoid aspirin, which can increase bleeding.
What Happens at the Dentist
The dentist will clean the socket, reposition the tooth, and secure it to the neighboring teeth with a flexible splint, which is a small wire or composite strip bonded across several teeth. This splint typically stays in place for about two weeks to let the root reattach.
You’ll likely be prescribed antibiotics to prevent infection during that first week of healing. Your dentist may also ask whether your tetanus vaccination is current, especially if the tooth hit the ground or was contaminated with soil. A root canal is often needed within the first couple of weeks, because the nerve and blood supply inside the tooth rarely survive the trauma of being knocked out.
Recovery and What to Eat
For the first several days after replantation, stick to soft foods: yogurt, scrambled eggs, pasta, mashed potatoes, smoothies, fish, and cooked vegetables. Avoid anything crunchy, hard, or sharp-edged like chips, toast, raw carrots, nuts, and popcorn for at least the first week. Don’t bite into anything with the replanted tooth for several weeks.
On the day of the procedure, don’t rinse your mouth vigorously or spit forcefully, as this can dislodge the clot forming in the area. Starting the next day, rinse gently with warm salt water (one teaspoon of salt in a glass of warm water) four times a day, especially after meals. Brush the rest of your teeth normally, but use a soft-bristle brush and be very gentle around the injured area.
Long-Term Complications to Watch For
Even a successfully replanted tooth needs monitoring for years. The two most common complications are root resorption and ankylosis.
Root resorption happens when the body’s inflammatory response starts breaking down the root from the outside. Mild surface resorption is normal in the first weeks of healing and often resolves on its own, particularly if the nerve inside the tooth is still alive. But when it becomes progressive, the root gradually dissolves and the tooth loosens. This is often caught on follow-up X-rays before you notice any symptoms, which is why regular dental visits after the injury matter.
Ankylosis occurs when the root fuses directly to the jawbone instead of maintaining the thin cushion of ligament that normally surrounds it. You might notice the tooth makes a different, more metallic sound when tapped compared to neighboring teeth, or that it stops having any natural give when you press on it. Over time, an ankylosed tooth can appear to sink below the level of surrounding teeth because it no longer moves with normal jaw growth and tooth shifting. In children and teens, this is a particular concern because the jaw is still growing.
Baby Teeth Are Different
If a child’s baby tooth gets knocked out, do not try to replant it. The developing permanent tooth sits directly beneath the baby tooth root, and pushing a baby tooth back into the socket risks damaging that permanent tooth bud. Replanted baby teeth also tend to fuse to the bone, which can block the permanent tooth from coming in normally and cause cosmetic problems as the jaw grows.
Save the tooth if you can find it (so the dentist can confirm the whole thing came out), control the bleeding with gauze, and see a pediatric dentist promptly. The priority shifts from saving the knocked-out tooth to protecting the permanent one developing underneath.