So you, or more likely a child, have had a tooth knocked out and you don’t know what to do.  Well time is critical in order to get the tooth back and have it stay.  However, first we need to be rule out more serious injuries.  If someone has sustained a head injury and passed out for any amount of time they must go to the ER first to rule out any serious brain injuries or bleeding.  If no one lost consciousness then the sooner you can get to a dentist the better.  The cells connecting a tooth to the bone will die after 2 hours outside of the body.

So if the tooth is knocked loose you can try to reposition it yourself.  This will be painful and may not be successful.  It’s much better to get to a dentist quickly without messing with the tooth too much. We can get the area numb and quickly get the tooth back into place.

If the tooth or teeth are completely knocked out then find the tooth or teeth, but be careful how you handle it.  Please avoid touching the root of the tooth (the part of the tooth that was embedded in the gums) because it is easily damaged.  Do not wipe any dirt or debris off of it; this will only do more damage.  Ensure it is an adult tooth; baby teeth should not be put back in for any reason.

Store a lost tooth or teeth in a either Pedialyte, saliva, or Hank’s Balanced Salt Solution.  Milk and saline solution also work as storage solutions but are not as good as the others.  I would prefer that if the tooth is from an adult/older child and none of the liquids above are available for storage, to place it between the cheek and gum and go to the dentist.  You can’t trust a young injured child to do this without possibly swallowing it so have them spit in a cup and store it there.  Some athletic team’s emergency kits have Hank’s Balanced Salt Solution to store a tooth in.  Also, within most crowds someone will have saline solution.

Knocked out tooth STEP by STEP

1. Rule out more serious head injury (if unconscious go to hospital)
2. Pick up tooth (or pieces) without touching root (pick up part of tooth you usually see in the mouth)
3. Do not bother trying to save a baby tooth.  We do not advise replacing baby teeth.
4. Store in HBSS>Pedialyte>Saliva-Milk-Cheek(if child old enough not be trusted not to swallow it)>Saline solution
5. Get it back in within 2 hours

So here is Ethan after a hockey accident; the ice never loses.

 Here he is right after Dr. Bryan Bauer repositioned it and Dr. Danielle Bauer (orthodontist) made a custom retaining wire for him.