Knocked-out or chipped tooth? What to do right away

If you can't put the tooth back in

Store it straight away so the root doesn't dry out. Drying starts within a few minutes.¹ The guidelines list storage options in this order:¹

1. Milk
2. A tooth-preservation kit containing Hank's balanced salt solution, if you have one
3. Saliva: spit into a cup or container and put the tooth in it³
4. Saline

Water is a poor choice, but it's still better than letting the tooth dry out.¹ Don't wrap the tooth in a tissue or cloth.⁴

Don't try to put the tooth back if the person might swallow or breathe it in, for example if they are unconscious.^1,6 An adult can carry the tooth inside the mouth, between the back teeth and the cheek, but this may not suit children because of the risk of choking.⁵

Why speed matters

A key factor is the layer of living cells on the root surface. In a tooth put back within about 15 minutes, those cells are most likely still alive. After 30 minutes out of the mouth and dry, most of them have died.¹ The International Association of Dental Traumatology's patient page puts it simply: the best chance to save the tooth is within the first 20 minutes.⁷

Quick care gives the tooth its best chance, but no one can promise a result. Even a well-handled tooth may be lost later, which is why follow-up visits matter.^1,7

What the dentist will do

The dentist will usually splint the tooth (attach it to the teeth on either side) to hold it in place. A follow-up visit a couple of weeks later is common, for other treatment such as a root canal and to remove the splint.³ The dentist may also ask you to check with your doctor about a tetanus booster.¹

Knocked-out baby tooth

Don't put a baby tooth back. Replanting it could damage the adult tooth growing underneath, and the most important reason is to avoid the child breathing the tooth in.⁸ If there's bleeding, rinse the mouth with water and press gauze on the spot, and contact your dentist as soon as you can.²

If you can't find the tooth, tell the dentist. They will need an X-ray to make sure it wasn't pushed up into the gum. A missing tooth may also have been swallowed or breathed in, so if your child is coughing, wheezing or having any trouble breathing, go to the emergency department right away.⁸

Not sure whether it's a baby tooth? Children usually start losing baby teeth around age six and keep losing them until about twelve.⁹ If you're not sure, don't put it back. Put it in milk straight away and call a dentist.¹

Chipped or broken tooth

A chipped or broken tooth usually isn't an emergency, but it does need treatment soon,^10,11 and in many cases the tooth can be saved.² If there's bleeding or pain, contact the dentist right away,² and get urgent dental care if the break goes through to the nerve in the middle of the tooth (the pulp).⁵

• Find the broken piece if you can and keep it moist in milk or water. Don't let it dry. The dentist may be able to bond it back on.^10,11
• Rinse your mouth with water and put a cold compress on your face to keep swelling down.²
• If an edge is sharp, you can cover it with a piece of paraffin wax until your visit.⁶
• For pain, an over-the-counter pain reliever such as acetaminophen or ibuprofen may help. Ask your doctor or pharmacist whether it's right for you, and follow the label.^12,13 Don't put a pill on the sore tooth or gum.² Don't give aspirin to anyone under 16.¹⁶

Treatment depends on the break. Small chips may need a filling; bigger breaks may need a crown or a root canal.²

Not sure what to do?

Not sure what to do? Ontario's Health811 line connects you with a registered nurse for free, 24 hours a day. Call 811 (TTY: 711).¹⁵ For other urgent problems, see dental emergencies: what to do.