Pick it up by the crown, not the root

The crown is the part you normally see when you smile. The root is the pointed end that was in the bone. That root is covered in living cells, and those cells are what allow a tooth to reattach. Handling the root crushes them.

Pick the tooth up by the crown. If it has fallen on the ground, rinse it gently in milk or saline for a second or two. Do not scrub it, do not use soap, and do not wrap it in tissue to dry it off.

Milk, not water

This is the part most people get wrong. Water looks clean, and it is the obvious thing to reach for. But plain water is the wrong concentration for the cells on the root surface, and it kills them quickly.

Milk is close enough to the body’s own fluid to keep those cells alive for a couple of hours. Saline works. So does the patient’s own saliva — if they are old enough to be sensible about it, holding the tooth in the side of the mouth is a perfectly good transport method.

Or put it straight back in

If the person is calm and the tooth is clean, the single best thing you can do is push it gently back into the socket the way it came out, and have them bite softly on a clean cloth to hold it there. A tooth that goes back within a few minutes has a far better outlook than one that spends an hour in a cup.

If it will not go back easily, do not force it. Milk, and move.

Baby teeth are different

Do not re-implant a knocked-out baby tooth. Pushing it back can damage the adult tooth developing above it. Keep the child calm, control the bleeding with gentle pressure, and call us so we can check that nothing else has been injured.

Then call us straight away

We keep time aside every day for emergencies. Phone rather than email — this is not something to wait on. If it is outside our hours, go to the nearest hospital emergency department or the Royal Dental Hospital of Melbourne.

Even if the tooth cannot be saved, a knock hard enough to remove a tooth is hard enough to damage the ones either side of it. Those need checking within a day or two, not whenever it next suits.

More on what we do for urgent problems: emergency dentist in Ashburton.