Dental injuries almost always happen at the worst possible moment: a Saturday, a playground, a birthday party. The first thirty minutes matter enormously and most parents have never thought through what to do.
Read this once now. It takes three minutes and could save a tooth.
First: baby tooth or permanent tooth?
This determines everything.
A knocked-out baby tooth should NOT be put back in. Reimplanting it risks damaging the permanent tooth developing directly above it. Control the bleeding, call the dentist, and let them assess.
A knocked-out permanent tooth is a true emergency. Every minute counts, and the actions below apply.
Rough guide: children under about five almost certainly have baby teeth. From six to twelve it's a mix — the front teeth are usually the first permanent ones to arrive. If you're not sure, handle it as permanent and let the dentist sort it out. Erring that direction is safer.
Knocked-out permanent tooth: the steps
- Find the tooth. Look carefully — in grass, in the car, in the mouth.
- Pick it up by the crown. The white chewing part. Do not touch the root. The root surface carries living cells that make reattachment possible, and handling destroys them.
- If dirty, rinse gently for ten seconds in milk, saline, or the child's own saliva. Cool running water is acceptable if nothing else is available. Never scrub, never use soap, never dry it off, never wrap it in a tissue.
- Try to reinsert it. If your child is calm enough, place the tooth back into the socket in the correct orientation and have them bite gently on a clean cloth to hold it. This is the single best thing you can do — a tooth back in its socket within five minutes has dramatically better odds than one transported.
- If you can't reinsert it, keep it wet. In order of preference:
- Cold milk — best commonly available option
- The child's own saliva — have them spit into a cup and submerge it; or, for an older, reliable child, hold it inside the cheek
- Saline or a commercial tooth-preservation kit (Save-a-Tooth)
- Water — last resort only. Plain water damages root cells within minutes.
- Get to a dentist immediately. Under 30 minutes is the target; under 60 is still good. After two hours dry, the odds fall sharply.
Call ahead so they can prepare. If your dentist can't be reached, go to an emergency room or an urgent dental clinic.
Other common injuries
Chipped tooth. Save the fragment in milk — it can often be bonded back. Rinse the mouth, apply cold to the lip, and be seen within a day or two. If pink or red is showing at the fracture, that's the nerve exposed and it needs same-day attention.
Loosened or displaced tooth. Don't wiggle it. If it's pushed out of position and clearly interfering with biting, gentle repositioning with a fingertip is reasonable, but same-day evaluation is the priority.
Tooth pushed up into the gum (intrusion). Common in toddlers falling face-first. Leave it alone. Many re-erupt on their own over weeks, but it must be evaluated because of the risk to the tooth beneath.
Bitten lip or tongue. Clean gently, apply firm pressure with gauze for ten minutes, cold compress for swelling. Bleeding that won't stop after fifteen minutes of steady pressure, or a cut that gapes open, needs medical attention.
Toothache. Rinse with warm salt water, floss gently on either side in case something is wedged, give age-appropriate ibuprofen or acetaminophen, and call. Never place aspirin against the gum — it causes chemical burns. Facial swelling, fever, or a swollen eye means go now, not tomorrow — those suggest a spreading infection.
Build your kit now
Keep in the car or diaper bag:
- Small sealed container with a lid
- Sterile gauze
- Instant cold pack
- Your dentist's emergency number, written down
- Optional: a Save-a-Tooth kit, roughly $25 online
Program the number into your phone under "Dentist Emergency." At 8pm on a Sunday, nobody wants to be searching a website.
Prevention worth the effort
The overwhelming majority of dental injuries in school-age children come from sports and falls. A properly fitted mouthguard reduces injury risk substantially and costs far less than an emergency reimplantation and follow-up. If your child plays anything with contact, a ball, or wheels, get one.
Save this page. And save our number: Galaxy Smiles For Kids — 303-228-0340. We keep emergency slots open daily and we'd rather hear from you at 7am than have you wait it out. More about our emergency care.