Knocked-out tooth
What to do in the next thirty minutes.
Or come to 7 W 45th St, 2nd Floor — Midtown Manhattan
A fully knocked-out adult tooth is one of the few true dental emergencies. The first thirty to sixty minutes are critical. After two hours out of the socket, the chance of saving the tooth drops sharply.
The first five minutes
- Find the tooth. Hold it by the crown — the white part you see when you smile — not by the root. The cells on the root are what allow re-implantation to work.
- Rinse briefly with cold water if it’s dirty. Do not scrub, do not use soap, do not remove any tissue still attached to the root.
- Try to re-seat it in the socket. Gently push it back into place using your fingers. Bite down softly on a clean cloth or gauze to hold it. This is the single best thing you can do.
- If you cannot re-seat it, put the tooth in cold milk. If milk is not available, hold it in the cheek pouch — only if the patient is an alert adult and not at risk of swallowing it. Saliva works in a pinch. Tap water is a last resort. Never store the tooth dry.
- Call now. 212-382-3782. Tell us a tooth has been knocked out and you are on your way.
What we do when you arrive
If the tooth is re-seated, we confirm position, take an X-ray, and splint it to the adjacent teeth for one to two weeks while the ligament reattaches. A root canal is usually done at one to two weeks on a re-implanted adult tooth, because the nerve almost always dies even when the tooth itself survives.
If the tooth could not be saved or did not survive re-implantation, the next conversation is about replacement: a dental implant, a bonded bridge for a younger patient whose jaw is still growing, or — in some cases — orthodontic closure of the space.
What about a baby tooth?
Do not re-implant a knocked-out baby tooth. Pushing it back in can damage the developing adult tooth underneath. Stop the bleeding with gauze, comfort the child, and call a dentist the same day.
If you can’t reach us
For a fully knocked-out adult tooth and no available dentist, the ER is a reasonable backup — they can stabilize and refer. Bellevue and NYU Langone in Midtown East both handle dental trauma. But a dentist’s office is always the better destination if one is open.
Other emergencies: broken front tooth · lost crown or filling · all emergencies.