A tooth that has been ‘knocked out’ or avulsed can be re-implanted in its socket, but there are important guidelines to follow. A recent study discussing the effectiveness of liquids to store such a tooth before getting dental treatment had me review not only this article, but the current information on the treatment of teeth knocked out. It is not common to see teeth that are knocked out, but when it occurs it is more often in youth, and more often in boys than girls.

Current Information and Guidelines

  • Time is a critical factor to successful re-implantation. Teeth re-implanted less than 15 minutes have a high success rate, and those out of the mouth for more than an hour a low success rate.
  • In addition, how the tooth is handled and stored prior to re-implantation are very relevant.

Time, handling and storage are all related to the biology of a tooth, and in particular the cells holding the tooth in the jaw bone – the periodontal ligament. These cells are torn when a tooth is knocked out, and begin to die once the tooth is out of the mouth.

A baby tooth has been knocked out need not be re-implanted. A permanent tooth that has been knocked out, but broken, especially if part of the root remains in the socket, cannot be salvaged.

  • once a permanent tooth is knocked out, call your dentist right away
  • only touch the enamel part of the tooth, not the root (to not crush the periodontal ligament cells)
  • do not rinse off the tooth
  • do not store the tooth in water, salt water, or in your mouth
  • preferred transport solutions: Save-A-Tooth (often with medical, paramedical professionals at sporting events), green tea (room temperature, not prepared drinks), milk

The re-implanted tooth will almost always need a root canal (not necessarily if the tooth root is not fully formed in a young person), and even then the tooth may not be saved.

Some helpful online resources: Colgate.com, Wikipedia, Save-A-Tooth.com, DoctorSpiller.com

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