Avulsed Tooth

What is an avulsed tooth?

An avulsed tooth (knocked-out tooth) is a tooth that’s knocked out of its socket and, often, out of your mouth. Healthcare providers may call this dental avulsion.

Avulsed teeth are a type of dental trauma and require immediate treatment. If this happens to you or someone else, you may be able to save the tooth by putting it back in the socket right away. This is reinsertion or replantation. If you can’t put the tooth back, keep it moist and contact your dentist for an emergency appointment or go to an emergency room.

Are avulsed teeth common?

It’s a common issue. Every year, more than 5 million people in the U.S. have their teeth knocked out (avulsed). Most avulsed teeth involve your incisors. These are the teeth at the front of your mouth in your upper and lower jaw. While anyone can have a tooth knocked from their mouth, this issue mostly occurs in kids ages 7 to 11.

What are the symptoms of an avulsed tooth?

Symptoms of a tooth avulsion may include:

• A gap in your mouth where your tooth used to be.
• Mouth pain.
• Bleeding.

What causes avulsed teeth?

It takes a lot of force to knock a tooth out of your mouth. The most common ways tooth avulsion happens are:

• Falls.
• Bicycle accidents.
• Injuries from participating in contact sports like football, hockey, lacrosse, rugby and martial arts.
• Traffic accidents.
• Assaults.

How are avulsed teeth diagnosed?

That depends on your situation. If you can place your tooth in its socket, a healthcare provider may check the tooth and then begin treatment. If you bring your tooth to the provider, they may examine your mouth for any other injury before replacing your tooth in its socket. They’ll ask what happened. For example, if your tooth was knocked from your mouth in a hard fall, they may check for signs of head injury, like a concussion.

What should I do if a tooth is avulsed?

Avulsed teeth are dental emergencies and require immediate treatment. To save your tooth, try reinserting (replanting) your tooth right away. Teeth treated within 30 minutes to one hour have the best chance of success. Here’s how to do that:

• Pick up your tooth by the crown (white chewing surface).
• Rinse your tooth with water or milk to remove any dirt. Avoid using soap, and don’t scrub or dry the tooth.
• Gently place your tooth back into the socket, root first. Hold your tooth by the crown and avoid touching the root.
• Bite on a napkin, gauze or handkerchief to anchor your tooth in place.
• Contact a dentist for an emergency appointment so they can check your tooth.

If you can’t reinsert your tooth, store it in milk — not water — until you can see a dentist. Milk is the best protection. But you can also store your tooth in your cheek, tucked against your gum or under your tongue. Saliva pooling in your cheek or under your tongue will keep your tooth wet.

How do dentists treat an avulsed tooth?

If you put your tooth into its socket, your dentist will make sure your tooth is in the right position. They’ll place a splint on your tooth to anchor it to your surrounding teeth.

They’ll follow the same process if they need to reinsert your tooth. They may schedule a root canal if your tooth avulsion leads to an infection in your tooth pulp.

What should I do after my tooth is put back in its socket?

To help protect your tooth after reinsertion, you should:

• Consume only soft food and liquids for two weeks.
• Avoid foods that are too cold or too hot.
• Brush gently with a soft toothbrush after each meal.
• Rinse with an antibacterial chlorhexidine mouthwash two times a day for two weeks.
• Take nonsteroidal anti-inflammatory drugs (NSAIDs) as needed for pain relief.
• Avoid contact sports.

Complications of tooth replantation

You may develop some of the complications listed below:

• Ankylosis: Your replanted tooth may fuse to your alveolar bone and sink into your gum tissue. Your alveolar bone is part of your jawbone. It holds your tooth sockets.
• Apical periodontitis: The tissue around your tooth becomes inflamed and tender.
• Inflammatory root resorption: If your tooth’s root system breaks down, your tooth will loosen in the socket and may fall out.
• Pulp canal obliteration (PCO): This is when you have hard tissue deposits along the walls of the root canal space in your tooth. PCO is usually painless but can lead to pulp necrosis.
• Pulp necrosis: Your tooth pulp may die. When that happens, you’ll need a root canal or your dentist may need to extract (pull) your tooth.

What happens if my tooth can’t be replaced in my socket?

If your dentist can’t replace your tooth, they may recommend one of the following treatments:

• Partial denture: Dentures are removable oral appliances that replace missing teeth. A partial denture holds artificial teeth. The denture rests on your gums and hooks onto nearby teeth.
• Dental bridge: Bridges fill the gap left by your avulsed tooth. They consist of dental crowns that fit over your natural teeth on either side of the gap and artificial teeth that bridge the gap between your teeth.
• Dental implant: Dental implants are replacement teeth. They’re permanent metal screws that secure artificial or fake teeth — like dental crowns, dental bridges or dentures — in place.

Can I prevent an avulsed tooth?

You may not be able to prevent everything that can knock a tooth from its socket and your mouth, like being hit in the face in an accident or during a fight.

But this issue usually happens when people play contact sports where there’s a chance they’ll be hit in the mouth — like football, basketball or hockey. If you play those sports, wearing a mouth guard may protect your teeth.

What can I expect if I have an avulsed tooth?

If you or your dentist reinserts your avulsed tooth, you’ll have regular follow-up appointments with your dentist so they can check on your tooth. You may see your dentist a month after treatment and then every three months after treatment for the first year. You’ll have annual checkups for the next five years.

How long do reinserted avulsed teeth last?

A reinserted tooth may stay in place for 10 to 20 years. But the tooth will come loose or fall out at some point during your lifetime. When that happens, you’ll need replacement treatment, like a partial denture, dental bridge or dental implant.

How do I take care of myself?

The most important thing is to protect your replanted tooth while it heals:

• Leave it be: Your dentist will put a splint on your tooth to keep it in place during healing, so don’t poke at it with your finger or your tongue.
• Easy does it: Eat soft foods for at least two weeks, use a soft-bristled toothbrush and be gentle as you brush.
• Follow-up: Your dentist will schedule regular follow-up appointments to confirm your replanted tooth is stable. Your dentist will also check for complications.
• Protect your teeth: Wear a mouth guard anytime you play contact sports.

When should I see my dentist?

If you have a replanted tooth, you should see your dentist if you experience:

• Bleeding.
• Continued tooth pain.
• Swelling.
• Tooth discoloration.

What questions should I ask my dentist?

You may want to ask the following questions about your avulsed tooth:

• When will I know if the replantation process is successful?
• Will I need a root canal?

Why do I need to put an avulsed tooth in milk?

Milk has the best combination of proteins and antibacterial protection to protect your tooth until it’s replaced in your socket.

I only found part of my tooth. Can I put it back into its socket?

Never try to only put part of your tooth back into the socket. See a dentist as soon as you can. They may take a dental X-ray to look for root damage before treating your tooth.

Should an avulsed baby tooth be replanted?

No, it’s not a good idea to reinsert a baby tooth. Reinserting the tooth may lead to issues with the permanent tooth that’ll replace the baby tooth.

What should I do if I can’t find my tooth after it’s knocked out?

You may have swallowed or aspirated (breathed in) your tooth. Swallowed teeth are usually harmless. But breathing in a tooth may cause lung infections like aspiration pneumonia. Tell your provider you may have breathed in your tooth. They’ll do a chest X-ray to make sure your tooth hasn’t gone into your lungs.

A note from Cleveland Clinic

An avulsed tooth is a medical emergency. If you move quickly, you can save your knocked-out tooth. If you’re hit in the mouth and your tooth is knocked from its socket, your first step is to put it back into its socket. Your second step is contacting a dentist for an emergency appointment or going to the emergency room. If you or your dentist can reinsert your tooth, it may stay in place for many years to come.