Dental Trauma (Knocked Out or Broken Tooth)

Content reviewed against published AAP, ADA, IADT guidelines

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Dental injuries are common in children from falls and play. A knocked-out permanent tooth is a dental emergency with a 30-minute window for reimplantation. Baby teeth should NOT be reimplanted. Quick action can save a permanent tooth.

Immediate actions

  • May not require 911 — see guidance below
  • Control bleeding with gentle pressure using clean gauze
  • DO NOT: Do NOT handle a knocked-out tooth by the root

Step-by-Step Response

1

Control bleeding

Have the child bite on a piece of clean gauze with gentle pressure for 10-15 minutes. A cold compress on the outside of the cheek can help with pain and swelling.

2

Find the tooth

If a tooth was knocked out, find it. Handle ONLY by the crown (white part). Never touch the root (the yellowish part that was in the gum).

3

Clean gently if dirty

If the tooth is dirty, rinse briefly (10 seconds max) under running water while holding by the crown. Do NOT scrub, use soap, or wrap in tissue.

4

Reimplant permanent tooth

If it is a permanent tooth (child 6+ years), try to gently push it back into the socket. Have child bite on gauze to hold in place. If you cannot reimplant, go to step 5.

5

Store properly if cannot reimplant

Place the tooth in cold milk, saline, or the child's saliva (have them spit into a cup with the tooth). Do NOT store in water. Do NOT let it dry out.

6

Get to a dentist immediately

Time is critical for permanent teeth — best chance of saving the tooth is within 30 minutes. Call your dentist or go to an emergency dental clinic.

7

For broken/chipped teeth

Save any tooth fragments in milk. If you can see pink or red in the broken area, the nerve may be exposed — this is urgent. See a dentist within hours.

What NOT to Do

  • ✕Do NOT handle a knocked-out tooth by the root
  • ✕Do NOT scrub or clean the tooth with soap or chemicals
  • ✕Do NOT let a knocked-out permanent tooth dry out
  • ✕Do NOT reimplant a baby tooth — this can damage the developing permanent tooth underneath
  • ✕Do NOT ignore a chipped or broken tooth — the nerve may be exposed
  • ✕Do NOT give aspirin (increases bleeding)

When to Seek Help

Call 911 if:

  • Dental trauma with loss of consciousness or suspected head/neck injury
  • Uncontrolled bleeding that does not stop after 15 minutes of pressure
  • Difficulty breathing due to a displaced tooth or blood
  • Jaw appears broken or dislocated

Go to ER if:

  • Cannot reach a dentist within 30 minutes for a knocked-out permanent tooth
  • Significant facial swelling
  • Jaw injury or inability to open/close mouth
  • Dental injury with other facial injuries
  • Tooth pushed up into the gum (intruded)

Call your doctor if:

  • Baby tooth knocked out — still needs evaluation to ensure tooth fragment is not embedded
  • Tooth is loose but not knocked out
  • Minor chip without pain or visible nerve
  • Lip or tongue bite that is not deep

Age-Specific Guidance

0-1 year

Dental injuries are less common but can occur from falls when learning to walk. Baby teeth start erupting around 6 months. Any trauma to erupting teeth should be evaluated by a pediatric dentist.

1-5 years

Falls are the primary cause of dental trauma. All teeth at this age are baby teeth — do NOT reimplant them. Still see a dentist to check for embedded fragments and damage to developing permanent teeth underneath.

6-12 years

Children have a mix of baby and permanent teeth. Permanent incisors (front teeth) erupt around age 6-7 and are most commonly injured. A knocked-out permanent tooth is a true emergency — reimplant or store in milk and get to dentist within 30 minutes.

Prevention

  • Use a mouthguard for contact sports and activities (even recreational)
  • Childproof the home — secure rugs, pad sharp corners
  • Use car seats and seatbelts properly
  • Supervise bathtub play and swimming pool areas (slippery surfaces)
  • Avoid running with objects in the mouth (toothbrush, lollipop sticks)
  • Address protruding front teeth with orthodontic evaluation — they are more prone to injury

Frequently asked questions

Should I call 911 for dental trauma (knocked out or broken tooth)?
Not always. Call 911 if: Dental trauma with loss of consciousness or suspected head/neck injury
What should I do first?
Control bleeding with gentle pressure using clean gauze. Find the tooth if knocked out — handle by the crown (white part), NEVER the root. For a permanent tooth: reimplant or store in milk immediately. For a baby tooth: do NOT reimplant — but see a dentist to ensure nothing is embedded
What should I NOT do?
Do NOT handle a knocked-out tooth by the root. Do NOT scrub or clean the tooth with soap or chemicals. Do NOT let a knocked-out permanent tooth dry out. Do NOT reimplant a baby tooth — this can damage the developing permanent tooth underneath. Do NOT ignore a chipped or broken tooth — the nerve may be exposed. Do NOT give aspirin (increases bleeding)
How can I prevent this?
Use a mouthguard for contact sports and activities (even recreational). Childproof the home — secure rugs, pad sharp corners. Use car seats and seatbelts properly

Sources

AAPADAIADT

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Related Emergency Guides

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Bottom line

Stay calm and follow the steps above. When in doubt, call your pediatrician or go to the nearest emergency room.

You are doing the right thing by learning what to do in an emergency. Being prepared is one of the best things you can do for your child.