What do I do if my child's permanent tooth is knocked out?

It's an emergency: time matters. Pick the tooth up by the crown (not by the root), if it's dirty rinse it with saline or milk without scrubbing, and try to put it back in place. If you can't, keep it in milk or saline and go to the dentist immediately. Reimplanting it quickly can save it.

And if the tooth that falls out is a milk tooth?

A milk tooth knocked out by a blow is normally NOT reimplanted, so as not to damage the permanent tooth coming through underneath. Even so, it's worth going to the dentist to check there's no other damage and to keep an eye on the permanent one.

My child has had a knock but the tooth only wobbles or has changed colour, is it serious?

It's worth getting it checked. A tooth that wobbles, hurts or darkens after a blow may have a damaged nerve. It's not always urgent, but it is a reason to consult so it can be assessed and followed up.

A knock to a child's tooth: what to do step by step

In short: after a knock to a tooth, the first thing is to stay calm and assess what has happened. If a permanent tooth is knocked out, it’s an emergency: pick it up by the crown, keep it in milk or saline and go to the dentist as soon as possible (putting it back quickly can save it). If it’s a milk tooth, it isn’t reimplanted, but it’s worth checking. And if it only wobbles, hurts or changes colour, it also needs looking at.

First of all: what has happened?

Knocks to teeth are common in childhood (falls, games, sport). What you do depends on the injury. Stay calm: your composure helps the child.

If a permanent tooth has been KNOCKED OUT (emergency)

Here time is gold. The sooner it’s put back, the better the chances of saving it:

Pick the tooth up by the crown (the white part), never by the root.
If it’s dirty, rinse it gently with saline solution or milk, without scrubbing or using soap.
If you feel able, put it back in its socket and have the child bite on a tissue to hold it.
If you can’t, keep it in milk (or saline, or even the child’s own saliva), never in water or dry.
Go to the dentist immediately.

If the tooth that falls out is a MILK tooth

Everything changes: a milk tooth knocked out by a blow is normally NOT reimplanted, because putting it back could damage the germ of the permanent tooth that is forming underneath. Even so, go to the dentist to check there are no other injuries and to keep an eye on the permanent one.

If the tooth BREAKS (a piece)

Keep the piece if you find it (in milk or saline) and go to the dentist: it can often be rebuilt. In the meantime, watch for bleeding or pain.

If it only WOBBLES, hurts or changes colour

It’s not always an emergency, but it is a reason to consult:

Sign after the knock	What to do
Tooth that wobbles	Get it checked soon
Pain that doesn’t ease	Get it checked
Tooth that darkens (days/weeks later)	Get it checked: the nerve may be damaged
Bleeding gum	Wash gently and monitor; if it doesn’t stop, consult

A tooth that darkens some time after a knock is a classic sign that the nerve suffered, and it’s worth assessing even if the child doesn’t complain.

The prevention that really helps

For contact sports, a mouthguard prevents many scares. And knowing in advance what to do (and having your clinic’s phone number to hand) makes all the difference on the day of the knock.

For any dental trauma, call us and we’ll guide you. We see emergencies and, if it’s during the day, we’ll see you as soon as possible. Here’s how to contact us.