Knocked out teeth


A multitude of teeth are knocked out every year in the United States. The main causes in the permanent dentition are fights and sports injuries. Researchers have developed methods of saving over 90% of these teeth. These knocked out teeth can often be re-implanted under favorable conditions. If the tooth can be replanted within 15-30 minutes after the accident, there is a greater than 90% chance the tooth will be retained for life. However, practical life experience shows us that may be unrealistic.

The critical determining factors for success of replantation are the condition of the alveolar socket (bone) which should be free from periodontal (gum) disease and be reasonably intact, the time the tooth is out of the bone socket, the storage and transport medium used to deliver the tooth to the dentist, and how the tooth is handled between the accident and arrival at the dentist.

After the accident, the tooth should be located and picked up by the crown or enamel portion and NOT the root. If the tooth is dirty or contaminated, it should gently be placed in a transport solution of Hank's Balanced Salt Solution. If HBSS is not available, the next best alternatives are whole cold milk, saline, or saliva.
Never transport the tooth to the dentist in tissue or gauze. If none of the above are readily available, use water.
Once the dentist receives the tooth preserved in this system he/she may precede to implant the tooth and do the proper splinting procedures with a favorable prognosis.

It should be noted that if a primary (baby) tooth is knocked out, it should NOT be replanted as it could damage the permanent tooth bud in formation. Parents should NOT try to place the baby tooth back into the socket, and should immediately seek the advise and treatment of their dentist.

It is advised that if the accident victim shows any signs of head injury, unconsciousness, nausea, or persistent headaches, they should be first evaluated for their head injury by proper medical personnel. Once a head injury is ruled out, they may precede to the dentist for treatment of the avulsed (knocked out) tooth. This is another reason why a proper storage medium for the tooth is critical.

Therefore the treatment of choice is HBSS followed by whole cold milk. Hanks Balanced Salt Solution can be purchased by the trade name Save-a-Tooth, at (888) 788-6684 or on

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