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Emergency!
Where to look first when a tooth gets hurt or something urgent happens.
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Emergency!
An adult tooth has come out of its socket completely. This page explains what has happened and what a dentist may do. What you do in the first few minutes matters, and that guidance is being written by a pediatric dentist — until it is here, contact your dentist or your local emergency services now.
Call your dentist or your local emergency number.
This section is waiting for reviewed guidance. Step-by-step advice for the first few minutes is being written by a pediatric dentist and has deliberately not been drafted here. Until it appears, contact your dentist or your local emergency services — they can tell you what to do for your child now.
This section is waiting for reviewed guidance too. Things to avoid are as important as things to do, and both belong with the dentist who is writing them rather than with this website.
A permanent tooth has been displaced entirely from its socket. Unlike a baby tooth, an adult tooth is not replaced by another one, so this is treated as an urgent situation rather than something to raise at the next appointment.
If the tooth cannot be found, say so when you call. The AAPD states that when a tooth or fragment remains unaccounted for, radiographs are required to rule out its having been breathed in or coming to rest in the surrounding tissues — which is why an unfound tooth is itself a reason to be seen.
The AAPD lists reimplantation — putting the tooth back — among the surgical interventions that may be required for dental trauma, alongside stabilisation or splinting, and, where a tooth cannot be saved, extraction and later replacement. Which applies depends on the tooth and on what has happened to it, and that is an assessment only the dentist in front of your child can make.
The AAPD notes that complex cases may involve consultation with or referral to an endodontist, orthodontist, oral and maxillofacial surgeon, periodontist or prosthodontist, and it points to the International Association of Dental Traumatology guidelines for managing dental injuries.
If a big tooth has come out, a grown-up will ring the dentist straight away. That is the right thing to do and it is not your fault. The dentist will look after it.
Will the tooth go back in? Sometimes, and it depends on the tooth and on what has happened since. Reimplantation is one of the interventions the AAPD lists for dental trauma, but whether it is possible here is a judgement for your dentist. Ring them now rather than reading on — and take the tooth with you if you have it.
Treat it as one. A permanent tooth has no replacement coming, and the AAPD groups traumatic injuries among the conditions requiring both acute and ongoing management to prevent negative consequences. Contact your dentist or your local emergency services now. This page cannot tell you how urgent your particular situation is.
Yes, and it is worth saying when you call. The AAPD states that when a tooth or fragment remains unaccounted for, radiographs are required to rule out aspiration or the tooth being lodged in surrounding tissue — for example embedded in a lip laceration. A missing tooth is a reason to be seen, not a reason to wait.
The situation is handled differently. See Knocked-out baby tooth. If you are not certain which it is, that in itself is a reason to contact your dentist rather than to work it out at home.
Every clinical statement on this page comes from the American Academy of Pediatric Dentistry document below. The step-by-step guidance in the sections above is being written separately by a pediatric dentist and is not drawn from this source.
This website is for education only and does not replace care from your dentist, physician, or emergency services.