Dental Trauma:
When Every Minute Counts
If a tooth has been knocked out: the next 60 minutes are critical. Call us immediately and we'll guide you through what to do on the way.
If a Tooth Has Been Knocked Out
Do these steps in this order — quickly but calmly.
Pick up the tooth by the crown (white part). Never touch the root.
If dirty, gently rinse with cold milk or saline for 10 seconds. Do NOT scrub or use soap.
If possible, place the tooth back in the socket immediately. Bite gently on a clean cloth to hold it in place. This is the single best thing you can do.
If you can't replant it, store the tooth in cold milk, saliva, or a Save-a-Tooth solution. Do NOT store in water — water damages the root cells.
Call our office: (669) 234-2354. We will see you the same day, evening, or weekend.
Get to the office within 60 minutes if at all possible. After that window, success rates drop sharply.
⚠️ Do NOT replant a baby (primary) tooth — call your pediatric dentist instead.
Types of Dental Trauma We Treat
Every dental injury needs evaluation — even ones that don't hurt right away. Damage to the pulp (nerve) can develop weeks or months after the original injury.
Avulsed Tooth (Knocked-Out)
Complete displacement of a tooth from its socket. The single most time-sensitive dental emergency. Call immediately.
Luxation (Loose / Displaced)
Tooth pushed in, out, or sideways. Needs to be repositioned and stabilized within hours, not days.
Crown Fracture (Chipped)
Visible chip or break in the visible part of the tooth. May or may not involve the pulp depending on depth.
Crown-Root Fracture
Fracture extending below the gum line. Treatment depends on how deep — sometimes savable, sometimes not.
Root Fracture
Crack in the root, often invisible without CBCT 3D imaging. Some root fractures heal; others require extraction.
Concussion / Subluxation
Tooth feels sore but isn't visibly displaced. Pulp damage can develop weeks later — needs monitoring.
Soft-Tissue Injury
Cuts to the lip, gum, or tongue often accompany dental trauma. Bleeding usually controlled with pressure.
Pediatric Dental Trauma
Children's teeth need a different approach. We coordinate with pediatric dentists when needed.
What Happens at Your Appointment
Immediate Evaluation
We assess the injury, control any bleeding, and take diagnostic images including CBCT 3D imaging to see the full extent of damage to the tooth, root, and surrounding bone.
Stabilization
If the tooth is loose or has been replanted, we splint it to the neighboring teeth with a thin, flexible wire-and-composite splint for 7–14 days to allow healing.
Pulp Vitality Testing
We check whether the nerve has survived the trauma. Pulp testing is repeated at follow-up visits — sometimes the pulp dies weeks or months after the injury and root canal becomes needed at that point.
Treatment Decision
Based on the type of injury, age of the patient, and pulp status: monitoring only, root canal therapy, regenerative endodontic treatment (in younger patients with immature roots), or — in worst cases — discussion of extraction and implant.
Follow-Up Care
Trauma needs follow-up at 2 weeks, 6 weeks, 3 months, 6 months, and 12 months. Late complications (root resorption, pulp death) can develop years later — we keep watching.
Frequently Asked Questions
How long do I have to save a knocked-out tooth?
The first 30–60 minutes are critical. The periodontal ligament cells on the root must stay alive for replantation to succeed. After about 60 minutes outside the mouth in an unsuitable medium (especially water), success rates drop sharply.
What's the best way to transport a knocked-out tooth?
In order of preference: 1) back in the socket, 2) inside the patient's cheek (if old enough not to swallow it), 3) cold milk, 4) saliva, 5) Save-a-Tooth solution. Never water or dry storage.
My tooth chipped but doesn't hurt — do I still need to be seen?
Yes. Even chips that don't hurt now can damage the pulp and lead to nerve death weeks or months later. An evaluation tells us if the pulp is exposed or at risk and lets us monitor over time.
Will the tooth turn dark after trauma?
Sometimes. After trauma, a tooth may discolor (turn gray, pink, or yellow) as the pulp responds to injury. Discoloration that develops days to weeks after trauma usually indicates pulp damage and needs a root canal. We can also internally bleach the tooth back to its natural shade afterward.
Can a baby tooth that was knocked out be replanted?
No. Replanting a primary (baby) tooth can damage the developing permanent tooth underneath. Control bleeding with gauze pressure and call your pediatric dentist.
What about root resorption?
After dental trauma, the root can sometimes start to dissolve (resorb) — either externally or internally. This can develop months to years after the injury, which is why long-term follow-up matters. Caught early, resorption can sometimes be arrested.
Based on the research
The natural tooth outperforms the implant at every long-term follow-up point.
Setzer & Kim, Journal of Dental Research 2014 — long-term comparison of implants and endodontically treated teeth.
A traumatized tooth that can be saved should be saved. Natural teeth — including those that have undergone endodontic treatment after trauma — exceed the life expectancy of implants at 10-year and longer follow-ups. Extraction is rarely the right first choice.
See the researchThe evidence behind dental-trauma care
- Every treatment decision on this page — replantation timing, the moist storage media, splinting duration, and the monitoring schedule — follows the International Association of Dental Traumatology (IADT) avulsion and trauma guidelines.[1]
- Subsequent endodontic management of trauma-injured teeth — pulp-vitality monitoring, root canal treatment for necrosis, and resorption surveillance — follows the AAE Guide to Clinical Endodontics standard of care.[2]
Dental trauma care — serving 30+ Bay Area cities
Dr. Jason Kung provides dental trauma care to patients across Silicon Valley from our Sunnyvale office. Evening and weekend hours, same-day emergencies, free on-site parking.
Trauma? Call Now.
For knocked-out teeth, every minute matters. Call directly and we'll see you the same day — evenings and weekends included.
Mon–Fri 8am–7pm · Sat–Sun 8am–3pm · After-hours emergencies welcome