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1565 Hollenbeck Ave, Suite 106, Sunnyvale, CA 94087(669) 234-2354
Silicon Valley Endodontics and Microsurgery
Time-Critical Emergency Guide

Dental Trauma
First Aid

What to do — and what NOT to do — in the first 30 minutes after a tooth is knocked out, broken, or pushed out of place. Bookmark this page on your phone, print it for the fridge, and keep it in the team first-aid kit.

Medically reviewed by Dr. Jason Kung, DDS, MS · Specialist Endodontist · UCLA DDS · OHSU MS ·
Call Now: (669) 234-2354

Most people don't know this: a May 2026 national survey commissioned by the American Association of Endodontists (n=2,000 US adults, Atomik Research, ±2pp at 95% CI) found that only 27% of US adults know a knocked-out tooth has roughly a 30-minute window to be saved. If you're reading this, you're already ahead of the curve — full survey breakdown →

Jump to a scenario

Knocked-out toothPushed-out-of-place toothChipped or broken toothLoose tooth after impactSoft-tissue injury

A permanent tooth has been knocked completely out (avulsion)

The whole tooth — root and crown — has come out of the socket. This is the most time-critical dental emergency. Every minute the tooth is out of the mouth lowers the chance of saving it.

Do this now

  • 1.Pick the tooth up by the crown (the chewing part) only. Never touch the root.
  • 2.If the tooth is dirty, rinse it for no more than 10 seconds in cool milk or saline. Do NOT scrub it.
  • 3.If you can, gently push the tooth back into the socket and have the person bite on a clean cloth to hold it in place. This is the single best thing you can do.
  • 4.If you cannot reimplant it, put the tooth in cold milk. If milk isn't available, use the person's own saliva (in their cheek or in a cup) or Hank's Balanced Salt Solution from a 'Save-A-Tooth' kit.
  • 5.Call us immediately. This is a true same-day emergency.

Do NOT

  • ×Do not store the tooth in tap water — it kills the cells on the root surface.
  • ×Do not let the tooth dry out, even for a few minutes.
  • ×Do not scrub, brush, or use disinfectant on the root.
  • ×Do not reimplant a baby tooth — only permanent teeth.

Timeframe

Best results within 30 minutes. Outcomes drop sharply after 60 minutes.

A tooth is pushed sideways, in, or out of position (luxation)

The tooth is still in the mouth but is loose, tilted, pushed deeper into the socket, or extruded longer than the neighboring teeth. The ligament holding the tooth has been damaged.

Do this now

  • 1.If the tooth is mostly in position, leave it alone and seek same-day care.
  • 2.If the tooth is sticking out further than its neighbors, gently press it back into position with steady, even pressure. Stop if it resists.
  • 3.Bite on a clean cloth or gauze to stabilize the tooth on the way to the office.
  • 4.Use a cold compress on the outside of the lip or cheek to reduce swelling.
  • 5.Take over-the-counter pain medication (ibuprofen) if not contraindicated.

Do NOT

  • ×Do not try to wiggle, twist, or rotate the tooth.
  • ×Do not eat anything firm or chew on the area.
  • ×Do not delay — the longer the ligament is stretched or torn, the worse the outcome.

Timeframe

See an endodontist or your dentist within 6 hours. Same-day repositioning and splinting dramatically improves the prognosis.

Part of the crown of the tooth has broken off (crown fracture)

A piece of the visible part of the tooth has fractured off. There may or may not be exposure of the inner pulp tissue (a pink or red spot in the middle of the broken surface).

Do this now

  • 1.Find the broken fragment if you can — even a small piece can sometimes be bonded back on.
  • 2.Store the fragment in milk or saline to keep it hydrated.
  • 3.Rinse the mouth gently with warm water.
  • 4.If the inner pulp is exposed (pink/red center, sharp pain to air), this is urgent. Call same-day.
  • 5.Cover sharp edges with sugarless gum or orthodontic wax to protect the tongue and cheek.

Do NOT

  • ×Do not throw away the fragment, even if it looks small.
  • ×Do not let the fragment dry out.
  • ×Do not delay if the pulp is exposed — the longer it sits, the more likely a root canal will be needed.

Timeframe

Within 24 hours if there is no pulp exposure. Same-day if the pulp is exposed.

The tooth feels loose but is still in place (possible root fracture)

After an impact, the tooth feels mobile but is not displaced. The fracture may be in the root and is not visible from the outside. Diagnosis requires CBCT 3D imaging.

Do this now

  • 1.Avoid biting on the tooth. Eat soft foods only.
  • 2.Use a cold compress on the outside of the lip or cheek.
  • 3.Schedule an evaluation within 24–48 hours, even if the pain seems to settle.

Do NOT

  • ×Do not assume it will heal on its own — root fractures need to be diagnosed and stabilized.
  • ×Do not chew on the area.

Timeframe

Evaluation within 24–48 hours. Some root fractures can be saved with splinting and follow-up care.

Bleeding from the lip, gum, or tongue

Cut or laceration of the lip, cheek, gum, or tongue, often along with a tooth injury. Mouth wounds bleed heavily but usually stop with steady pressure.

Do this now

  • 1.Apply firm, steady pressure with clean gauze or a clean cloth for 10 full minutes without checking.
  • 2.Use a cold compress on the outside to reduce swelling.
  • 3.Once bleeding has stopped, rinse gently with warm salt water.

Do NOT

  • ×Do not keep removing the gauze to check — it disrupts clotting.
  • ×Do not use aspirin, which thins the blood.

Timeframe

If bleeding doesn't stop after 15 minutes of firm pressure, or if the cut is deep or gaping, go to an emergency room.

What's the best way to store a knocked-out tooth?

Hank's Balanced Salt Solution

Best. Sold as 'Save-A-Tooth' kits — keep one in sports bags.

Cold milk

Excellent and almost always available. Whole or low-fat both work.

The patient's own saliva

Acceptable — in the cheek pouch (only if old enough not to swallow), or spit into a clean cup.

Sterile saline

Acceptable if available. Do NOT use contact-lens solutions — most contain preservatives or cleaning agents that damage root cells. Plain bottled or tap water is also unsafe (see warning below).

Never store a tooth in tap water. Never store a tooth in tap water. The wrong salt concentration causes the cells on the root surface to burst within minutes, dramatically lowering the chance of successful reimplantation.

Protocols here align with the International Association of Dental Traumatology (IADT) guidelines and standard endodontic teaching, including the trauma chapter in Endodontics Review: A Study Guide (Blicher, Lucier Pryles & Lin, Quintessence, 2016). For comprehensive trauma background, see our dental trauma page.

Additional authoritative reference: AAE — Traumatic Dental Injuries (patient guide).

The best dental trauma is the one that never happens

Most knocked-out and fractured front teeth in children, teens, and adults come from sports and recreation. A properly fitted mouthguard is the single most effective way to prevent them. The American Dental Association and the American Association of Endodontists recommend wearing a mouthguard for any contact or collision sport — basketball, soccer, football, hockey, martial arts, skateboarding, and mountain biking included.

A custom mouthguard made from a dental impression fits better and protects more reliably than a boil-and-bite version from the drugstore, but any mouthguard is far better than none. Replace it when it wears down or, for growing children, when their bite changes.

In a tooth emergency right now?

Call us. We hold same-day slots for trauma. If we don't pick up immediately, leave a voicemail with your name, the type of injury, and a callback number — we monitor and return trauma calls within minutes.

(669) 234-2354

Emergency dental trauma care — serving 30+ Bay Area cities

Dr. Jason Kung provides emergency dental trauma care to patients across Silicon Valley from our Sunnyvale office. Evening and weekend hours, same-day emergencies, free on-site parking.

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