Knocked Out Tooth: What to Do in Houston, TX

An elbow at a Saturday game near NRG, a spill on the Brays Bayou trail, a fall on a driveway in Braeswood. However it happens, the next half hour decides whether that tooth goes back in. Here is what to do while you're still standing there.

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Short Answer

Pick the tooth up by the crown, never the root, rinse it briefly with milk or saline if it's dirty, and put it back in the socket if you can. If you can't, keep it in a cup of milk and get to a dentist within 30 to 60 minutes.

Key Takeaways

• Handle the tooth by the white chewing surface only.
• Milk is the best storage liquid you're likely to have. Water is the worst.
• Never scrub the root or let the tooth dry out, especially in a hot car.
• The best chance of saving it is inside the first half hour.
• Baby teeth are the exception and should not be put back in.

The First Thirty Minutes

Find the tooth and pick it up by the crown. The root is covered in living tissue that reattaches the tooth to the bone, and rubbing it, wiping it on a shirt, or soaking it in tap water destroys those cells. That tissue is the whole reason a replant works.

If the tooth is visibly dirty, rinse it for a few seconds in milk, saline, or the person's own saliva. Then slide it back into the socket the right way round and have them bite gently on a clean piece of gauze or a folded paper towel to hold it there. A tooth back in its socket is in the best storage container that exists.

If that isn't possible, because the person is a child, is panicking, or the bleeding is heavy, drop the tooth into a cup of milk and go. Tucking it inside the cheek works for a calm adult, but not for a kid who might swallow it.

The Mistakes That Cost People the Tooth

Dr. Tarsem Lal notes that most failed replants were handled wrong before anyone reached a chair, not treated wrong afterward. Three things do the damage: scrubbing the root, storing the tooth in plain water, and letting it dry out.

Drying is the one that catches Houston parents. A tooth wrapped in a napkin and left in a gym bag or on a hot dashboard while you look up directions is usually gone within the hour. Wet and moving is the goal.

Where to Go

A dental office is the right destination. The Texas Medical Center is close by, but hospital emergency rooms don't replant teeth, so a trip there for an avulsion alone usually means doing the drive twice. Go to a hospital instead if the injury also involved a blow to the head, a possible broken jaw, or bleeding that won't stop with steady pressure.

Call an emergency dentist from the car so they know a knocked-out tooth is on the way. That one call gets the room ready before you arrive.

What Happens at the Visit

The socket is checked and cleaned, the tooth is placed back and held with a thin splint bonded to the neighboring teeth for one to two weeks. A root canal is usually needed a week or two later, since the nerve rarely survives the injury even when the tooth does. If too much time has passed or the root is fractured, the plan shifts to removing what is left and discussing a replacement.

FAQ

What if my child knocks out a baby tooth?

Don't put it back. Replanting a baby tooth can damage the permanent tooth forming above it. Control the bleeding with gentle pressure and have a dentist check the area anyway.

Can I use water if I don't have milk?

Only as a last resort, and only briefly. Plain water damages the root cells quickly, so saliva is a better option than a glass of tap water.

How long is too long?

After about an hour dry, the chances drop sharply, but bring the tooth regardless. It's still worth an exam, and the socket needs looking at even if the tooth can't go back. The same urgency applies to several other dental emergencies.

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