What to Do if a Permanent (Adult) Tooth Is Knocked Out

A knocked-out permanent tooth is a dental emergency. Handle it by the crown, keep it moist, and get emergency dental care straight away – the sooner the tooth is back in place, the better its chances.

Is this a permanent tooth or a baby tooth?

Do not put a baby (milk) tooth back in. This guide is for permanent (adult) teeth only. If you’re not sure which type of tooth has come out, check our guide on telling a baby tooth from a permanent tooth, or look for these quick clues:

• Permanent teeth are usually larger, more yellow-white, and appear from around age 6 onwards, often alongside baby teeth still in the mouth.
• If the child is under about 6 and this is a front tooth, it is very likely a baby tooth. If in doubt, treat it as a baby tooth and go straight to our baby tooth guide – replanting a baby tooth can damage the permanent tooth developing underneath it.

What to do right now

1. Stay calm and find the tooth. Pick it up by the white crown (the part that normally shows), never by the root. The root is covered in a thin layer of living cells (the periodontal ligament) that the tooth relies on to reattach – touching or damaging them lowers the tooth’s chances before a dentist even sees it.
2. If the tooth is dirty, rinse it briefly – a few seconds only – in cold running water. Do not scrub it, do not use soap or disinfectant, and do not dry it or wrap it in tissue. Scrubbing removes the same cells the root needs to survive.
3. Can you safely put it back in yourself? See the box below.
4. If you can’t replace it, keep it moist straight away – see the storage table below. A tooth left dry for even a short time is far less likely to succeed once replanted.
5. Get emergency dental care immediately. Don’t wait to see if things settle down. Go straight to a dentist, or if none is available, to an emergency department.

Should you try to put the tooth back in yourself?

Yes, if:

• The injured person is conscious and cooperative
• You can see clearly which way round the tooth goes
• You’re able to do this calmly, without forcing it

Don’t attempt it if:

• They’re unconscious, or unable to cooperate
• You’re not sure the tooth is facing the right way
• There’s a risk it could be swallowed or knocked further in
• You’re simply not comfortable doing it – that’s fine, move straight to storage instead

If you do replace it, get the person to gently bite on a clean cloth or handkerchief to hold it in place, then go straight to emergency care. If you don’t, that’s not a mistake – safe storage and a fast dentist visit still gives a good chance.

Storing the tooth safely

Milk and saliva keep the root’s surface cells alive; water and dryness kill them. This is one of the most consistent points across every major guideline, because it makes a measurable difference to whether the tooth can reattach.

Get help now

• Call your dentist first, even if it’s outside normal hours – many practices have an emergency line or an answerphone message with next steps.
• No dentist available? Call NHS 111 for the nearest urgent dental service.
• Go to A&E or call 999 if there’s also a head injury, loss of consciousness, heavy bleeding that won’t stop, or a suspected broken jaw.

This is a genuine emergency. Aim to be seen as soon as physically possible – don’t treat any specific number of minutes or hours as a deadline to wait until, and don’t treat it as a point after which there’s no reason to hurry.

Do not do these things

• Don’t scrub the tooth or clean it with soap, alcohol, or disinfectant.
• Don’t handle the tooth by the root.
• Don’t let the tooth dry out.
• Don’t store it in plain water.
• Don’t try to replant a baby tooth.
• Don’t wait to “see how it settles” – go for emergency care straight away.

What if…?

I can’t find the tooth.
Check the area carefully, including clothing and any grass or debris. If it genuinely can’t be found, or if you think it might have been swallowed or inhaled (for example, after a fall with breathing difficulty or coughing), still go for emergency care straight away and mention this – a chest X-ray may be needed to rule out inhalation. See our missing tooth guide.

The tooth is dirty and I’m worried about rinsing it wrong.
A brief, gentle rinse under cold running water is fine if there’s visible dirt. The aim is just to remove debris, not to sterilise it – a few seconds is enough.

The person is too distressed to let me put the tooth back in.
Don’t force it. Move straight to safe storage (milk or saliva) and get to emergency care as quickly as possible – a dentist can replant it there.

I’m not sure if it’s a baby or permanent tooth.
Treat it cautiously: don’t attempt to replant it, store it safely as above, and get professional advice urgently either way.

If this happens at school, nursery or a club

The steps above don’t change, but who does what does:

At school or nursery: One member of staff should manage the tooth (find it, store it, keep it safe) while another contacts the parent or carer and arranges transport to emergency dental care. Record the incident once the immediate response is underway, not before. See Dental Trauma First Aid for Schools.

On the sports pitch or in a club setting: The coach or first aider handles the tooth and storage; someone else contacts the parent and, where relevant, arranges the fastest route to a dentist. See Dental Trauma First Aid for Sports Coaches and download the Dental Trauma Decision Flowchart to keep pitchside.

At home: A parent or carer usually manages both the tooth and the phone call – having a dentist’s emergency number and NHS 111 saved in advance removes one thing to think about in the moment.

What the dentist may do

At the appointment, the dentist will assess the tooth and socket, and – if it hasn’t already been replanted – will usually reposition the tooth and splint it to the neighbouring teeth to hold it steady while it heals. They’ll normally recommend a course of follow-up appointments over the following weeks and months to check how the tooth is settling, and may prescribe antibiotics or recommend a tetanus check depending on how the injury happened. Root canal treatment is often needed at a later stage, particularly for teeth that were out of the mouth for some time before being replanted.

Every case is different, and the dentist will explain what to expect for this specific tooth. Replanting a tooth quickly and correctly gives it the best chance, but there’s no way to guarantee the outcome in advance.

Aftercare and follow-up

Once the immediate emergency is dealt with, you’ll likely have questions about eating, brushing, pain relief, and what changes to watch for. See:

• What to eat and how to brush after a dental injury
• Warning signs after a dental injury
• What to expect after a knocked-out tooth is replanted

Related guides

• What to do if a baby tooth is knocked out
• How to tell a baby tooth from a permanent tooth
• Dentist, NHS 111, A&E or 999: where to get help for a dental injury

Print this before you need it

Most people reading this today aren’t in the middle of an emergency – they’re making sure they’d know what to do if one happened. The Knocked-Out Tooth Poster puts these steps on one page, sized for a kitchen, first-aid room, or kit bag. Download free

Being prepared

Knowing the steps is the first part. Having the right things on hand – a way to store the tooth properly, without having to search for milk or a clean container in the moment – is the other. A dental trauma kit kept at home, at school, or pitch-side means one less thing to figure out while you’re getting to emergency care. Learn about the ToothRevive Kit

References

• International Association of Dental Traumatology (IADT), Guidelines for the Management of Traumatic Dental Injuries: Avulsion of Permanent Teeth, 2020 (current as of August 2026)
• NHS, Knocked-out tooth, nhs.uk
• American Association of Endodontists, Traumatic Dental Injury Guidance, April 2026

This guide does not replace assessment by a dentist or emergency service. It reflects current international and UK guidance as at 14 August 2026, reviewed by Dr Yousuf Ibrahim, BDS.