Emergency dental symptoms
Knocked-out tooth: the sixty minutes that decide if it can be saved
An adult tooth knocked clean out can be put back and can last for years, but only if you act in minutes, not hours. Do the steps below first, then ring us on the way.
Clinically reviewed by Dr Ibraheem Ijaz, Principal Dentist · GDC 301711 · Last reviewed April 2026
Why the clock matters so much
A tooth is not fixed to the jaw like a post in concrete. It hangs in its socket on a sling of living fibres, the periodontal ligament, and a layer of those fibre cells stays attached to the root when the tooth comes out. Those cells are what the socket uses to knit the tooth back in. They start to die within minutes of drying out; after about half an hour dry, most are gone. Milk keeps them alive for around an hour because its salt balance is close to the body’s own. Tap water does the opposite: it is so dilute that the cells swell and burst.
If enough cells survive, the ligament heals and the tooth behaves almost normally. If they have died, the body treats the root as foreign, and over the following years bone slowly replaces it. The tooth may still last a long time, but the difference between the two outcomes is decided in the first hour, mostly by whoever is standing next to you when it happens.
What to do right now, step by step
- 01Find the tooth and pick it up by the crown, the white part you normally see. Do not touch the root.
- 02If it is dirty, rinse it for a few seconds in milk, saline, or the person’s own saliva. Do not scrub, wipe or dry it, and avoid tap water unless there is nothing else.
- 03Put it straight back in the socket, the right way round, using gentle finger pressure. The curved side of a front tooth faces the lip. Then bite softly on a folded handkerchief or clean cloth to hold it in place.
- 04If you cannot get it in, put it in a small pot of milk. An adult can also keep it inside the cheek, between the gum and the cheek, on the way to us. Never carry it dry, in a tissue, or in water.
- 05Ring 0114 288 2121 and say the words "knocked-out tooth". We will make room straight away. Out of hours the same number reaches Dr Ijaz directly.
- 06Bring any other fragments, and press a clean cloth on the socket if it is bleeding. If the person was knocked out, is being sick, or has a wound that needs stitches, go to A&E at the Northern General first and bring the tooth in milk.
Baby teeth are different
Never put a knocked-out baby tooth back in. The adult tooth is developing in the bone just above it, and pushing the baby root back can damage the adult tooth’s enamel or knock it off course. Keep the tooth in milk anyway and bring the child to us the same day, so we can check for pieces left in the gum, look at the neighbouring teeth and deal with any cut to the lip. If you are not sure whether it is a baby or an adult tooth (children start losing front baby teeth from around six), store it in milk and let us decide. Our tooth trauma guide covers other injuries to children’s teeth.
Replanting the tooth at the practice
The emergency examination is £30 including X-rays. We check the socket for fractures, look at the neighbouring teeth for cracks and looseness, and X-ray the area. If the tooth is already back in, we confirm the position on the X-ray and adjust it if needed. If it arrives in milk, we numb the area, gently wash the socket with saline, lift out the blood clot, and ease the tooth in with finger pressure, then X-ray again to check it is fully seated.
The tooth is then held with a splint: a thin flexible wire or fibre bonded to the teeth either side, left on for about two weeks. It needs to be flexible rather than rigid, because slight movement helps the ligament heal without the root fusing to the bone. Following the international trauma guidelines, we usually prescribe a course of antibiotics after replanting and check that your tetanus cover is up to date. The details are on our knocked-out tooth reimplantation and splinting pages. Splinting is priced at the visit and agreed in writing before we start; visits after 6pm or at the weekend carry an out-of-hours charge.
| Treatment | Fee (from) |
|---|---|
| Emergency examination including X-rays | £30 |
| Replanting and splinting | priced at the visit |
| Emergency root canal stage 1 | £200 |
| Completed root canal treatment | £450 |
| Dental implant (once healed, adults) | £2,400 |
What happens in the weeks after replanting
- Soft food for two weeks and no biting on the tooth. Brush it with a soft brush after every meal and use a chlorhexidine mouthwash twice a day for the first week.
- No contact sport until the splint is off and we are happy with the healing.
- Splint removed at around two weeks, with an X-ray.
- For an adult tooth with a fully formed root, the nerve inside will not survive the loss of its blood supply, so we start root canal treatment within the first two weeks before it can become infected. Emergency root canal stage 1 is from £200 and the completed treatment from £450. In a child’s tooth with a still-open root tip we wait and watch, because the blood supply can sometimes grow back in.
- Reviews at about four weeks, three months, six months and a year, each with an X-ray, looking for the early signs of the root being resorbed.
If the tooth cannot be saved
A tooth that has been dry for more than an hour has a poor long-term outlook, but we will usually still replant it. It keeps the bone and the gum shape in place, holds the space, and often gives several years of service before it needs replacing. We tell you honestly what to expect. If the tooth is lost, or was never found, the options once the socket has healed are a bridge, a denture or a dental implant (from £2,400), though implants wait until jaw growth has finished, which is the late teens at the earliest.
Questions, answered
Common questions
Can a knocked-out tooth be saved after an hour?
Sometimes, particularly if it has been in milk the whole time. Its ligament cells will mostly have died, so the root is likely to be slowly resorbed over the following years, but replanting still keeps the bone and space and can give years of use.
Should I put a knocked-out baby tooth back in?
No. Replanting a baby tooth can damage the adult tooth forming above it. Keep it in milk, and bring your child in the same day so we can check the gum and the other teeth.
What is the best thing to keep a knocked-out tooth in?
The socket itself. Failing that, milk, or the person’s own cheek if they are an adult. Saline works too. Never water, and never dry in a tissue or a pocket.
Does putting a knocked-out tooth back hurt?
Less than you would expect. The socket is usually numb from the injury for the first few minutes, which is why replanting on the spot is often painless. At the practice we numb the area before repositioning and splinting.
Will a replanted tooth need a root canal?
In an adult, yes. The nerve loses its blood supply when the tooth comes out and will not recover, so root canal treatment is started within about two weeks of replanting. Children’s teeth with unfinished roots are monitored instead.
How long does a replanted tooth last?
It depends almost entirely on how long the tooth was dry. Replanted within a few minutes, or kept in milk and replanted within the hour, it can last for decades. After longer dry time it usually gives some years before the root is resorbed and it needs replacing.
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