If the child is 5 years of age or less and it is a front tooth that has been knocked out, it is most likely a baby tooth and you should NOT replant the tooth.
If the child is greater than 5 years of age, and it is a front tooth, you must assess whether it really looks like a LARGE adult tooth, or a smaller baby tooth. Check the size of adjacent or opposing teeth for comparison. If the root of the tooth is very long, it is likely an adult tooth.
Baby teeth are NOT replanted, but adult teeth should be.
The FASTER a tooth can be replanted by an adult, the greater the chance of keeping the tooth, but:
- NEVER replant a dirty tooth
- partial replantation is better than none until a professional is seen
It is crucial to keep the tooth moist if it cannot be replanted right away - more than 15 minutes of exposure to air (drying out) can reduce the success of replantation to almost zero.
Important Do’s And Don’ts For Handling The Knocked-Out Tooth
- try to replant the tooth (if it is clean) right away—part way in is better than not at all because it is still in the warm, wet mouth
- clean the tooth off thoroughly but gently before replanting
- try to hold the tooth in place during transit to the dental professional
- store the tooth in one of the ways listed below if it cannot be replanted right away before seeing the dental professional
- touch or handle the knocked-out tooth by the root (the long, pointy end)
- scrub or scrape the tooth to clean it - gentle rinsing with tap water or one of the storage liquids detailed below is best
- try to clean or disinfect the tooth or root with alcohol or peroxide
- let the tooth dry out - storage of the tooth in any simple liquid greatly increases the chances of success with replantation
Ways to Store a Knocked-out Tooth for Transit
- In the mouth - keeping the tooth in the fold of the cheek or under the tongue is a great way to keep it moist, warm, and safe during transit, but ONLY if the child understands not to swallow it
- Saline solution - to make isotonic saline (water that is just as salty as body fluids), mix 1 teaspoon of salt (preferably non-iodized) in 500 mL (= 16 oz. = 1 pint) warm water
Note: This solution is also great for cleansing a tooth of debris before replanting
- Milk - useful for short-term storage and readily available
- Keep the tooth as cold as possible in its storage container while in transit, i.e. in ice