Dental Trauma — Knocked Out, Broken, and Loose Teeth
Dental injuries need fast action. Find out what to do if a tooth is knocked out, broken or loose, including the key steps that can save a tooth.
Urgent help: who to contact
If an adult (permanent) tooth is knocked out, time is critical. Pick it up by the crown (the white part). Never touch the root. If it is dirty, rinse it briefly (10 seconds) under cold running water. If you can, push it gently back into the socket. Bite on a clean cloth to hold it in place. If you cannot put it back, put it in cold milk straight away. See a dentist within 60 minutes, and ideally within 20 minutes. Do NOT put a baby tooth back in.
Knocked-out tooth — what to do now
An adult (permanent) tooth that has been knocked right out (avulsed) can often be saved if you act fast. Every minute matters.
- Find the tooth. Pick it up by the crown only (the white part you normally see). Never touch the root.
- If the root is dirty, rinse it very briefly (no more than 10 seconds) under cold running water or in milk. Do not scrub or scrape it. Do not use soap or disinfectant.
- Try to push the tooth back into the socket with gentle finger pressure. Once it is in place, bite on a clean cloth or handkerchief to hold it there.
- If you cannot put it back, put the tooth straight into one of these (best first):
- Cold milk. This is the best choice that most people have to hand. It can keep the root cells alive for several hours.
- Sterile saline (for example from a first aid kit), not home-made salt water — if you have it
- The injured person's own saliva. Put the tooth in their mouth, between the cheek and gum. Do not do this with young children, as they could swallow it. Do not do it with anyone who is not fully alert.
- Do NOT keep the tooth in tap water. Water damages the cells on the root surface. This makes it much less likely that the tooth can be put back successfully.
- Do NOT wrap it in tissue or cloth. This dries the root out.
- See a dentist straight away. The best chance of saving the tooth is within 20 minutes. It can still work within 60 minutes. After that, the chance of the tooth lasting long term drops a lot.
Baby teeth — do NOT put them back
If a baby (primary) tooth is knocked out, do not try to put it back in.
Putting a baby tooth back can damage the adult tooth growing underneath. The adult tooth could be pushed out of place, become discoloured, or not grow normally.
What to do instead:
- Stop any bleeding by having your child bite gently on a clean cloth.
- Hold something cold (a cold compress) on the outside of the face to reduce swelling.
- Contact your dental team. They will want to check the area and keep an eye on the adult tooth as it grows.
- Keep the knocked-out tooth if you can find it. Then the dentist can check that the whole tooth came out.
- If you cannot find the tooth, tell your dental team. They may need an X-ray to check that it came out and was not pushed up into the gum.
Broken or chipped teeth
A broken tooth can be anything from a small chip to a bad break that exposes the nerve. The type of break decides how urgent it is and what treatment you need.
- Small chip in the enamel. A small piece of the outer layer has broken off. The tooth may feel rough or sharp but does not hurt. Your dental team can smooth it or repair it with tooth-coloured bonding. It is not urgent. But get it seen within a few days, so the sharp edge does not cut your tongue or lip.
- Break into the enamel and dentine. A bigger break shows the yellow layer (dentine) under the enamel. The tooth may be sensitive to air, cold or touch. See your dental team within 24 hours. While you wait, you can cover the exposed part with dental wax (from a pharmacy). You can take ibuprofen or paracetamol for pain. Do not take ibuprofen if you have asthma, heart or blood vessel disease (cardiovascular disease), stomach problems or kidney problems. Do not take it if you take blood thinners or are pregnant.
- Break that exposes the nerve. The break is deep enough to expose the nerve (pulp). You may see a pink or red spot, and the tooth will be very painful. See your dental team urgently (the same day). The tooth will need a pulp cap, root canal treatment or removal, depending on how bad it is.
If you find the broken piece, keep it in milk or saline and bring it to your appointment. Your dental team may be able to stick it back on.
Loose or moved teeth
A blow to the face can loosen a tooth, push it in or move it without knocking it out. These are called luxation injuries.
- Slightly loose tooth (sore to bite on). Eat soft foods. Do not bite on that tooth. See your dental team within a few days. This often gets better on its own.
- Very loose or pushed sideways. See your dental team as soon as you can (the same day if possible). The tooth may need to be moved back into place. It may then be splinted (fixed to the teeth next to it with a wire) for several weeks while it heals.
- Pushed up into the gum (intruded). The tooth looks shorter, or has gone up into the gum. See your dental team urgently. In children, the tooth may come back down on its own. In adults, it may need to be moved back into place.
- Pushed partly out of the socket (extruded). The tooth looks longer than the teeth next to it. See your dental team urgently. The tooth can usually be gently pushed back into place and splinted.
After any injury to a tooth, your dental team will check the nerve over the next few months. Even teeth that seem to recover well at first can sometimes have problems weeks or months later.
Cuts and other injuries in the mouth
Dental injuries often come with cuts or bruises to the lips, gums, tongue or cheeks.
- Bleeding cuts. Press firmly on the cut with a clean cloth for 10–15 minutes. Most small cuts in the mouth stop bleeding if you keep pressing.
- Cut lip. Go to A&E if the cut is deep, goes across the edge of the lip (the line between the red lip and the skin), or does not stop bleeding. It may need stitches.
- Torn frenum. This is the thin strip of tissue that joins the lip to the gum. It can tear in an injury. It usually heals on its own but may bleed quite a lot.
Important: if a tooth has broken, always check inside the lip for bits of tooth. Your dental team may take an X-ray of the lip to check.
Tetanus: a tooth may have been knocked out, or a cut or wound may have touched soil or dirt. If so, check that your (or your child's) tetanus vaccinations are up to date. If you have not been fully vaccinated, or you are not sure, ask your GP for an urgent appointment or call NHS 111.
When to go to A&E
Call 999 or go to A&E now if you have:
- difficulty breathing or swallowing after an injury to the face
- a possible broken jaw. Signs include not being able to open or close your mouth, a numb lower lip, teeth that do not meet properly, or a jaw that looks out of shape.
- bleeding that will not stop after 15 minutes of firm pressure
- a head injury with passing out, confusion, being sick, or feeling very sleepy
- swelling that is spreading fast to the neck or throat
- clear fluid leaking from the nose or ears
Some dental injuries do not have these signs, such as a knocked-out, broken or loose tooth. For these, contact your dental team or call NHS 111 for an emergency dental appointment.
Do not go to A&E for injuries a dentist can treat. A&E does not have dental tools or dental experts.
After treatment — what to expect
If a tooth has been put back or splinted, your dentist will give you instructions. In general:
- Eat soft foods for at least 2 weeks.
- Do not bite directly on the injured tooth.
- Keep your mouth clean. Use a chlorhexidine (antiseptic) mouthwash if you are advised to.
- Avoid contact sports until your dental team says it is safe.
- Go to all your follow-up appointments. Your dental team will check the nerve and root over weeks and months.
- Problems can start later, even if the tooth feels fine at first. For example, the nerve may die or the root may be slowly worn away (resorbed).
- You may need root canal treatment later. Your dental team will explain if this is needed.
Preventing dental injuries
Many dental injuries can be prevented:
- Wear a mouthguard for contact sports, such as rugby, boxing, hockey, martial arts, football, cricket and basketball.
- A custom-made mouthguard from your dental team fits and protects best. It is much better than boil-and-bite or ready-made mouthguards.
- Replace children's mouthguards every year, as the jaw grows and teeth change. Replace adult mouthguards every 1–2 years.
- Use the right safety gear for activities such as cycling, skateboarding and horse riding.
- Do not use your teeth to open bottles, tear packets or hold things.
This leaflet is for general information only and does not replace professional dental advice. Your dental team will discuss your individual circumstances and any risks and treatment specific to you. Treatment outcomes vary between patients depending on individual circumstances.
Sources
- Guidelines for the evaluation and management of traumatic dental injuries. International Association of Dental Traumatology (IADT), 2020.
- Dental Trauma Guide: treatment guidelines for primary and permanent teeth. Dental Trauma Guide.
- Knocked-out tooth. NHS website (nhs.uk), reviewed February 2025.
- Chipped, broken or cracked tooth. NHS website (nhs.uk), reviewed January 2025.
- Management of Acute Dental Problems, 2nd edition. Scottish Dental Clinical Effectiveness Programme (SDCEP), 2026.
Links checked 18 October 2026.
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