Chipped, Cracked or Knocked Out Tooth: What to Do in the First Hour

By the team at Mark Bilello, DDS. 5 min read

If an adult tooth gets knocked out, pick it up by the crown (the part you chew with), rinse it briefly in water, and try to put it back in its socket. If it won’t go back in, keep it in milk or inside your cheek and get to a dentist, ideally within 30 minutes. For a chipped, cracked or broken tooth, save any pieces, rinse your mouth with warm water, and call a dentist soon.

Go to the emergency room instead if there is trouble breathing or swallowing, swelling with a fever, a head injury, or bleeding that won’t stop.

What should you do if an adult tooth gets knocked out?

Move fast and keep the tooth wet. The American Association of Endodontists (AAE) says your best chance is to see a dentist within 30 minutes. A tooth can sometimes still be saved after an hour or more out of the mouth, so don’t give up if more time has passed.

1. Pick it up by the crown. That’s the white part you chew with. Don’t touch the root.
2. Rinse it briefly if it’s dirty. Use only water. Don’t use soap, don’t scrub it and don’t dry it.
3. Try to put it back. Gently push it into the socket the way it was, even if there is bleeding. Then bite softly on gauze, a clean handkerchief or a napkin to hold it in place (IADT).
4. If it won’t go back, keep it moist. Put it in a cup of milk, hold it in your mouth between your cheek and gum, or use a tooth-saving kit with the ADA Seal (ADA MouthHealthy).
5. Don’t store it in tap water. The AAE says the cells on the root can’t handle tap water for long.
6. See a dentist right away. Bring the tooth with you.

What if a child’s baby tooth gets knocked out?

Don’t put a baby tooth back in. The International Association of Dental Traumatology (IADT) is firm on this, and the AAE says knocked-out baby teeth usually should not be put back.

Call your child’s dentist so the mouth can be checked. If a baby tooth is chipped rather than knocked out, the AAE notes it can often be repaired.

What should you do about a chipped or broken tooth?

Save the broken piece and book a dental visit as soon as you can. The IADT says a broken tooth is usually not an emergency, but it does need treatment. The AAE says any chipped or cracked tooth should be checked by a dentist, no matter how small it looks.

• Find the piece. Keep it in milk or water so it doesn’t dry out. A dentist may be able to reattach it.
• Skip aspirin on the gum. Don’t put aspirin directly on the tooth or gum, because it can irritate the tissue (MedlinePlus).
• Watch for warning signs. If the injury came with a blow to the head, read the ER section below first.

What if your tooth feels cracked or hurts when you bite?

A tooth that hurts when you bite down, or when you let go of a bite, may be cracked and should be checked soon. The AAE lists pain when chewing, pain when you release your bite, and pain with hot or cold as common signs. The pain may come and go, so it can be hard to tell which tooth it is.

Until your visit:

• Rinse your mouth with warm water (ADA MouthHealthy).
• Hold a cold compress on your cheek if it’s swollen.
• Don’t put aspirin on the gum (MedlinePlus).
• Avoid chewing ice, popcorn kernels and pens. The AAE lists these among the habits that crack teeth.

You can learn more in our guide to cracked tooth signs, causes and treatment.

What should you do if a filling or crown falls out?

Save the crown or the piece and call our office to set up a visit. Keep it in a small, clean container and bring it with you. When you call, tell us which tooth it is and whether it hurts.

Don’t wait if the pain gets worse. MedlinePlus, from the National Library of Medicine, says to get care for a severe toothache, a toothache that lasts more than a day or two, or a toothache with fever or pain when you open wide.

When should you go to the ER instead?

Call 911 or go to the emergency room for any of these:

• Trouble breathing or swallowing. MedlinePlus says breathing trouble from a mouth infection is an emergency (Ludwig angina).
• Swelling that is spreading. This includes swelling in your face, your jaw or under your tongue. Swelling under the tongue can grow quickly and block the airway.
• Swelling with a fever. Fever, redness or tenderness along with swelling can be a sign of infection (MedlinePlus).
• A head or face injury. Get help right away if the person is confused, very sleepy or passed out, or if you think the head or neck is badly hurt (MedlinePlus).
• Bleeding that won’t stop. Severe bleeding from the face or mouth is a reason to call 911.

Once you’re safe, see a dentist to check the tooth.

Your first-hour checklist

When should you see a dentist about a tooth injury?

You should see a dentist after any knocked-out, chipped or cracked tooth, even if it doesn’t hurt. Damage inside the tooth isn’t always visible, and the IADT advises follow-up visits so injured teeth can be watched over time.

Our office is open Monday to Thursday, 7 AM to 3 PM. During those hours, call our office and tell us what happened. Dr. Bilello will examine the tooth and walk you through the options. Depending on the damage, he offers tooth repairs like tooth-colored fillings, bonding and crowns.

If an adult tooth is knocked out while our office is closed, don’t wait for us to open. The AAE advises going to the nearest dentist or endodontist (a dentist who treats the inside of the tooth).

FAQ

Can a knocked-out tooth be saved after an hour?
Sometimes. The AAE says a tooth can sometimes be saved after an hour or more out of the mouth, but the chances are better the sooner you’re seen. Keep it moist and go right away.

Should I put a knocked-out tooth in water?
Only for a quick rinse if it’s dirty. For the trip to the dentist, keep it in milk, between your cheek and gum, or in a tooth-saving kit with the ADA Seal. Tap water is not good for storing it, because the cells on the root can’t handle it for long.

Is a chipped tooth an emergency?
Usually not, but it still needs treatment soon. Save the piece in milk or water. If the chip came with a head injury, heavy bleeding or swelling, go to the ER.

Can I put my child’s baby tooth back in?
No. Dental trauma experts say knocked-out baby teeth should not be put back. Call your child’s dentist so the mouth can be checked.

How can I protect my teeth from injury?
The ADA recommends a mouthguard for sports and other active play (ADA MouthHealthy). Avoid chewing ice and hard candy, and use scissors rather than your teeth to open packages.

Hurt a tooth? Call our office Monday to Thursday, 7 AM to 3 PM, and tell us what happened. The team at Mark Bilello, DDS, in Houma will help you work out the next step.

Sources

1. American Association of Endodontists. Knocked-Out Teeth. https://www.aae.org/patients/dental-symptoms/knocked-out-teeth/
2. American Association of Endodontists. Traumatic Dental Injuries. https://www.aae.org/patients/dental-symptoms/traumatic-dental-injuries/
3. American Association of Endodontists. Cracked Teeth. https://www.aae.org/patients/dental-symptoms/cracked-teeth/
4. American Dental Association, MouthHealthy. Dental Emergencies. https://www.mouthhealthy.org/all-topics-a-z/dental-emergencies
5. International Association of Dental Traumatology. Knocked Out. https://iadt-dentaltrauma.org/knocked-out/
6. International Association of Dental Traumatology. Broken Teeth. https://iadt-dentaltrauma.org/broken-teeth/
7. MedlinePlus (National Library of Medicine, NIH). Toothaches. https://medlineplus.gov/ency/article/003067.htm
8. ADA MouthHealthy. Mouthguards. https://www.mouthhealthy.org/all-topics-a-z/mouthguards
9. MedlinePlus. Ludwig angina. https://medlineplus.gov/ency/article/001047.htm
10. MedlinePlus. Facial swelling. https://medlineplus.gov/ency/article/003105.htm
11. MedlinePlus. Head injury, first aid. https://medlineplus.gov/ency/article/000028.htm