First Aid for a Tooth Knocked Out Whole: How to Hold It, Storage Liquid and Time

If a permanent tooth is knocked out whole, the best first aid is to hold the white crown part without touching the root and, if possible, put it back right there on the spot. If it cannot be put back at once, keep it from drying in milk, HBSS, saliva or saline in that order, and go to the dentist immediately. Baby teeth are not replanted.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Best care	Replant at once at the scene (baby teeth are not replanted) (source: KDCA and International Association of Dental Traumatology (IADT))
Storage liquid priority	Milk, HBSS, saliva, saline in that order; water is not good but better than air drying (source: KDCA and International Association of Dental Traumatology (IADT))
High chance of cell survival	Replantation at the scene immediately or within about 15 minutes (source: International Association of Dental Traumatology (IADT) 2020 Guidelines)
30 minutes dry	After 30 minutes dry outside the tooth socket, most periodontal ligament cells do not survive (source: International Association of Dental Traumatology (IADT) 2020 Guidelines)
Over 60 minutes dry	Cells have probably not survived regardless of storage (source: International Association of Dental Traumatology (IADT) 2020 Guidelines)
Fixation after replantation	A flexible splint for 2 weeks; root canal treatment started within 2 weeks for fully formed roots (source: International Association of Dental Traumatology (IADT) 2020 Guidelines)

What do I do first if a tooth is knocked out whole?

A completely knocked-out permanent tooth is a dental emergency where the outcome changes by the minute. First check whether the tooth is a permanent one. Baby teeth are not replanted, so you only need to take the tooth to the dentist and have the surrounding injury checked. If it is a permanent tooth, act in the order below.

When putting it back, check the front-back orientation and push it slowly into its original place. If the person is unconscious or has another major injury, first aid for the person comes before the tooth, and the tooth is brought along stored in a storage liquid.

Calm the patient and find the knocked-out tooth
Hold only the white crown part of the tooth and do not touch the root
If there is dirt, dip it briefly in milk, saline or saliva and swirl to rinse
If possible, put it back in place at once
Bite on gauze, a handkerchief or a napkin to hold the tooth and head to the dentist

Where do I keep the tooth if I cannot put it back at once?

If the child is young and might swallow it, or pain makes it hard to put in, carry the tooth in a storage liquid. The root surface starts to dry after only a few minutes, so putting it in liquid as soon as possible matters. The order recommended by the Korea Disease Control and Prevention Agency (KDCA, 질병관리청) and the International Association of Dental Traumatology (IADT) is below.

Carrying it wrapped in tissue or a dry cloth dries the root surface and damages the cells. When there is no suitable liquid, water can be used, but water is a poor storage liquid, so choose milk or saliva if you can get them.

1st choice: milk
2nd choice: HBSS (Hank's balanced salt solution made for tooth storage)
3rd choice: saliva (spit into a cup and place the tooth in it)
4th choice: saline
Last resort: water (better than air drying)

How important is time in first aid for a knocked-out tooth?

For a knocked-out tooth to settle back in, the periodontal ligament cells on the root surface must be alive. The IADT 2020 guideline considers that cells are most likely alive when the tooth is replanted at the scene immediately or within about 15 minutes.

The same guideline explains that after 30 minutes dry outside the socket most cells do not survive, and when the dry time exceeds 60 minutes cells have probably not survived regardless of whether the tooth was placed in a storage liquid. So putting it back or into liquid as soon as you find the tooth is most important.

Even past 60 minutes, replantation is sometimes performed, so do not give up; take the tooth with you. On arrival at the dentist, telling them the time of the accident and how long the tooth was left dry helps decide the treatment plan.

How does a dentist treat a knocked-out tooth?

At the dentist, after checking the tooth and the empty socket, the tooth is placed in the socket and splinted to the neighboring teeth with a flexible splint for 2 weeks. If a jaw fracture is also present, a firmer splint may be used for longer.

For a tooth whose root has fully formed, starting root canal treatment within 2 weeks after replantation is the basis of the guideline. For a young tooth with an immature root, the course is sometimes observed to see whether the nerve might recover. The KDCA explains that the earlier complications such as pulp necrosis and root resorption after trauma are found, the better the outcome, so do not skip the scheduled follow-up checks.

What should I do when a baby tooth is knocked out?

Both the KDCA and the IADT advise that a knocked-out baby tooth is not replanted. A permanent tooth is growing beneath the baby tooth, so when a baby tooth comes out, the right response is not to try to put it back but to take the tooth to the dentist.

That does not mean leaving it alone. Bring the knocked-out baby tooth so the dentist can check whether the whole tooth came out, whether any root fragment remains, and whether the gum and neighboring teeth are injured. After that, progress is monitored regularly until the permanent tooth comes in.

Common myths and facts

Myth: A knocked-out tooth must be scrubbed clean.

Rubbing the root damages cells that need to stay alive. Hold only the crown, and if dirty, a gentle rinse in milk, saline or saliva is enough.

Myth: A knocked-out tooth can be carried in water.

Water is a poor storage liquid. Milk, HBSS, saliva and saline are recommended in that order, and water is a last resort that is better than air drying.

Myth: A child's baby tooth must also be replanted when it comes out.

Baby teeth are not replanted. A dental visit is still needed to check the surrounding injury and the permanent tooth.

Frequently asked questions

May I carry the tooth in my mouth?

The IADT accepts saliva as a storage liquid, but to reduce the risk of swallowing it gives the example of spitting into a cup and placing the tooth in it. Young children may swallow it, so carrying it in milk is safer.

What kind of milk should I use?

The IADT guideline lists milk as the first-choice storage liquid. A few minutes is enough for the root to start drying, so putting the tooth into the nearest milk and setting out for the dentist matters most.

I put the tooth back but do not know if the direction is right.

Check that the height and front-facing direction match the neighboring teeth, and do not push forcibly. If it does not go in easily, do not force it; it is better to put it in a storage liquid and take it to the dentist.

Where should I go if a tooth comes out at night?

First contact a dental clinic offering emergency care or a hospital emergency room with dentistry to check that care is available. While travelling, keep the tooth in a storage liquid and note the time of the accident.

Can a replanted tooth be used for life?

The course of a replanted tooth varies greatly with dry time, storage method and root maturity. Changes such as root resorption or fusion with the bone can occur, so follow-up checks on the set schedule are needed.

References

Korean version →