This article is general information for our patients, not a diagnosis. If something in your mouth hurts, changes, or worries you, have it examined.
A knee to the face at hockey, a fall on the Barrie trails, an elbow at basketball — when a tooth gets hit, what you do in the first fifteen minutes can matter as much as anything I do afterwards. I’d rather you knew these steps before you need them; they follow the International Association of Dental Traumatology (IADT) 2020 guidelines we work to.
One thing first. What you can do at the scene is first aid — protect the tooth, settle the bleeding. What you can’t do at home is read how much damage was really done: a chip that looks shallow, a tooth that feels fine, a knock that seemed minor — none tells the real story alone. The picture only comes clear when everything is read together at once: what happened, an exam, how the tooth responds to specific tests, and an X-ray. A single sign can point one way and mean another. So the steps below buy time; they don’t decide how the tooth will do — that part we settle in the chair.
The first few minutes with a knocked-out adult tooth
If a permanent tooth is knocked clean out of its socket (an avulsion), the next few minutes count for more than anything I do later. Putting it back yourself, right there, is the one act that gives an adult tooth a real chance.
- Find the tooth and pick it up by the crown — the white part you normally see. Never touch the root: it’s covered in living cells we’re trying to keep alive.
- Rinse it only if it’s dirty — about 10 seconds under cold water or in milk. Don’t scrub it, don’t dry it, don’t wrap it in tissue.
- Put it back in the socket the right way round, and have the person bite gently on a clean cloth to hold it.
- Call us at 705-721-9229, or your nearest emergency dental provider, straight away.
Can’t bring yourself to replant it — or the person is very young, badly shaken, or not fully awake? Don’t force it. Skip to storing the tooth and get to us fast. This is exactly what counts as a dental emergency, and what our emergency dental care in Barrie is for.
Speed is the part you control. A tooth back in place within about 15 minutes tends to settle in well; after roughly 60 minutes of dry time, the root-surface cells (the periodontal ligament, which lets a tooth reattach) have usually died, and long-term trouble becomes far more likely. Middle of the night and we’re closed? Replanting matters more, not less — a tooth in its own socket is safer overnight than one sitting in milk — so get it back in if you can, leave a message, and call again when we open.
I’ll be honest about what “saved” means. Even done perfectly, a replanted adult tooth can later fuse to the bone (ankylosis) or have its root slowly dissolve over years — and the longer it spent dry, the likelier that is. So I won’t promise it lasts a lifetime. But replanting holds the space and bone, keeps your smile, and often lasts many years; getting it back in, or into milk, quickly stacks the odds in your favour.
If you can’t replant it, store it right
Can’t put it back? Then the whole job is keeping the root from drying out — a dry root surface is what makes a replanted tooth fail later. Hold the tooth by the crown, never the root, and get it into the right liquid. Not all storage is equal; here’s the order I’d reach for.
| Where to keep the tooth | Use it? | Why |
|---|---|---|
| Cold milk | First choice — grab this | Gentle on the living root cells, and almost every fridge has it |
| Tooth-rescue solution (a balanced salt solution in some sports first-aid kits) | Just as good — if it’s already in the kit | Made for the job, but don’t waste time hunting for one |
| Saliva (tuck it inside the cheek, or spit into a clean cup) | Good backup | Keeps the root wet; only if the person is awake and won’t swallow it |
| Saline (contact-lens or wound saline) | Fine | Better than water; use it if it’s what you have |
| Plain water | Avoid for storage | A 10-second rinse is fine — it’s soaking or storing the tooth in water that makes the root cells swell and die |
Whatever you use, bring the tooth with you. Even one that can’t go back in tells us a lot, and we need to be sure no fragment is left behind in the lip or socket.
A knocked-out baby tooth is the opposite
Here’s the one that surprises parents: never push a knocked-out baby tooth back in. Its root sits right above the developing adult tooth, and forcing it back can bruise or deform that tooth bud — showing up later as white or yellow marks on the new tooth, a misshapen crown, or a delayed eruption. A baby tooth gets replaced anyway, so the trade isn’t worth it. Instead: keep the child calm, press clean gauze on the gum to stop the bleeding, bring the tooth so we can confirm none is buried in the socket, and see us promptly. We’ll watch the permanent tooth as it develops. Not sure whether it’s a baby or an adult tooth? That’s part of children’s dental visits and fillings — bring the child and the tooth and we’ll sort it out.
A chipped or broken tooth
Find any broken piece, keep it moist in milk or saliva, and call us — we can often bond a fragment back on once we’ve checked what’s happening inside. A chip is less urgent than a knock-out, but the same moisture rule keeps your repair options open. How deep the break goes is the clue I weigh first:
- A small enamel chip with a rough edge is usually a comfortable, unhurried fix.
- A larger break into the softer yellow layer underneath (the dentine) can be sensitive to air and cold, and is worth seeing within a day or two, because covering that exposed layer protects the nerve.
- A pink or red dot in the middle of the break can mean the soft core inside the tooth (the pulp) is exposed — that one needs prompt care.
But how the tooth will do isn’t something I’d settle from the size of the chip; whether the nerve pulls through depends on what an exam and X-ray show alongside how it responds to testing, all read together. In children especially, a young tooth with an exposed nerve can often be saved with a small procedure if we catch it early. So save the piece in milk, note whether the tooth is loose or just chipped, and get in touch.
A loose or knocked-sideways tooth
Don’t wiggle it. If a tooth has been loosened, pushed out of line, or driven up into the gum, we can usually ease it back into place and splint it — a thin, flexible wire bonded gently across a few teeth, passive, just holding the tooth steady while the ligament heals. We numb the area first, and the splint stays on for a few weeks. What we do depends on how the tooth moved:
| What happened to the tooth | What we usually do | About how long the splint stays |
|---|---|---|
| Loosened but not moved (subluxation) | Settle it, soft diet, monitor | Often none, sometimes up to 2 weeks |
| Pushed partly out of the socket (extrusion) | Ease back into place, splint | About 2 weeks |
| Put back after a full knock-out | Replant, splint | About 2 weeks |
| Knocked sideways (lateral luxation) | Ease back into place, splint | About 4 weeks |
| Driven up into the gum (intrusion) | Let it come back down on its own, or ease it back into place | If repositioned: about 4 weeks |
While it heals, a soft diet, careful brushing with a soft brush, and an antiseptic mouthrinse give the area good conditions. If a tooth turns out to be beyond saving, we’ll talk you through tooth-replacement options properly rather than rushing it.
When to skip us and go to hospital first
Some injuries belong in the emergency department before the dental chair. The first thing I weigh after any facial blow isn’t the tooth — it’s the head. A tooth can wait a short while; a head injury can’t. Go to hospital first for a blackout, repeated vomiting, confusion, a possible broken jaw, or bleeding you can’t control. Other signs that point to hospital rather than us:
- losing consciousness, even briefly
- not being able to bite your teeth together evenly
- a jaw that won’t open or close properly, or feels like it has a “step” in it
- numbness across the chin or lip
- unusual drowsiness
- clear fluid leaking from the nose (can signal a skull injury)
- a deep facial cut
Get the head checked first — the tooth will keep in milk while you’re seen. When in doubt, the emergency room is the right first stop.
Why we keep checking a tooth that feels fine
The nerve inside a knocked or jolted tooth can quietly die weeks or months later with no pain at all — and “it feels fine” is exactly why that gets missed. How a tooth is really healing isn’t something it can tell you; we read it from its colour, an X-ray, and how it responds to testing, together, over time. So we monitor an injured tooth on a set schedule — usually at 2 and 4 weeks, again around 3 and 6 months, then yearly; after a knock-out, for at least five years.
I know that’s a lot of visits for a tooth that looks recovered. But the warning signs are subtle: a tooth slowly turning grey, a small pimple on the gum (an early sign of the kind of infection we cover in our toothache and abscess guide), tenderness creeping back, a change on an X-ray. Caught early, a dying nerve often means a straightforward root canal saves the tooth; caught late, it can mean losing it. The follow-ups are how we protect what you saved in those first frantic minutes.
Mouthguards, and whether they help
A properly fitted mouthguard cushions blows during sport and meaningfully lowers the risk of broken, loosened, and knocked-out teeth. Across sports studies, athletes playing without one are roughly 1.6 to 2 times more likely to injure their teeth or mouth. It isn’t total protection, but it’s a real, measurable difference — and the stakes start young: up to about one in three children injures a baby tooth, and blows to the adult front teeth are common in sport too. Two main kinds:
| What you’re comparing | “Boil-and-bite” (pharmacy) | Custom-made (from a mould of your teeth) |
|---|---|---|
| Cost | Inexpensive | Costs more upfront |
| Fit and staying put | Shaped at home in hot water, so the fit is approximate and it can loosen mid-game | Formed on an exact model of your teeth, so it fits closely and stays put during play |
| Bulk and comfort | Often bulky; harder to breathe and talk through | Slim; easy to breathe and talk through |
| Growing kids | Cheap to replace as teeth change | We time it so the guard still fits as new teeth come in |
A boil-and-bite guard is far better than nothing, but the guard that actually gets worn is the comfortable one — that’s where a custom fit earns its place. Hockey, basketball, soccer, rugby, skateboarding — any sport with contact or falls gives a mouthguard a job to do. If your child plays and doesn’t have one yet, that’s an easy appointment to book.
If a tooth has been knocked out, broken, or pushed out of place, call us at 705-721-9229, then keep the tooth or fragment moist in milk and bring it with you. For anything that isn’t urgent, including a sports mouthguard, you can book a visit through our contact page.
