If a baby tooth is knocked out, do not try to put it back. Reimplanting a baby tooth risks damaging the permanent tooth developing directly above it. A knocked-out permanent tooth is the opposite — it should be reimplanted as quickly as possible, ideally within minutes.
That distinction is the single most important thing for a parent to know, and it is the reverse of what most people assume.
First: check the child, not just the tooth
Dental injuries usually come with a fall or a knock to the face. Before anything else, look for signs of a head injury: loss of consciousness even briefly, vomiting, drowsiness, confusion, or a headache that is worsening. Any of those means medical attention first — the tooth can wait.
Also check for cuts to the lips, tongue or inside of the mouth, which bleed dramatically and often look worse than they are, and for any debris or fragment embedded in the soft tissue.
A knocked-out baby tooth
- Do not put it back. Reimplantation can damage the developing permanent tooth above.
- Control bleeding with gentle pressure using clean gauze or a clean cloth for around ten minutes.
- Give a cold compress on the outside of the lip or cheek for swelling.
- Find the tooth if you can. If it cannot be found, it needs to be confirmed that it has not been inhaled or pushed up into the gum — tell us, and bring the child in.
- Contact the clinic the same day.
- Soft food for a few days, and keep the area clean.
A knocked-out permanent tooth — act within minutes
This is a genuine emergency and the outcome depends heavily on speed.
- Pick the tooth up by the crown, never the root.
- If it is dirty, rinse it briefly in milk or the child’s saliva. Do not scrub it, do not use soap, and do not rinse it under a running tap for long — the cells on the root surface must survive.
- Put it back into the socket straight away if you can, the right way round, and have the child bite gently on a clean cloth to hold it.
- If you cannot reimplant it, store it in milk. Saliva is second best — in a container, or held inside the child’s cheek if they are old enough not to swallow it. Never store it in water.
- Get to a dentist immediately. Minutes matter.
A broken or chipped tooth
- Find the fragment and keep it in milk — it can sometimes be bonded back.
- Rinse the mouth gently with warm water.
- Cover a sharp edge with orthodontic wax or sugar-free gum if it is cutting the lip or tongue.
- Cold compress for swelling, and pain relief appropriate to the child’s age and weight.
- Contact us the same day.
Be seen urgently if you can see a pink or red spot in the middle of the broken surface, which means the nerve is exposed. See also fixing a chipped or worn front tooth.
A tooth pushed in, out or sideways
A tooth driven up into the gum, or displaced out of position, needs assessing promptly even if it is a baby tooth — particularly because a tooth pushed up into the bone sits close to the permanent tooth developing above it. Do not try to reposition it yourself. Contact us.
A tooth that is loose but still in place
Soft diet, careful cleaning around it, and an appointment to have it assessed and radiographed. Many settle on their own; some do not.
What to watch for in the following weeks
Even an injury that seems minor can affect the nerve of the tooth, sometimes months later. Watch for:
- The tooth darkening — turning grey, brown or pink. This is common after trauma and means the nerve has been affected. It is not always an emergency, but it needs assessing.
- A small bump or pimple on the gum above the tooth — a draining abscess. See us promptly.
- Pain, or the tooth becoming tender to bite on.
- The tooth becoming loose weeks later.
- Swelling of the gum or face.
Follow-up appointments after any dental injury are not optional, even if everything looks fine. The tooth is checked and radiographed at intervals because problems often appear late.
If a baby tooth is lost early
The main consequence is space. The neighbouring teeth drift into the gap and the permanent tooth may not have room to come through. A space maintainer is sometimes fitted — ask about it. See why baby teeth matter.
Frequently asked questions
How do I know if it is a baby tooth or a permanent one?
Age is the best guide: permanent front teeth usually arrive around six to eight. Permanent teeth are larger, less bright white, and often have slightly serrated edges when new. If you are unsure, store it in milk and get to a dentist immediately — that is safe either way.
Will a new tooth grow in its place?
If it was a baby tooth, yes, though it may arrive later than it would have. If it was a permanent tooth, no.
Can a darkened tooth be treated?
It is assessed and monitored. Some darkened baby teeth stay in place without problems until they are due to be lost; others need treatment.
Should we go to the emergency department?
For a suspected head injury, a large facial wound, or uncontrolled bleeding, yes. For the tooth itself, a dentist is the right place.
Contact us straight away after any dental injury
Even minor knocks should be assessed, and speed matters most with permanent teeth. See our pediatric dentistry page and dental emergencies.
To reach our clinic on Abbas El-Akkad in Nasr City, call +20 101 969 7597 or message us on WhatsApp.
