Can a knocked-out tooth be reimplanted successfully?

Sometimes, yes - if you act quickly and handle the tooth correctly. A knocked-out permanent tooth can potentially be reimplanted and heal successfully, but the outcome depends heavily on what happens in the first 30 to 60 minutes.

This post covers the factors that affect reimplantation success, what to do immediately, and what happens if the tooth cannot be saved. For step-by-step first aid instructions, see our detailed guide on what to do if you knock out a tooth.

What improves the chance of saving it

The two most important factors are time and handling.

Time. The cells on the root surface of a knocked-out tooth are damaged when they dry out. Prompt reimplantation generally offers a better chance of success, so contact a dentist immediately and keep the tooth moist while travelling.

Handling. The root surface of the tooth contains a layer of cells (the periodontal ligament) that allows it to reattach to the bone. Touching, scrubbing, or scraping the root damages these cells and reduces the chance of successful healing. Always hold the tooth by the crown (the white part you normally see), never the root.

Storage. If you cannot reimplant the tooth immediately, keep it moist. Cold milk is generally considered an effective and readily available storage option. Saline solution also works. The patient's own saliva (placing the tooth inside the cheek) is acceptable for short transport. Do not store the tooth in water, as it damages the root cells faster than milk or saline.

What makes the outcome worse

Several factors reduce the chance of a successful reimplantation:

• The tooth has been out of the mouth for more than 60 minutes
• The tooth has dried out
• The root surface has been scrubbed or cleaned aggressively
• The tooth was stored in plain water
• The socket has been damaged or fractured
• There is significant contamination (the tooth fell in dirt and was not rinsed gently)
• The patient is very young and the root is not fully formed (open apex - these cases are more complex but may still be viable)

How to store the tooth

If you find the knocked-out tooth:

1. Pick it up by the crown only. Do not touch the root.
2. If the root is dirty, rinse it very gently under cold running water for no more than 10 seconds. Do not scrub it. Do not use soap or disinfectant.
3. Try to place it back in the socket yourself, gently pushing it in with finger pressure. Bite down on a clean cloth to hold it in place.
4. If you cannot reimplant it, place it in a container of cold milk. If milk is not available, place it in saline, or have the patient hold it inside their cheek (against the gum, not between the teeth).
5. Get to a dentist as quickly as possible.

Do not wrap the tooth in tissue or cotton wool. Do not let it dry out. Do not store it in ice or warm water.

When reimplantation may not be possible

Reimplantation may not be viable when:

• The tooth has been out of the mouth for too long and the root cells are no longer viable
• The socket is severely damaged or fractured
• The tooth itself is fractured in a way that makes reimplantation unstable
• The knocked-out tooth is a baby tooth (primary teeth are generally not reimplanted because of the risk of damage to the developing permanent tooth underneath)

In these cases, the focus shifts to managing the socket, preserving the bone, and planning a long-term replacement.

Call Ivy Dental immediately if a tooth has been knocked out: (07) 3266 7120

What happens if it cannot be saved

If the tooth cannot be reimplanted or the reimplantation fails, replacement options include:

• A dental implant (once the socket has healed and bone is adequate)
• A bridge using adjacent teeth as supports
• A removable partial denture as a temporary or longer-term solution

The replacement option depends on the location of the tooth, the condition of the surrounding bone and teeth, and the patient's age and goals. For more on replacement options, see our missing teeth page. Your dentist will discuss these options once the acute situation is managed. For pricing on implant replacements, see our implant cost guide.

What happens after reimplantation

Even when a tooth is successfully reimplanted, it requires careful monitoring over the following months. Your dentist will typically apply a flexible splint for 7 to 14 days to stabilise the tooth while it reattaches to the bone and surrounding ligaments.

Follow-up appointments are usually scheduled at 2 weeks, 4 weeks, 8 weeks, and 6 months. During these visits, your dentist checks for signs of root resorption, infection, or nerve death. Root canal treatment may be needed if the nerve does not recover, which is common in teeth that have been out of the mouth for longer periods.

The long-term prognosis depends on how quickly the tooth was reimplanted, how it was stored, and the extent of damage to the root surface. Some reimplanted teeth function well for many years. Others may eventually need replacement. Regular monitoring allows your dentist to identify issues early and intervene if needed.

Ivy Dental provides emergency dental care at our Everton Park and Nundah clinics in Brisbane, 7 days a week.

Next step

If a permanent tooth has been knocked out, arrange emergency dental care immediately. Book online at any time and call us during opening hours for phone triage and booking help. Because time is critical and availability depends on clinic capacity, contact another emergency dental provider if no immediate appointment is available.

Book an emergency consultation at Ivy Dental | Call (07) 3266 7120

For detailed first-aid steps, see our knocked-out tooth page.