A fall at the playground, a bump against the edge of a table, a collision with a sibling: most knocked-out baby teeth happen in the toddler and preschool years, and they are frightening to see. Leave the tooth out of the mouth, press on the gum to stop the bleeding, and arrange for a dentist to see your child that day or the next. That is almost the reverse of the advice for an adult tooth, which is the main reason parents feel unsure what to do.
In the first few minutes
Your child will take their cue from you, so a calm voice matters more than speed here. Sit them down where you can see into their mouth in good light.
Rinse gently with cool water to clear blood and grit. Fold a clean gauze square or a face washer, wet it with cold water, and have your child bite on it, or hold it against the socket yourself, with steady pressure for ten minutes or so without peeking. A cold pack wrapped in a cloth on the outside of the lip helps with swelling.
If you find the tooth, pop it in a clean container or a zip bag and bring it with you. The dentist will not put it back, but seeing it lets them check whether the whole root came out or a piece is still in the gum.
Do not push the tooth back into the socket. Under each baby front tooth sits the crown of the adult tooth that will replace it, separated by very little bone. Forcing the baby tooth back in risks pressing on that developing tooth or carrying infection close to it. International dental trauma guidelines (IADT, Day and colleagues, Dental Traumatology, 2020) advise against replanting baby teeth for this reason. Our separate article on why baby teeth are not replanted explains the biology in more detail.
Signs that need help straight away
Go to a hospital emergency department, rather than waiting for a dental appointment, if your child:
- hit their head and is drowsy, confused, vomiting or complaining of a headache
- is bleeding heavily and it has not slowed after ten to fifteen minutes of firm pressure
- has a deep cut to the lip or face, or the jaw looks out of shape or will not close properly
- may have inhaled the tooth and is coughing or having trouble breathing
If you cannot find the tooth and none of these apply, mention it at the dental visit. It may have been swallowed, which is usually harmless, or it may have been pushed up into the gum, which looks very similar to a lost tooth from the outside. That second situation is covered in our guide to a baby tooth pushed into the gum.
Later that day: the dental check
Even when the bleeding stops quickly and your child is back to playing, the dental visit is worthwhile. A knock strong enough to remove one tooth often loosens, chips or bruises the ones beside it. The dentist will look at the gum and lip, feel how firm the neighbouring teeth are, and usually take a small X-ray to confirm there is no root fragment left behind and no tooth hidden in the gum. The X-ray also shows how far the adult tooth underneath has formed, which helps predict when the gap will fill.
At home over the next few days, offer soft, cool foods, use a soft toothbrush around the area, and avoid dummies or bottles pressing on the sore spot if you can. Children's paracetamol or ibuprofen, at the dose on the pack for their age and weight, can help with soreness.
Baby tooth or adult tooth: the rules differ
Children aged about six to eight have a mix of both kinds of teeth at the front, so it is worth being sure which one was lost. Adult front teeth are larger, have slightly ridged edges when they first come through, and tend to appear from around age six.
| Baby tooth knocked out | Adult tooth knocked out | |
|---|---|---|
| Put it back? | No | Yes, as soon as possible, holding it by the crown |
| If it cannot go back | Bring it in a clean container | Keep it in milk, saline or the person's own saliva and never let it dry; water is a poor last resort |
| How fast to be seen | Same day or next day | Immediately, minutes count |
| Main aim | Protect the adult tooth forming below | Keep the root's living fibres alive so the tooth can reattach |
If you are not sure which type of tooth it is, keep it moist in milk and call a dentist straight away so they can advise.
The weeks and months afterwards
Most gums heal within a week or two. The dentist or OHT will often suggest a review about a week later, and then watch the area at routine check-ups until the adult tooth arrives. Some adult teeth that sat under an injured baby tooth come through with a white or yellow mark or a change in shape. These can usually be treated if they need it.
A gap at the front from an early lost baby incisor generally does not close up enough to cause problems, so a space maintainer is rarely needed there. When a baby molar is lost early, it is a different story, and holding the space may be worth discussing. Our article on space maintainers after early tooth loss explains when they are used. If the adult tooth comes through crowded or out of line, an assessment for early orthodontic treatment may be suggested.
If the same fall damaged an adult tooth instead, see our guides to a chipped permanent front tooth and loose adult teeth.
Questions parents ask
Will my child have a gap until the adult tooth comes?
Usually, yes. Depending on age, that may be a few months or a few years. Children tend to adapt quickly to eating and talking with the gap.
Can a false tooth be fitted?
It is possible in some cases with a small appliance, but most families choose to leave the gap. The dentist can talk through the pros and cons for your child.
Should I keep the tooth for the tooth fairy?
Once the dentist has seen it, the tooth is yours to keep.
Knocks and bumps are part of growing up, and our team sees families with them regularly. You can learn about our general dentistry for the whole family or see our current deals.
This article is general information and does not replace an individual dental assessment.
