A dental injury in a public place or on public transport in NSW starts two clocks at the same moment: a clinical clock measured in minutes, and an administrative clock measured in weeks. The clinical clock decides whether a knocked-out tooth can be saved. The administrative clock decides whether anyone can work out later what happened, where it happened and why. The clinical one always comes first. Look after the tooth, then look after the record.
Key takeaways
- Hold a knocked-out adult tooth by the crown only, and if you can bear to, put it straight back into the socket.
- healthdirect asks you to aim to reach a dentist or hospital within 30 minutes, and states it may still be possible to save a tooth up to two hours after the injury.
- If the tooth cannot go back in, the IADT 2020 guidelines rank storage media as milk, then HBSS, then saliva, then saline.
- Tell station, venue or shop staff while you are still there and ask that an incident report be made, because a verbal account is far harder to rely on later.
- Transport for NSW states that most network footage is retained for one to two weeks only, and bus footage is held by the bus operator rather than by Transport for NSW.
- Time limits apply and differ depending on which scheme a claim falls under, so get free legal information early from LawAccess NSW on 1300 888 529.
Get help straight away if any of these apply
Some mouth injuries are not dental problems at all. healthdirect says to call 000 or go straight to a hospital emergency department if there is:
- trouble breathing;
- trouble talking or swallowing;
- a lot of blood running down the throat;
- severe swelling of the mouth or tongue;
- a head injury, loss of consciousness, vomiting or confusion after the knock;
- a jaw that will not close, or teeth that no longer meet the way they did.
If none of those apply, you are dealing with a dental emergency rather than a medical one, and the next few minutes matter.
The clinical clock: full first aid before anything else
An adult tooth knocked completely out
Find the tooth. Pick it up by the crown, which is the part you normally chew with, and do not touch the root. If it is visibly dirty, rinse it briefly under warm water. Do not scrub it, do not wipe it with a cloth and do not soak it, because the periodontal ligament cells on the root surface are what allow the tooth to reattach. Put the tooth back into the socket the right way round, and bite gently on a clean cloth or handkerchief to hold it in place while you get to help.
The IADT 2020 guidelines for the management of traumatic dental injuries, published by Fouad and colleagues in Dental Traumatology, sort avulsed teeth into three groups. A tooth replanted immediately, or within roughly 15 minutes, has ligament cells that are likely still viable. A tooth kept in a suitable storage medium with less than 60 minutes of total dry time outside the mouth is compromised but may still be viable. Past 60 minutes of dry time, those cells are likely to be non-viable regardless of what the tooth was stored in. That is why replanting on the spot, unpleasant as it sounds, is the single most useful thing a bystander can do. Our guide to first aid for a knocked-out tooth walks through the same steps in more detail.
If the tooth cannot go back in
Sometimes replanting is not possible. The person may be too shaken, the socket may be too damaged, or the injury may involve other facial trauma. In that case the tooth must not be allowed to dry out. healthdirect suggests a little milk or saliva. The IADT ranks storage media in descending order of preference as milk, Hank's balanced salt solution, saliva and saline. Plain water is not on that list. If you are on a platform or in a food court, a small carton of milk is usually the most realistic option, and we cover why milk works as a storage medium separately.
A knocked-out baby tooth
Do not put a baby tooth back in. healthdirect is clear on this because replanting can damage the permanent tooth developing above it. Rinse the child's mouth with warm salt water, use a cold pack on the outside of the face if there is swelling, and see a dentist as soon as you reasonably can.
A broken piece of tooth
Keep any fragment. healthdirect says a broken-off piece should go into milk or sterile saline, in the same way a whole tooth would. Fragments can sometimes be bonded back on, and even when they cannot, they tell the treating dentist how much tooth structure was lost.
A loose or displaced tooth
A tooth that is wobbly but still in place can often be gently pushed back into line with finger pressure. healthdirect notes that a small piece of aluminium foil moulded over the tooth and its neighbours can hold it steady while you travel. Avoid biting on that side.
Pain relief and antibiotics
Paracetamol is the usual first choice. healthdirect advises avoiding high-dose aspirin because it can increase bleeding, and says aspirin should not be given to a child under 12 unless a doctor directs it. Most dental injuries do not need antibiotics. It is also worth knowing early that a replanted adult tooth has a high chance of needing root canal therapy at some point, so the day of the injury is rarely the end of the story.
Where to go, and who to call after hours
During business hours, phone a dental practice and say the words "knocked-out tooth" or "broken tooth after a fall". Most practices hold time for trauma. After hours, healthdirect lists the Australian Dental Foundation Emergency Dental Hotline on 0407 111 117, and the healthdirect helpline on 1800 022 222, which is staffed around the clock by a registered nurse. If the injury involves the head, the jaw or heavy bleeding, a hospital emergency department is the right destination rather than a dental surgery. Our general guide to what to do in a dental emergency sets out how to triage the first phone call.
Lumi Dental does not provide general anaesthetic. If sitting through emergency treatment would be difficult, you can read about IV sedation at Melrose Park and discuss what suits you at the appointment.
The administrative clock: what to do once the tooth is handled
Report it while you are still there
Tell station staff, the driver, the venue manager or the shop supervisor at the time. Ask that an incident report be made, and write down the name of the person you spoke to. An incident report does not create a legal right and it does not decide anything. What it does is fix the time, the place and the fact of the injury in someone else's records, which is a very different thing from remembering it yourself six weeks later.
Photograph the hazard, not just the tooth
People photograph their mouth and forget the floor, and the hazard is the part that disappears. A spill gets mopped, a broken tile gets replaced, often within the hour. Photograph what you tripped or slipped on, in context so the location is identifiable, and note the platform number, carriage, stop, aisle or street address. In Strong v Woolworths Ltd t/as Big W, the leading NSW slip case on causation under the Civil Liability Act 2002 (NSW), the argument turned on whether the absence of an adequate cleaning system caused the debris to be on the floor. Evidence about the hazard itself is what those questions run on.
CCTV does not wait for you
This is the part almost nobody knows. The Transport for NSW access to information page states that, except where a particular incident has been identified, most footage is retained for one to two weeks only. Transport for NSW centrally administers access requests for Sydney Trains, NSW Trains, Sydney Metro and the Point to Point Commission. Because footage is kept so briefly, Transport for NSW deals with some requests informally: you can send a written request to information@transport.nsw.gov.au setting out the time, location and detail of the incident, and Transport for NSW says it will endeavour to save and retrieve any relevant footage. There is also a dedicated request to preserve CCTV footage form published on the same site. Formal access runs under the Government Information (Public Access) Act 2009 (NSW), which carries an application fee, a processing charge and a decision timeframe of 20 working days that can be extended. Preserving the footage and formally accessing it are two separate steps, and the preservation request is the urgent one.
Bus footage is not held by Transport for NSW
Transport for NSW states that requests for bus footage should be made directly to the relevant bus carrier, and publishes contact numbers for the operators on its access to information page. If you were hurt on a bus, sending your request to Transport for NSW may cost you the only window you had. Identify the operator from the livery, the ticket machine or the route number, and contact them in writing.
Different transport, different scheme
Where the injury happened changes the process, and this is a real distinction rather than a technicality. A bus is a motor vehicle, so an injury on or involving a bus runs through the compulsory third party scheme under the Motor Accident Injuries Act 2017 (NSW), which is regulated by SIRA. An injury on a station platform, on transport property or in a shopping centre is generally pursued as an ordinary negligence matter under the Civil Liability Act 2002 (NSW). A bus is not a train for these purposes.
SIRA states that anyone injured in a motor crash in NSW can claim, including pedestrians and cyclists. A police event number is required to lodge a CTP claim, obtained through the Police Assistance Line on 13 14 44, and a certificate of fitness from a GP is also required. SIRA states the insurer must contact you within three days of lodgement and must give a liability decision within four weeks, and that weekly income payments start within 10 working days if you are entitled to them. If you disagree with a decision you have 28 days to request an internal review, after which the matter can go to the Personal Injury Commission. CTP Assist can be reached on 1300 656 919. If the injury happened while you were working, SIRA notes you must also lodge a workers compensation claim, and we cover that path in our article on dental injury at work and workers compensation in NSW. If a car was involved rather than a bus, the same CTP scheme applies and our guide to dental injury in a car accident explains it in more detail.
For an injury on land occupied by someone else, occupier's liability is not a separate area of law in Australia. Since Australian Safeway Stores Pty Ltd v Zaluzna in 1987, the High Court has treated it as part of ordinary negligence. Section 5B of the Civil Liability Act 2002 (NSW) then sets out when someone is negligent: broadly, they are not negligent for failing to take a precaution unless the risk was foreseeable, the risk was not insignificant, and a reasonable person in their position would have taken that precaution. The Act also has an obvious risk division, under which there is no duty to warn of an obvious risk and an injured person is presumed to have been aware of it. All of that is fact-specific, which is exactly why nobody should tell you over the internet whether you have a claim.
One thing you will see quoted with great confidence online is a specific deadline. Time limits do exist and they differ by scheme, but the primary legislative text behind the commonly quoted figures could not be verified for this article, so no number appears here. Treat every deadline you read as unconfirmed until a lawyer confirms it against your own circumstances, and act early rather than late.
| Time after the injury | The tooth (clinical) | The record (administrative) | Why it matters later |
|---|---|---|---|
| First 5 to 15 minutes | Best window to replant an adult tooth; handle by the crown, do not scrub the root | Tell station or venue staff there and then | Immediate replanting gives the ligament cells the best chance (IADT 2020) |
| Within 30 minutes | Get to a dentist or a hospital emergency department | Ask that an incident report be made and note the staff member's name | healthdirect nominates 30 minutes as the target |
| Within 60 minutes | A tooth kept in milk, saliva or saline is compromised but may still be viable; past 60 minutes dry, cells are likely non-viable | Photograph the hazard and the location before it is cleaned or repaired | The hazard usually disappears within hours |
| Same day | Examination, photographs and radiographs; write down exactly what happened | Note the exact platform, carriage, stop, aisle or address | A dated clinical record fixes the injury in time |
| Within a few days | Follow-up review; pulp status is not settled on day one | Lodge the report in writing through the operator's or occupier's own channel | A written report is much harder to dispute than a verbal one |
| Within one to two weeks | Splint review and pulp testing as advised | Request CCTV preservation in writing; Transport for NSW says most footage is retained only one to two weeks | Once footage is overwritten it is gone |
| Weeks to months | Replanted teeth often need root canal therapy later; keep every referral and receipt | Keep the incident reference number and all correspondence | The full cost of a dental injury is rarely known on day one |
| Anytime | Ongoing dental care continues regardless | Get legal information early from LawAccess NSW on 1300 888 529 | Time limits apply and differ by scheme; only a lawyer can tell you which applies to you |
Why the dental record itself is evidence
A clinical note written on the day sets out which tooth was involved, what the damage was, how mobile the tooth was and what treatment was provided. Intra-oral photographs show the fracture line, and a radiograph shows root fractures, displacement and the state of the surrounding bone. Together they establish that the injury existed and when, independent of anyone's memory.
Dental trauma has a long tail. Pulp death, discolouration, resorption and root canal treatment can surface months later, and a contemporaneous record connects them to the day. If a child is injured on the way to or from school, the reporting path is different again, and our article on dental injury at school and who pays covers it.
A dental practice cannot decide liability or advise you on a claim. That belongs to a lawyer.
Where to get real legal help
LawAccess NSW provides free legal information to anyone with a legal problem in NSW on 1300 888 529, from 9am to 5pm Monday to Friday, and by web chat. Legal Aid NSW provides free advice appointments to eligible people. Nothing here substitutes for advice about your own situation.
Frequently asked questions
What should I do if I knock out a tooth in a public place?
Find the tooth, hold it by the crown, rinse it briefly only if it is dirty, and put it back into the socket if you can, biting gently on a clean cloth. If you cannot replant it, keep it in milk. Aim to reach a dentist or hospital within 30 minutes, and tell venue or station staff before you leave so an incident report is made.
Who pays for my dental treatment if I am injured at a train station?
There is no automatic answer. An injury on a platform or on transport property is generally dealt with as an ordinary negligence matter under the Civil Liability Act 2002 (NSW), and whether anyone else is responsible depends on the facts. In the meantime the treatment still needs to happen, so keep every invoice, referral and report and get legal information from LawAccess NSW.
Do I need to report an accident on public transport straight away?
Reporting immediately is much better than reporting later, but the injury comes first. Tell staff at the time if you can, then lodge a written report through the operator's own feedback channel once you have been seen. Road incidents and hazards can be reported on 131 700.
How do I get CCTV footage of an accident at a train station in NSW?
Ask for it to be preserved first. Transport for NSW says most footage is retained for one to two weeks only, so send a written request to information@transport.nsw.gov.au with the time, location and detail of the incident, or use the request to preserve CCTV footage form on the Transport for NSW site. Formal access is a separate process under the Government Information (Public Access) Act 2009 (NSW).
Is a bus accident treated differently from a train station accident?
Yes. A bus is a motor vehicle, so a bus injury runs through the compulsory third party scheme under the Motor Accident Injuries Act 2017 (NSW), which requires a police event number. An injury at a station is generally a negligence matter under the Civil Liability Act 2002 (NSW). Bus CCTV is also held by the bus operator, not by Transport for NSW.
How long does a knocked-out tooth last outside the mouth?
The IADT 2020 guidelines treat 60 minutes of total dry time as the point past which the ligament cells are likely to be non-viable whatever the storage medium. Within 15 minutes the cells are likely still viable, and under 60 minutes in milk or saline the tooth is compromised but may still be viable. healthdirect states it may still be possible to save a tooth up to two hours after the injury, which is why you should bring it in even if time has passed.
If you have been hurt and need to be seen
The team at Lumi Dental in Melrose Park sees dental trauma and can assess, photograph and record an injury on the day. You can read about emergency dental care at Melrose Park, see what is currently available on our current offers page, or book online. We are open Monday to Saturday. If the injury involves your head, your breathing or heavy bleeding, go to a hospital emergency department first.
This article is general information only. It is not legal advice and it is not a substitute for an examination and individual dental advice. Whether any person or organisation is legally responsible for an injury depends entirely on the facts of the case, and time limits apply and differ by scheme. For free legal information in NSW, contact LawAccess NSW on 1300 888 529.
