Avulsion of Permanent Teeth

Avulsed permanent teeth are a true dental emergency!

Time and appropriate management are of the essence. Immediate reimplantation, within five minutes, has the best outcome. Everyone - parents, coaches, sports trainers, and clinicians - must know what to do when a permanent tooth is knocked out.

The longer that the tooth is out of the socket, the less chance of survival. Options, if less optimal, remain available even if a tooth has been out of the mouth for longer than 60 minutes.

Patient Procedure at the Time of Accident

  • Locate the tooth.
    • If you can't find it, consider aspiration, ingestion, or intrusion.
  • Hold the tooth by the crown (not the root) to avoid damaging the periodontal ligament that is critical for tooth survival.
    • Rinse off any debris gently with saline or milk.
    • DO NOT touch, rub, or scrub the root.
  • Replace the tooth in the socket. Be careful not to reverse it!
  • Bite down on a gauze or handkerchief for stabilization while going to the dentist.


Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM. Replantation of 400 avulsed permanent incisors. Part 4. Factors related to periodontal ligament healing. Endod Dent Traumatol 1995;11:76-89.

American Association of Endodontists. Recommended Guidelines of the American Association of Endodontists for the Treatment of Traumatic Dental Injuries. Chicago; 2004.

International Association of Dental Traumatology. Dental Trauma Guidelines. Revised 2012. Accessed March 15, 2017 .