Knocked-Out Tooth Emergency — Gilbert, AZ

You have less than 30 minutes to save the tooth. Call us now at 480-331-4955 — we’ll talk you through the right steps over the phone while you head to the office. A permanent tooth that’s been knocked out (avulsed) can be successfully re-implanted in a meaningful percentage of cases — but only if it’s handled correctly in the next 30-60 minutes. This page covers exactly what to do right now, what to avoid, and what we do once you arrive at our Gilbert practice.

Right now — what to do in the next 5 minutes

• 1. Find the tooth. Look at the site of the injury, the floor, and any clothing or surfaces nearby. Pick it up by the crown (the white chewing portion) — not by the root (the longer pointed end that was inside the gum). Touching the root with your fingers damages the periodontal ligament cells that need to survive for re-implantation to work.
• 2. Rinse it gently if dirty. Hold under cool tap water for 5-10 seconds. Do not scrub. Do not use soap. Do not use alcohol or hydrogen peroxide. The root surface needs the tissue cells preserved.
• 3. Try to put it back in the socket immediately. If the patient is conscious and cooperative (this is the best storage medium), gently place the tooth back into the empty socket in the correct orientation, hold a clean cloth over it, and have the patient bite gently to keep it in place. Then come straight to our office.
• 4. If you can’t reposition it, store it correctly. The tooth must stay moist with the right fluid. In order of preference: (a) a small container of cold milk — the best widely-available storage medium; (b) a tooth-preservation kit (Save-A-Tooth, in some first aid kits); (c) saliva — have the conscious patient hold it in their cheek (not appropriate for young children due to swallowing risk); (d) cold saline or sterile water. Never store in plain water for more than a few minutes — it bursts the surface cells.
• 5. Call us — 480-331-4955 — and head to the office. Time matters. Each minute the tooth is out of the socket reduces the chance of long-term re-implant survival. Call as you’re leaving so we’re ready when you arrive.

What NOT to do

• Don’t scrub the root. The cells on the root surface are what reattach to the bone and gum. Scrubbing destroys them.
• Don’t use soap, alcohol, hydrogen peroxide, or any antiseptic. They kill the cells we need alive.
• Don’t let the tooth dry out. Even 30 minutes of dry storage drops the success rate dramatically. Milk or saliva, not air.
• Don’t store in plain water for extended time — the osmotic pressure damages the cells.
• Don’t wrap in tissue or paper. The tooth dries out and the wrapping fibers stick to the root.
• Don’t wait for normal office hours. Knocked-out permanent teeth are a true dental emergency — we’ll see you immediately during business hours, and our after-hours line guides you to the right next step on evenings and weekends.

Adult tooth vs baby tooth — different rules

• Adult (permanent) tooth. Always try to re-implant. Even an imperfect attempt is better than no attempt — the tooth can sometimes survive even with delayed handling. Come in immediately.
• Baby (primary) tooth. Do not re-implant. Re-implanting a baby tooth can damage the developing permanent tooth forming below. If your child has knocked out a baby tooth, save it in milk and bring it with you so we can confirm it’s a baby tooth (not a partially-erupted permanent tooth that looks similar in young kids), but the treatment is to leave the empty space and monitor the eruption of the permanent tooth.
• Not sure if it’s baby or adult? If the child is under 6, almost certainly baby. Between 6 and 12 it’s a mix. Bring the tooth in either case — we can tell from the root shape and the X-ray whether it was a primary or permanent tooth.

What we do when you arrive

• Quick visual + X-ray of the socket and the tooth. Confirm whether the tooth is intact (not fractured below the gum line), check for damage to adjacent teeth, evaluate the socket for fragments.
• Gentle re-implantation. If the tooth has been out less than ~60 minutes and stored well, we re-position it into the socket. If it had already been re-implanted at home, we confirm position and clean any contamination.
• Splint to adjacent teeth. A flexible wire-and-composite splint holds the re-implanted tooth in place against the neighbors for 1-2 weeks. The flexible splint is critical — rigid fixation actually reduces re-implantation success because some micro-movement is needed for periodontal ligament reformation.
• Tetanus check + antibiotic if indicated. Avulsion injuries often involve dirty surfaces (sidewalk, sports field, court). We confirm tetanus status and prescribe antibiotics when contamination warrants it.
• Pain management. Local anesthesia for the procedure, ibuprofen + acetaminophen for the next several days. Soft diet for 2 weeks.
• Root canal at 7-14 days. Most re-implanted permanent teeth need a root canal within the first 2 weeks — the trauma usually severs the blood supply to the pulp, which then dies and becomes infected. Doing the root canal early prevents inflammatory root resorption (which is the most common cause of long-term re-implant failure).
• Splint removal at 2 weeks. The splint comes off, the tooth is checked for stability and resorption, and a long-term monitoring schedule begins.
• Long-term follow-up. Re-implanted teeth need monitoring for 5-10 years. Some succeed beautifully and last decades; some develop progressive root resorption and are eventually lost. We’ll lay out the realistic outcome ranges based on how long the tooth was out and how it was handled.

Realistic outcomes

• Re-implanted within 5 minutes, stored well or already in the socket: highest chance of long-term survival (5+ years).
• Re-implanted at 5-30 minutes, stored well: good chance of medium-term survival (3-5 years).
• Re-implanted at 30-60 minutes: moderate chance, often with eventual root resorption.
• Re-implanted past 60 minutes or stored dry: attempted because doing nothing is no better, but most of these fail in 1-3 years and need replacement with an implant or bridge.
• Babies (deciduous teeth): not re-implanted. The tooth is recorded, the socket is monitored, and the permanent tooth’s eventual eruption is tracked.

Even when re-implantation eventually fails, getting a tooth back into its socket promptly preserves the bone in the area — which makes a future implant easier and more aesthetic. The first-hour effort is worth making even if the long-term outlook is uncertain.

If the tooth can’t be saved

For permanent teeth that aren’t recoverable, we plan replacement. The two long-term solutions:

• Single dental implant. The functional gold standard. Titanium root + crown. Best aesthetic and structural outcome. $4,500-$6,500 total. Can be planned immediately or after socket healing (3-6 months).
• Dental bridge. Crowns on adjacent teeth + a pontic spanning the gap. Faster timeline, lower cost than implant. Cost of crowning the two healthy abutment teeth. $2,800-$4,800.
• Removable partial denture. Lower cost interim or permanent option. Less stable and aesthetic than fixed alternatives. $1,200-$2,800.

For young patients (under 18) where the jaw is still growing, we typically use a temporary appliance until skeletal growth completes, then place an implant. We’ll plan the timing carefully and explain each step.

Costs

• Emergency exam + consultation: $80-$180.
• Re-implantation + splint: $400-$800.
• X-rays during emergency visit: $50-$150.
• Root canal at 7-14 days follow-up: $700-$1,700 depending on tooth.
• Crown after root canal: $1,200-$1,900.
• Replacement options if re-implant fails: see above.

Emergency dental visits are usually covered by dental insurance like any other procedure. Many medical insurance policies also cover dental injuries that resulted from accidents (motor vehicle, sports, falls). We help you file under the right policy. We’re in-network with Delta, Cigna, Aetna, BCBS AZ, and AHCCCS.

Prevention

• Custom mouthguards for contact sports. The single biggest preventable cause of avulsed teeth in kids and adolescents. A boil-and-bite drugstore mouthguard is dramatically less effective than a custom-fitted one made from a model of the player’s teeth. $100-$200 for a custom guard, replaced as the child grows or the guard wears.
• Helmets with face protection where appropriate. Hockey, full-face helmets in football, age-appropriate cycling helmets for kids.
• Address fall risk in older adults. Falls are a major cause of tooth avulsion in seniors — vision check, medication review with primary care, home modifications matter.

If a tooth has been knocked out, time matters. Call 480-331-4955 now and head our way.