What to do now

Minutes matter here more than anywhere else in dentistry. A baby tooth is never put back in — it would damage the adult tooth forming above it. Front adult teeth come through from about six, so under six it is a baby tooth and from about twelve it is an adult one. In between: a baby tooth is small with a short, blunt root, an adult tooth is noticeably bigger with a long one. If you genuinely cannot tell, keep it in milk and ring a dentist straight away.

If the knock also caused blacking out, being sick or double vision, the head comes first — ring 999 or go to an emergency department, and take the tooth with you in milk.

1. Pick it up by the crown — the part that shows in the mouth. Do not touch the root.
2. If it is dirty, rinse it gently — in milk, in salt water, or in spit. Any of the three is better than the tap. Plain water will do if none of them is to hand: a few seconds under the tap is better than letting the tooth dry out. Do not scrub it, and do not stand there soaking it — rinse, then straight back in.
3. Put it straight back into the socket, the right way round, and bite gently on a clean cloth to hold it there.
4. If you cannot put it back, keep it in milk. Saliva is next best — spit into a cup and put the tooth in that. Salt water also works. Plain water is a poor substitute and should not be used if anything else is to hand, but a tooth in water is better than a tooth that dries out. What you must not do is wrap it dry in a tissue.
5. Get to a dentist within the hour. Ring ahead and say what has happened.

Go even if you cannot find the tooth, go even if you have managed to put it back — it has to be checked and splinted — and go even if more than an hour has passed. A late tooth is still worth taking in.