Dental trauma

Handle it by the crown only, never the root. Do not scrub it or let it dry. If possible, put it straight back into the socket and bite gently on a cloth to hold it: that is the best outcome. If you cannot, store it in milk, or in the person's own saliva, and get to a dentist or emergency department immediately. Plain water is the worst storage medium because it damages the cells on the root surface. Time out of the socket is the biggest factor in whether the tooth survives.

No, and this is an important exception. Reimplanting an avulsed primary tooth risks damaging the developing permanent tooth sitting in the bone above it, so the standard advice is not to put it back. The child should still be seen promptly to check for other injuries, to assess the socket and surrounding bone, and to plan monitoring of the permanent tooth. Take the tooth with you so it can be confirmed the whole tooth is accounted for.

Yes. A tooth that has been displaced, loosened or pushed into the bone usually needs repositioning and splinting, and even a tooth that looks unmoved may have suffered damage to its nerve supply or root that only radiographs will show. There is also the socket and surrounding bone to assess. Prompt assessment improves outcomes, and it establishes the baseline against which later changes, darkening, resorption, are judged.

Darkening usually means the pulp has died, which is a well-recognized delayed consequence of trauma. The blood supply entering through the root tip can be disrupted at the time of injury even if the tooth stays in place, and the tissue dies quietly afterwards. It is often painless. Treatment is normally root canal treatment, and the discoloration can then be addressed with internal bleaching, a veneer or a crown. This is exactly why follow-up after trauma matters.

The prognosis declines steeply with time out of the socket, and with drying, so this is genuinely a matter of minutes instead of hours. Immediate reimplantation at the scene gives the best chance. If that is not possible, appropriate storage, milk or saliva, not water, buys some time by keeping the cells on the root surface viable. Treat it as an emergency and go straight to a dentist or emergency department.

Mouthguards substantially reduce the risk of dental injury in contact and collision sports, and a custom-fitted one made from an impression of your teeth fits better, stays in place and is more likely to be worn than a boil-and-bite version. They are worth considering for cycling, skateboarding and similar activities too, not only organized sport. If front teeth protrude significantly, the risk of injury is higher and orthodontic assessment is worth discussing separately.

Yes: a fragment from a chipped or fractured tooth can sometimes be reattached with bonding, particularly for a clean fracture found and brought in promptly, so keeping it (dry, in a clean container) and bringing it to the appointment keeps that option available. Even if reattachment turns out not to be possible, having the fragment can help the clinician understand exactly what happened to the tooth.

The duration depends on the specific type of injury. A tooth that was simply loosened needs a shorter splinting period than one that was more significantly displaced or where the root itself may have been affected. The timing matters in both directions: removing a splint too early risks the tooth not stabilizing properly, while leaving it too long can itself cause problems, which is why the interval is specifically prescribed instead of left to guesswork.

Yes: the nerve supply entering through the root tip can be disrupted by the force of an impact even when the tooth itself shows no visible chip, crack or displacement, and the pulp can subsequently die without any external sign at the time. This is exactly why scheduled radiographic review over the following months and, in some cases, years is standard practice after significant trauma, instead of assuming an intact-looking tooth is unaffected.

Not immediately, and not on the injured side: practices typically advise a soft diet and avoiding chewing on an injured tooth for a period while healing gets underway, particularly where a tooth has been repositioned, splinted, or where a fracture has been treated. Specific guidance varies by injury type and should come from whoever assessed you, since the right restriction depends on exactly what was done.

Yes: root resorption and pulp death can both develop gradually after trauma and may not become apparent for months or even years, which is precisely why scheduled follow-up radiographs continue well beyond the initial treatment. A tooth that looked stable at the six-month check can still show a new problem at a later review, so ongoing monitoring genuinely matters, not being a formality once the initial healing period has passed.

No: a fragment or a whole avulsed tooth should never be frozen, since freezing damages the cells on the root surface just as badly as letting it dry out does. If you cannot reach a dentist immediately, the correct storage is milk or the person's own saliva at normal temperature, and getting to care as quickly as possible remains far more important than any storage method.