If an adult tooth is knocked out, handle it by the crown only, rinse briefly with milk or saline if dirty, and try to place it back in the socket immediately. If you can't reinsert it, store it in cold milk or saliva, never tap water, and call PARCS Dentistry at (725) 250-2840 within 60 minutes for the best chance of saving the tooth.
We get these calls often, especially in summer. A dad in Whitney watched his 12-year-old faceplant on wet tile at a backyard pool party. A rec-league softball player near UNLV took an elbow at second base. In each case, the parent or friend on the other end of the phone did one thing right. They called fast.
Here is the exact playbook we walk callers through, minute by minute.
Why does the first hour matter so much?
A tooth is a living thing. On its root are microscopic periodontal ligament cells, and those cells start dying the moment the tooth leaves the socket. According to the International Association of Dental Traumatology (IADT), immediate replantation gives the best long-term prognosis, and success drops significantly after 60 minutes of extraoral dry time.
Sixty minutes. That is the clock you are racing.
The good news: if the tooth is stored correctly and you can reach us quickly, we can often save it. If it dries out on a bathroom counter for two hours, the odds fall hard.
Step 1: Find the tooth and pick it up the right way
Locate the tooth first. Then pick it up by the crown, which is the white chewing part you normally see in the mouth. Never touch the root, which is the pointier, off-white section that was inside the gum.
Do not scrub. Do not use soap, alcohol, or hydrogen peroxide. Do not wrap it in a tissue or paper towel, which can pull off the ligament cells you are trying to protect.
If the tooth is visibly dirty (sand from a pool deck, grass from a Sunrise Manor park), give it a very brief rinse. Use cold milk or saline for no more than 10 seconds. That's it.
Step 2: Try to reinsert the tooth into the socket
This is the single most important move you can make. For a permanent (adult) tooth only, line the tooth up the way it was and gently push it back into the socket. Use finger pressure, then have the person bite down softly on a clean piece of gauze or a folded washcloth to hold it in place.
It may feel scary. Do it anyway. A tooth back in its socket within a few minutes has a dramatically better chance of surviving than one sitting in a cup.
Never try to replant a baby tooth. The American Academy of Pediatric Dentistry advises against reinserting avulsed primary teeth because it can damage the developing permanent tooth underneath. If a child under about age 6 loses a baby tooth in a fall, skip to Step 4 and call us.
Step 3: Store the tooth in the right liquid
If reinsertion isn't possible (fear, gag reflex, broken socket, unconscious patient), storage is your next priority. The IADT and the American Association of Endodontists rank storage media like this:
Best: Hank's Balanced Salt Solution, sold in Save-A-Tooth kits. Many athletic trainers carry them.
Excellent: cold milk. Any kind, whole or 2%, from any fridge.
Acceptable: saliva, held inside the cheek if the person is old enough not to swallow it. Saline (contact lens solution) also works.
Never: tap water. It damages the periodontal ligament cells through osmosis.
Cold milk is almost always in the fridge. Grab it. Drop the tooth in a small glass or a sealed bag with enough milk to fully cover the root. Head to the car.
Step 4: Call an emergency dentist, not the ER (usually)
Here is where a lot of people lose precious minutes. Hospital emergency rooms, including Sunrise Hospital & Medical Center just up the road from our office, generally cannot replant teeth. They can manage bleeding and rule out concussion, but the dental work still gets referred out.
Call PARCS Dentistry directly at (725) 250-2840 and say the words: "This is a dental avulsion." We will clear a chair. Our office sits on E Flamingo Rd near McLeod Drive, roughly three miles east of the Strip, and we see patients from Paradise, Henderson, Green Valley, Sunrise Manor, and Whitney. Saturdays are available by appointment, which matters when weekend sports and pool days are when most of these injuries happen.
Go to the ER first only if there is heavy uncontrolled bleeding, a possible head injury, loss of consciousness, or the injury involves the jaw or neck. In those cases, get stabilized, then bring the tooth (stored in milk) to us as soon as you are cleared.
What happens once you arrive at our office?
We move quickly and calmly. Here is the sequence:
Gentle cleaning of the socket and, if needed, the tooth itself with sterile saline
Replantation into the socket, positioned to match the neighboring teeth
A flexible splint bonded to the neighboring teeth to stabilize the tooth. Per IADT protocol, this splint stays in place for about two weeks
Tetanus status review and antibiotics if the situation warrants
Follow-up scheduling for root canal treatment, which the American Association of Endodontists notes is usually required to prevent infection and root resorption in replanted teeth
Sedation is available if the patient is anxious or the injury is complex. We have both doctors, Dr. Justin Nguyen and Dr. Eun Bee Kim, plus in-office sedation to keep things comfortable.
How to prevent knocked-out teeth in the first place
Prevention is cheap. Replacement is not.
The ADA reports that dental injuries are among the most common facial injuries in sports, and custom mouthguards significantly reduce the risk of trauma. If you or your kid plays contact sports, martial arts, or even competitive rec league at the parks around Paradise and Henderson, get a custom mouthguard. Boil-and-bite guards from the drugstore are better than nothing, but a properly fitted one is on another level.
Two more Las Vegas-specific tips:
Pool deck rule: no running. Wet tile is the single biggest cause of avulsion injuries we see between May and September.
Teeth are not tools. Don't open beer bottles, tear tags, or chew ice. Cracked and knocked-out teeth from ice chewing spike in our summer months.
Frequently Asked Questions
Can a knocked-out baby tooth be put back in?
No. Avulsed primary (baby) teeth should not be replanted, per American Academy of Pediatric Dentistry guidelines, because reinserting them can damage the developing permanent tooth underneath the gum. Still call us so we can examine the child, control any bleeding, and check for other injuries.
How long can a tooth survive outside the mouth?
The best outcomes come from replantation within about 15 minutes. Success drops significantly after 60 minutes of dry time. Cold milk or Hank's Balanced Salt Solution can extend that window somewhat, but sooner is always better. Treat every avulsion as a race against the clock.
What if the tooth is broken instead of knocked out?
Save any large pieces in cold milk and call us right away. A cracked or broken tooth is still a dental emergency, though the timeline is less brutal than a full avulsion. We can often repair a fractured tooth with bonding, a crown, or root canal therapy depending on how deep the break goes.
Will insurance cover emergency replantation?
Most dental insurance plans cover a portion of emergency treatment, including replantation, splinting, and follow-up root canal work. We verify benefits before treatment and offer financing and an in-house membership plan if you are uninsured. Cost should never be the reason you delay a call during that first hour.
Is a knocked-out tooth an ER visit or a dentist visit?
Almost always a dentist visit. Hospital emergency rooms typically can't replant teeth, so calling PARCS Dentistry at (725) 250-2840 first saves time. Go to the ER only if there is heavy bleeding, a head injury, loss of consciousness, or suspected jaw fracture, and bring the tooth in milk when you're cleared to see us.
If a tooth just got knocked out, stop reading and call us now: (725) 250-2840. PARCS Dentistry, 2840 E Flamingo Rd, Suite G, Las Vegas. We speak English, Español, and 한국어, and we will do everything we can to save the tooth.
