The short answer: For a knocked-out adult tooth, hold it by the crown, put it back in the socket if you can (or keep it in milk or saliva) and see a dentist immediately; never put a baby tooth back in. Most other dental problems need a dentist quickly rather than the ER. Go to the emergency room for trouble breathing or swallowing, swelling near the eye or in the neck, bleeding that won’t stop, a possible broken jaw or a head injury.
Knowing what to do in a dental emergency can mean the difference between saving and losing a tooth (American Dental Association, n.d.).
The steps below follow International Association of Dental Traumatology (IADT) guidelines and American Dental Association (ADA) advice; they are first aid, not a substitute for seeing a dentist. If an accident happens when your dental office is closed, the ADA advises going to your local emergency room (American Dental Association, n.d.).
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What should you do if a tooth is knocked out?
Adult (permanent) tooth: act within minutes
A knocked-out permanent tooth is one of the most serious dental injuries, and fast, correct first aid gives it the best chance. The IADT guideline advises (Fouad et al., 2020):
- Stay calm and find the tooth. Pick it up by the crown (the white part) and avoid touching the root.
- If it’s dirty, rinse it gently in milk, saline or the injured person’s saliva.
- Put it back into its socket in its normal position if you can, then bite on gauze, a handkerchief or a napkin to hold it in place.
- If you can’t put it back, keep it wet. Milk is the first choice; Hank’s balanced salt solution (HBSS), saliva (for example, spit into a cup) or saline also work. Plain water is a poor option, though still better than letting the tooth dry out.
- Get to a dentist immediately, and bring the tooth.
The ADA also lists holding the tooth between the cheek and gum, or using a tooth preservation product with the ADA Seal of Acceptance (American Dental Association, n.d.). Only use the cheek option for someone old enough and alert enough not to swallow the tooth.
Speed matters because the cells on the root surface that help a replanted tooth reattach die as it dries out: after about 30 minutes of dry time, most are no longer viable. Your dentist may also check your tetanus protection (Fouad et al., 2020).
Baby tooth: don’t put it back
Don’t try to replant a knocked-out baby tooth. The IADT points to the heavy treatment burden for a young child, possible damage to the permanent tooth developing underneath and, most importantly, the risk of the child inhaling the tooth (Day et al., 2020). Find the tooth, keep it moist and take your child to a dentist (American Dental Association, n.d.). For everyday care of baby teeth, see the parent’s guide to kids’ teeth.
What should you do about a chipped, cracked or broken tooth?
Rinse your mouth with warm water, and hold a cold compress against your face to keep swelling down (American Dental Association, n.d.). Save any broken pieces (Cleveland Clinic, 2022) and bring them in a little water or saline: an intact piece can sometimes be bonded back on, and a fragment that has dried out is soaked in water or saline first (Bourguignon et al., 2020).
A badly cracked tooth is a dental emergency, while a small chip or crack can usually wait for a regular appointment (Cleveland Clinic, 2022).
What if a tooth is pushed out of place or loose?
A blow can push a tooth partly out of its socket, sideways, or up into the gum. Don’t try to force it back. Repositioning is a job for the dentist, sometimes under local anesthetic, and the tooth is then usually held with a short-term flexible splint while it heals (Bourguignon et al., 2020).
Treat it as urgent: a permanent tooth pushed deep into the gums or far out of position needs care right away (American Association of Orthodontists, 2026). Even a slightly loose tooth should be checked, because injured teeth need proper diagnosis and follow-up (Bourguignon et al., 2020).
Is a toothache or swelling an emergency?
Severe toothache
Rinse your mouth with warm water and gently use dental floss to remove any food caught between your teeth. Don’t put aspirin on the aching tooth or gum, because it may burn the gum tissue (American Dental Association, n.d.), and the same goes for any other painkiller (Cleveland Clinic, 2022).
Over-the-counter pain relievers can help until you’re seen. For teens and adults, ADA guidelines name anti-inflammatory painkillers (NSAIDs) such as ibuprofen, alone or combined with acetaminophen, as the first choice for temporary toothache relief when they’re safe for you (Carrasco-Labra et al., 2024). Follow the label, and ask a pharmacist if you’re unsure a medicine is right for you. Children and teens under 16 should not take aspirin (NHS, 2024).
A severe toothache is a dental emergency (Cleveland Clinic, 2022), and antibiotics are no shortcut. For otherwise healthy adults, ADA guidelines advise against antibiotics for most toothaches, reserve them for infections causing whole-body signs such as fever or feeling unwell, and say dental treatment should come first (Lockhart et al., 2019). Our guide to whether antibiotics help tooth pain or a tooth infection explains the evidence.
Swelling, abscess or fever
An abscess is a pocket of infection around the root of a tooth or between the teeth and gums. Untreated, it can cause swelling of the face or jaw and spread to other parts of the body (Cleveland Clinic, 2022). Signs include a severe, throbbing toothache that can spread to the jaw, neck or ear, fever, facial swelling and tender lymph nodes (Mayo Clinic, 2022).
See a dentist as soon as possible if you think you have an abscess. Rinsing with a mild salt-water solution (half a teaspoon of table salt in 8 ounces of water) several times a day may ease the pain while you wait (Cleveland Clinic, 2022).
Go to the emergency room if you have a fever and facial swelling and can’t reach your dentist, or if you have trouble breathing or swallowing, which can mean the infection has spread deeper into the jaw, throat or neck (Mayo Clinic, 2022). Untreated, a dental infection can lead to sepsis, a life-threatening infection that spreads through the body (Mayo Clinic, 2022). Our article on how oral health affects your body covers other links between the mouth and general health.
How do you stop bleeding after an extraction or a cut?
After a tooth extraction
Some oozing on the first night after an extraction is normal. Fold a clean piece of gauze over the socket and close your teeth on it for 15 minutes to keep pressure on the area, repeating as needed. Rinse and spit gently, and avoid straws, which can dislodge the blood clot and cause a dry socket. Smoking and vaping reduce blood flow to the area (Cleveland Clinic, 2025). If pain gets worse a few days after an extraction, see how to tell dry socket from normal pain.
Call your dentist if you get a fever of 100.4°F (38°C) or higher, pus around the site, or severe pain that doesn’t improve with medication (Cleveland Clinic, 2025). If bleeding is heavy and won’t stop with pressure, see your dentist right away or go to the emergency room (Cleveland Clinic, 2022).
Cut or bitten lip, tongue or cheek
Clean the area gently with water and apply a cold compress (American Dental Association, n.d.). To stop bleeding, press a moistened piece of gauze or a damp caffeinated tea bag on the spot for 15 to 20 minutes (Cleveland Clinic, 2022). See your dentist or go to the emergency room if the bleeding is heavy or won’t stop, or you are in a lot of pain (American Dental Association, n.d.).
What if you lose a filling or crown, or a braces wire breaks?
Lost filling. Press a piece of sugarless gum into the hole (sugary gum will hurt) or use an over-the-counter dental cement, then see your dentist as soon as possible (Cleveland Clinic, 2022).
Lost crown. Keep the crown and bring it to your appointment. If you can, coat the inside with over-the-counter dental cement, toothpaste or denture adhesive and put it back in place. Never use superglue (Cleveland Clinic, 2022).
Something stuck between your teeth. Try to remove it gently with floss, never with a sharp or pointed object. If you can’t get it out, see your dentist, because it can be painful or cause an infection (American Dental Association, n.d.).
Broken or poking braces wire. Broken braces usually aren’t an emergency unless your mouth is bleeding (Cleveland Clinic, 2022). Gently push a poking wire flat against the tooth with a clean pencil eraser or cotton swab, or cover the end with orthodontic wax. If a small piece has broken off and you can remove it safely with clean tweezers, you may do so. Then contact your orthodontist (American Association of Orthodontists, 2026). Our guide to braces explains how they work.
What it means for you
If you or your child play contact sports
In athletes, wearing a mouthguard is linked to fewer injuries to the teeth (Fernandes et al., 2019). If a tooth is knocked out during a game, the first-aid steps above still apply: find the tooth, hold it by the crown, replant it or keep it in milk, and get to a dentist immediately (Fouad et al., 2020).
If your young child injures a tooth
Never put a knocked-out baby tooth back; keep it moist and take your child to a dentist (Day et al., 2020; American Dental Association, n.d.). Even a tooth that looks fine after a fall should be checked, because injured teeth need proper diagnosis and follow-up (Bourguignon et al., 2020). Our parent’s guide to kids’ teeth covers everyday care.
If you wear braces
A broken bracket or poking wire is rarely an emergency unless your mouth is bleeding. Cover the wire with orthodontic wax and call your orthodontist (Cleveland Clinic, 2022; American Association of Orthodontists, 2026). See our guide to braces for how the parts fit together.
If a toothache starts at night or on a weekend
Over-the-counter painkillers taken as directed can bridge the gap until you’re seen (Carrasco-Labra et al., 2024), and antibiotics are no substitute for dental treatment (Lockhart et al., 2019). Our guide to relieving a toothache at home explains what helps. If your dental office is closed after an accident, the ADA advises going to your local emergency room (American Dental Association, n.d.).
Questions to ask your dentist
- Does this injured tooth need follow-up visits or X-rays, and for how long?
- What signs mean the tooth or the area is not healing well?
- Would a mouthguard help me or my child, and what type do you recommend?
- Who should I call if a dental emergency happens out of hours?
- Should I check whether my tetanus protection is up to date?
When to see a dentist
Use this rough guide, based on the advice above, to decide how quickly to book a dental visit and where to go. When in doubt, call your dentist.
| Where to go | Examples |
|---|---|
| Emergency room or 911 | Trouble breathing or swallowing; swelling around the eye or in the neck; fever with facial swelling when you can’t reach a dentist; bleeding that won’t stop; a possible broken jaw or facial bones; danger signs after a head injury |
| Dentist right away | Knocked-out adult tooth (immediately); knocked-out baby tooth; tooth pushed out of place; badly cracked tooth; severe toothache; suspected abscess; lost filling or crown |
| Dentist soon | Dull or mild toothache; small chip or crack; broken braces wire covered with wax; something stuck between your teeth; minor cut that has stopped bleeding |
For help preventing many of these problems, see our guide to the 10 most common dental problems.
When should you go to the emergency room?
Go to the emergency room or call 911 if you have:
- Trouble breathing or swallowing, or swelling in your mouth or neck that makes it hard to breathe, swallow or speak (Mayo Clinic, 2022; NHS, 2024)
- Swelling around your eye or in your neck (NHS, 2024)
- A fever and facial swelling when you can’t reach your dentist (Mayo Clinic, 2022)
- Bleeding from the mouth that is heavy or won’t stop with pressure (American Association of Orthodontists, 2026; American Dental Association, n.d.)
- A possible broken jaw or other facial bones (American Dental Association, n.d.; Cleveland Clinic, 2022)
- A blow to the head followed by danger signs such as passing out, repeated vomiting, confusion, slurred speech, a headache that gets worse or one pupil larger than the other (Centers for Disease Control and Prevention, 2025)
Don’t drive yourself if swelling is affecting your breathing or swallowing; have someone take you, or call 911 (NHS, 2024).
The bottom line
In a dental emergency, speed and the right destination matter most. Replant a knocked-out adult tooth or keep it in milk or saliva and see a dentist immediately, never replant a baby tooth, and never put aspirin on your gums. Go to the emergency room for trouble breathing or swallowing, spreading swelling, bleeding that won’t stop, a possible broken jaw or a head injury.
References
American Association of Orthodontists. (2026). What is an orthodontic emergency and how do you handle them? https://aaoinfo.org/whats-trending/what-is-an-orthodontic-emergency/
American Dental Association. (n.d.). Dental emergencies. MouthHealthy. https://www.mouthhealthy.org/dental-care-concerns/dental-emergencies
Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O’Connell AC, Day PF, et al. (2020). International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dental Traumatology, 36(4), 314–330. https://doi.org/10.1111/edt.12578
Carrasco-Labra A, Polk DE, Urquhart O, Aghaloo T, Claytor JW, Dhar V, et al. (2024). Evidence-based clinical practice guideline for the pharmacologic management of acute dental pain in adolescents, adults, and older adults: A report from the American Dental Association Science and Research Institute, the University of Pittsburgh, and the University of Pennsylvania. Journal of the American Dental Association, 155(2), 102–117.e9. https://doi.org/10.1016/j.adaj.2023.10.009
Centers for Disease Control and Prevention. (2025). Symptoms of mild TBI and concussion. https://www.cdc.gov/traumatic-brain-injury/signs-symptoms/index.html
Cleveland Clinic. (2022). Dental emergencies. https://my.clevelandclinic.org/health/articles/11368–dental-emergencies-what-to-do
Cleveland Clinic. (2025). Tooth extraction. https://my.clevelandclinic.org/health/treatments/22120-tooth-extraction
Day PF, Flores MT, O’Connell AC, Abbott PV, Tsilingaridis G, Fouad AF, et al. (2020). International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology, 36(4), 343–359. https://doi.org/10.1111/edt.12576
Fernandes LM, Neto JCL, Lima TFR, Magno MB, Santiago BM, Cavalcanti YW, et al. (2019). The use of mouthguards and prevalence of dento-alveolar trauma among athletes: A systematic review and meta-analysis. Dental Traumatology, 35(1), 54–72. https://doi.org/10.1111/edt.12441
Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, et al. (2020). International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology, 36(4), 331–342. https://doi.org/10.1111/edt.12573
Lockhart PB, Tampi MP, Abt E, Aminoshariae A, Durkin MJ, Fouad AF, et al. (2019). Evidence-based clinical practice guideline on antibiotic use for the urgent management of pulpal- and periapical-related dental pain and intraoral swelling: A report from the American Dental Association. Journal of the American Dental Association, 150(11), 906–921.e12. https://doi.org/10.1016/j.adaj.2019.08.020
Mayo Clinic. (2022). Tooth abscess: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/tooth-abscess/symptoms-causes/syc-20350901
NHS. (2024). Toothache. https://www.nhs.uk/symptoms/toothache/
References checked October 2026 · Editorial policy · Report a correction
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