Adult Tooth Knocked Out? Act Within 30 Minutes.
A knocked-out permanent tooth (an "avulsed" tooth) can often be saved — but re-implantation success drops sharply after the first hour.¹ Do these steps while you're on the way to us or to the nearest emergency dental clinic.
832-779-5522Tell us a tooth is out — we'll prioritize your slot.
What to Do Right Now — 5 Steps
Ideally have someone else call us while you do the first-aid steps. If that's not possible, stabilize the tooth first, then call.
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1
Pick it up by the crown — never the root
The crown is the white chewing part you normally see. The root is the tapered part that sits inside the gum. Touching the root can damage the delicate ligament fibers that let the tooth reattach to the bone. Handle the crown only.
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2
If it's dirty, rinse gently — don't scrub
Hold it by the crown, rinse briefly under cool tap water or saline for a few seconds. Do not use soap, don't scrub with a cloth, don't dry it, and don't wrap it in a tissue. You want those root-surface cells to stay alive — a dry tooth loses viability in minutes.
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3
If you can, gently place it back in the socket
Line it up the same way as the teeth next to it and push it in with steady, gentle pressure until the top lines up. Bite down softly on a clean cloth or paper towel to hold it in place. This is the best-possible storage medium. If the patient is young, confused, or resistant, skip to step 4 instead.
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4
If you can't put it back — keep it moist
In order of best-to-okay: a commercial tooth-preservation solution (Save-A-Tooth, Hank's Balanced Salt Solution) if you happen to have one · cold milk · saline · saliva (between the patient's cheek and gum if they're conscious and won't swallow it). Plain water is the last resort — it damages the root cells quickly.
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5
Get to a dentist within 30–60 minutes
Call us at 832-779-5522 during clinical hours (Tue · Wed · Fri 9am–6pm, or Saturday by appointment). If we're closed, go to the nearest 24-hour dental emergency clinic or, if none is available, the ER for stabilization. Control any bleeding by biting on clean gauze; a cold compress on the cheek helps with swelling and pain on the way.
Why Those First 60 Minutes Matter
A tooth is held in its socket by tiny ligament fibers called the periodontal ligament. When a tooth is knocked out, those fibers are still alive on the root surface — but only briefly. They need oxygen and the right moisture to stay viable. The American Association of Endodontists' position is that re-implantation within 30 minutes gives the best prognosis, with success dropping after an hour and becoming unlikely after about two hours out of socket.¹
That's why the storage medium matters so much. Milk's ion concentration is close to what those cells need; water is actively harmful; saliva is acceptable but not ideal. And why re-implanting the tooth into its own socket is better than any transport medium — the tooth is immediately in its natural environment.
For baby (primary) teeth, the guidance is different — we do not re-implant knocked-out baby teeth, because doing so can damage the developing permanent tooth underneath. Call us anyway; we'll examine the socket and surrounding area for other injuries.
What Happens When You Arrive
Exam & X-ray
Dr. Maddipati confirms it's the right tooth, checks for a jaw or root fracture, and evaluates the socket.
Re-implantation & splinting
If the tooth is viable, it's carefully positioned in the socket and splinted to the neighboring teeth with a thin composite and wire for about 2 weeks.²
Antibiotics if indicated
A short course of antibiotics is often prescribed, and we confirm your tetanus status is current if the injury happened outdoors.
Follow-up plan
Most re-implanted teeth need a root canal within 7–14 days once the splint is removed, because the nerve inside the tooth usually doesn't recover. We plan all of this before you leave.
If the tooth can't be saved — which does happen, especially past the one-hour mark — we talk you through the replacement options. Missing-tooth replacement covers bridges, dentures, and implant-restoration options.
What Can Go Wrong — And How We Manage It
We believe in telling patients the truth about outcomes. Even a well-handled re-implantation can run into complications over the months or years after:
- Root resorption. The body can slowly break down the root over months or years, especially if the root surface dried out before re-implantation. We monitor with X-rays at 3, 6, and 12 months.
- Ankylosis. The root fuses to the bone instead of being held by ligament. The tooth becomes immobile but generally still functional; in a growing child, this can cause the tooth to sit lower than the others as the jaw grows.
- Pulp necrosis. The nerve inside doesn't re-establish blood supply, which is why a root canal is usually planned after the splint comes off.
- Eventual loss. Even a successfully re-implanted tooth may need replacement years down the line. The goal is still to preserve the bone and adjacent teeth for as long as possible — that makes any future restoration simpler.
Prevention — The Single Best Move
Most avulsed teeth in Houston come from sports, falls, car accidents, and (in younger children) playground mishaps.³ A custom-fitted athletic mouthguard cuts the risk of dental injury dramatically compared to no guard or a boil-and-bite guard bought at a pharmacy. If you or your child plays contact sports, we can take impressions for a custom mouthguard during a regular visit.
For grinders and night-clenchers, a night guard protects against cracks and fractures that can weaken teeth enough to knock them out more easily in a fall.
Frequently Asked Questions
General information only. When in doubt about the severity of your situation, err on the side of caution and call us or go to the ER.
Every Minute Matters. Call Us While You're On the Way.
Same-day slots are limited. The sooner you call, the sooner we can help.
Call 832-779-5522You're in Experienced, Caring Hands
Every patient sees the same doctor — Dr. Maddipati. No rotating associates.
A dentist who chose public health first
Dr. Maddipati earned her Master of Public Health before her dental degree — an unusual path that shapes how she practices. Accessible, honest, kind. She accepts Medicaid because she means it.
Patients often tell her she's the first dentist who made them feel truly at ease. That's not an accident — it's the whole point.
Insurance, Medicaid & Payment Options
We verify your coverage before your visit. You'll know what to expect before you arrive.
Medicaid, CHIP & Medicare Advantage
We accept Texas Medicaid (STAR) for adults and CHIP for children¹. Many Medicare Advantage (Part C) dental plans are also welcome. Call us with your plan and we'll look it up before you come in.
PPO / Private Dental Insurance
Emergency exams and X-rays are typically covered by PPO plans at the same benefit rate as routine visits, subject to your deductible. Problem-focused visits are usually a separate benefit category from preventive² — using benefits for an emergency visit generally won't affect your remaining preventive allowance. We check your specific plan before every appointment.
Plans accepted: Aetna · Delta Dental · Cigna · MetLife · Guardian · Humana · United Healthcare · Texas Medicaid · CHIP · Medicare Advantage · CareCredit · Sunbit financing³
Coverage varies by plan. We verify your individual benefits before your appointment. CareCredit and Sunbit financing subject to lender approval.
¹ Texas Health and Human Services — Medicaid and CHIP dental benefits: hhs.texas.gov/services/health/medicaid-chip
² ADA Council on Dental Benefit Programs — problem-focused vs. preventive benefit categories: ada.org/resources/practice/dental-insurance
³ CareCredit and Sunbit are third-party financing providers subject to credit approval.
Last reviewed: 2026
References
- American Association of Endodontists — Recommended Guidelines for Avulsed Permanent Teeth. aae.org/specialty/clinical-resources/treatment-planning/traumatic-dental-injuries/
- International Association of Dental Traumatology — Guidelines for the Management of Traumatic Dental Injuries: 2. Avulsion of Permanent Teeth. iadt-dentaltrauma.org
- CDC — Injury Prevention & Control: sports-related dental injuries. cdc.gov/injury
- American Academy of Pediatric Dentistry — Management of Acute Dental Trauma in Primary and Young Permanent Dentition. aapd.org/research/policies--guidelines
Last reviewed: 2026