What To Do If a Permanent Tooth Gets Knocked Out in a Child Care Setting

As a child care provider, you know that accidents happen quickly. Falls, sports, or even rough play can sometimes lead to dental emergencies. One of the most urgent dental situations is when a permanent tooth gets knocked out (also called an avulsed tooth). Knowing exactly what to do in those first few minutes can make the difference between saving and losing the tooth.

At PediNurse LLC, we specialize in helping Massachusetts and Rhode Island child care centers stay prepared for medical and dental emergencies through health care consulting and training. Here’s what every provider should know.

Step 1: Stay Calm and Act Quickly

A knocked-out permanent tooth is a true emergency. The faster you respond, the higher the chance of saving the tooth. Ideally, the child should be seen by a dentist within 30 minutes.

Step 2: Find the Tooth and Handle It Properly

• Pick up the tooth by the crown (the white part you see in the mouth), not the root.

• Do not scrub, scrape, or touch the root.

• If dirty, gently rinse with milk or saline. Avoid soap or tap water if possible.

Step 3: Try to Reinsert the Tooth (If Appropriate)

If the child is alert, cooperative, and old enough, you may carefully place the tooth back into the socket. Have the child bite gently on gauze or a clean cloth to keep it in place.

Step 4: Keep the Tooth Moist

If reinsertion isn’t possible, place the tooth in one of the following:

• Cold milk (best option)

• Saliva (child can hold the tooth in their cheek if safe)

• Emergency tooth preservation kit (if available)

Never let the tooth dry out. Water is the least effective option but is better than nothing.

Step 5: Seek Immediate Dental Care

Call the child’s parent/guardian right away and direct them to a pediatric dentist or emergency dental clinic. Provide a written incident report per EEC regulations.

Why This Matters in Child Care Centers

Dental trauma can be frightening for both children and staff. Quick action is critical when a child loses a permanent tooth. With the right steps, you can help save the tooth and reduce long-term complications. Having a health care consultant ensures your center has:

• Emergency protocols in place

• Staff training in first aid and dental emergencies

• Guidance on meeting state child care regulations

At PediNurse LLC, we help centers prepare for situations just like this—so children stay safe, and staff feel confident in their response.

If your child care center in Massachusetts or Rhode Island needs a health care consultant to support your staff with training, emergency protocols, and compliance, visit www.pedinurseconsulting.com today.

Sources

• American Academy of Pediatric Dentistry. Policy on Management of Acute Dental Trauma. (2023).

• American Dental Association. Knocked Out Tooth: First Aid Tips. ADA.org.

• Centers for Disease Control and Prevention (CDC). Emergency Preparedness for Child Care Programs.