Short answer
- Medical safety comes first. Loss of consciousness, confusion, vomiting, difficulty breathing, heavy bleeding that does not stop, or a jaw that looks broken needs emergency medical care before dental care.
- A knocked out permanent tooth is the most time sensitive dental injury. Hold it by the crown only, rinse it briefly if dirty, and put it back in its socket if you can. If you cannot, keep it in milk or saliva and get to a dentist immediately.
- Never put a baby tooth back in. Replacing one can damage the permanent tooth developing underneath it. Still see a dentist promptly.
- Keep any broken fragment. Store the piece of a broken tooth in milk and take it to the dentist, who may be able to reattach it.
- A displaced or loosened tooth needs urgent dental care the same day, even when pain is mild at first.
- A mouthguard is the main prevention. The American Dental Association and the American Academy of Pediatric Dentistry recommend a comfortable, well fitting mouthguard for sports with a risk of a blow or fall to the face.
- A painless chip still needs a prompt dental appointment. A small chip can hide a crack or injury inside the tooth.
Introduction
A blow to the face during sport can chip a tooth, loosen it, push it out of place, or knock it out completely. It can also cut the lips and cheeks and injure the jaw. The American Academy of Pediatric Dentistry notes that all sporting activities carry some risk of injury to the mouth and face, because falls, collisions, contact with hard surfaces, and contact with sports equipment can all reach the teeth. Quick, calm action in the first minutes matters, especially for a permanent tooth that has been knocked out. Prevention matters just as much, because most of these injuries are easier to prevent than to repair.
This guide covers the common sports dental injuries, what to do on the field and on the way to care, how mouthguards help, and which signs mean urgent dental care or emergency medical care. It gives general first aid and prevention information only. It is not a substitute for urgent dental or medical care, and it does not diagnose an individual injury. If there is a head injury, heavy bleeding, difficulty breathing, or a suspected jaw fracture, seek emergency medical care first and treat the dental injury second.
The First Minutes: Check the Person Before the Tooth
Before looking for a tooth, check the person and stop play. Loss of consciousness, even briefly, confusion, vomiting, a severe headache, blurred or double vision, difficulty breathing, or a suspected neck injury all need emergency medical assessment, not a return to the game. Do not move a person with a possible neck injury unless they are in immediate danger.
Control bleeding from the lips, cheeks, or tongue with gentle pressure from clean gauze or a clean cloth. The American Dental Association advises cleaning a bitten lip or tongue gently with water and applying a cold compress. If bleeding does not slow after steady pressure, seek emergency care. Once the person is safe, note what happened and when. The dentist will ask, and timing affects what can be done for a knocked out tooth.
Common Sports Dental Injuries
Chipped and cracked teeth
A chipped tooth is one of the most common sports dental injuries. A small chip may be painless, or the tooth may feel sensitive to cold or biting. A cracked tooth can be harder to spot: the crack may not be visible, and pain may come and go when biting pressure is released. The American Academy of Pediatric Dentistry identifies crown fractures, breaks in the visible part of the tooth, as the most common injury to permanent teeth in sport. Most sports dental injuries involve the upper front teeth, because they sit forward in the mouth.
Loosened, moved, and pushed in teeth
A tooth can be loosened without coming out, pushed sideways, forward, or backward, or driven up into the gum so it looks shorter than its neighbors. Dentists call these luxation injuries. The tooth may bleed a little at the gum line, feel tender, or make the bite feel wrong. Do not wiggle the tooth to test it, and do not try to force a moved tooth back into line yourself. NHS guidance treats a displaced tooth as a dental emergency, because the root and surrounding bone may be damaged in ways that are not visible.
A knocked out tooth
A tooth knocked completely out of its socket is called an avulsed tooth. For a permanent tooth, this is the most time sensitive injury in this guide. It can sometimes be saved if handled correctly and dental care is reached quickly, ideally within the hour. A baby tooth is handled differently, as the baby teeth section below explains.
Cuts and jaw injuries
Teeth can cut the lips, cheeks, and tongue during impact, and braces can make these cuts worse. Most small cuts stop with gentle pressure. A deep cut, a cut through the lip, or bleeding that does not stop needs care the same day. Jaw pain, difficulty opening or closing the mouth, a bite that suddenly feels uneven, or a jaw that looks out of line can signal a jaw fracture or dislocation. Keep the jaw still, do not try to force it back into place, and seek emergency medical care.
What to Do for a Knocked Out Permanent Tooth
These steps follow the first aid guidance of the American Dental Association, the International Association of Dental Traumatology, and the NHS. They apply to a permanent tooth only.
- Find the tooth and pick it up by the crown. The crown is the white part normally visible in the mouth. Do not touch the root, the part that sat in the gum.
- If the tooth is dirty, rinse it briefly. Rinse it shortly with water, for no more than about 10 seconds, or rinse it gently in milk or saline. Do not scrub it, do not use soap or disinfectant, and do not remove tissue attached to the root. Those surface cells help the tooth reattach.
- Put the tooth back in its socket if you can. Ease it gently into place the right way around, matching the teeth on either side. Never force it. Then bite gently on clean gauze, a clean cloth, or a handkerchief to hold it in place. The International Association of Dental Traumatology advises replanting immediately if possible.
- If you cannot put it back, keep it moist at all times. Place it in a small container of cold milk. Saliva is the next option: the person can spit into a container, or an older child or adult who will not swallow the tooth can hold it inside the cheek. The American Dental Association gives the same options: between the cheek and gums, in milk, or in a tooth preservation product carrying the ADA Seal of Acceptance. Do not store the tooth in plain water, do not wrap it in dry tissue, and do not let it dry out. Young children should not hold a tooth in the cheek, because they may swallow it.
- Get to a dentist immediately. Phone ahead and say clearly that a permanent tooth has been knocked out. Take the tooth with you even if it looks damaged, and even if more time has passed than you hoped. A tooth that arrives later is still worth assessing.
At the clinic, the dentist will check the tooth position, usually with an X ray, and will typically splint it to the teeth on either side while it heals. NHS guidance describes splinting for about two weeks. Follow up visits matter, because a replanted tooth needs monitoring for changes in the root and nerve, and treatment of the inner tooth is sometimes needed later. Our guide to how long a root canal takes explains that kind of appointment.
What to Do for Other Dental Injuries
Chipped or broken tooth. Find any fragment, store it in milk, and take it to the dentist, because it can sometimes be reattached. The International Association of Dental Traumatology advises storing a broken piece in milk or water, not dry. Rinse the mouth gently with warm water, as the American Dental Association advises for a cracked tooth, and put a cold compress on the face to limit swelling. See a dentist during working hours for a painless chip, and the same day if the break is large, the inner tooth is visible, or pain is severe. NHS guidance agrees: a simple chip can wait until the practice is open, while a badly broken tooth may need inner tooth treatment.
Loosened or moved tooth. Leave it alone. Do not press on it, wiggle it, or try to straighten it. Eat nothing on that side, and seek urgent dental care the same day. The dentist can check the root and bone with an X ray, reposition the tooth if needed, and splint it while it settles.
Cuts inside the mouth. Rinse gently with water, press a clean cloth or gauze against the cut, and use a cold compress outside the cheek or lip. Seek care the same day if bleeding does not stop or the cut is deep or gaping. If debris is caught between the teeth, remove it gently with dental floss and never with a sharp or pointed tool. Do not place aspirin directly on an aching tooth or the gum, because it can burn the tissue.
Baby Teeth Are Different: Never Put One Back
A knocked out baby tooth, also called a primary tooth, must not be put back in its socket. The International Association of Dental Traumatology states that a primary tooth should not be replaced once knocked out, and NHS guidance gives the reason: putting it back could damage the permanent tooth growing underneath it.
Instead, control bleeding with gentle pressure, comfort the child, and see a dentist promptly so the dentist can check that no fragment remains and that the developing permanent tooth has not been injured. The permanent teeth sit very close to the roots of the baby teeth, which is why these injuries always deserve a check even when the child settles quickly. For background, see our explainer on children’s dentistry and gentle care for young children.
If you cannot tell whether the tooth is a baby tooth or a permanent tooth, do not guess and do not reinsert it. Keep it in milk or in saliva collected in a container, and get urgent dental advice so the dentist can identify it.
Mouthguards: How They Protect the Mouth
A mouthguard, also called a mouth protector, is a resilient device worn over the teeth, usually the upper teeth. The American Dental Association explains that mouthguards cushion a blow to the face, minimizing the risk of broken teeth and injuries to the lips, tongue, face, and jaw. The American Academy of Pediatric Dentistry describes the same job in more detail: a mouthguard is constructed to protect the lips and inner tissues from bruising and cuts, to protect the teeth from fractures, loosening, displacement, and being knocked out, and to protect the jaw from fracture and dislocation.
A guard works by absorbing and spreading impact force rather than letting one tooth take the full blow, and by keeping a barrier between the teeth and the soft tissues. The American Academy of Pediatric Dentistry notes that mandatory protective equipment significantly reduces dental and facial injuries, and that helmets, face masks, and mouthguards reduce both how often these injuries happen and how severe they are. Injuries can still occur with a guard in place, so a guard lowers risk rather than removing it.
The Three Types of Mouthguard
There are three broad types, described in general terms by the American Dental Association, the American Academy of Pediatric Dentistry, and NHS guidance. The best guard is the one that fits well enough to be worn for every practice and every game.
| Type | How it is made | Strengths | Limits |
|---|---|---|---|
| Stock | Ready made in standard sizes | Lowest cost, available immediately | Cannot be adjusted, often bulky, can impair breathing and speech, stays in place only while the mouth is closed |
| Boil and bite (mouth formed) | Softened in hot water, then shaped to the teeth at home | Better fit than stock, widely available, moderate cost | Can wear quickly, can be hard to fit around braces |
| Custom made | Made by a dentist from an impression of the teeth | Most protection and comfort, least effect on speech and breathing | Highest cost of the three |
The American Dental Association states that the best mouthguard is one custom made by your dentist, and that if a custom guard is not affordable, a stock or boil and bite guard should still be worn rather than nothing. NHS guidance agrees that shop bought guards are better than no guard, while offering less protection than a custom made guard. For a boil and bite guard, always follow the manufacturer instructions, because a poorly shaped guard loses much of its value. Joint guidance from the Academy for Sports Dentistry, the American Academy of Pediatric Dentistry, and partner associations, including the American Dental Association, is that guards should be comfortable, well fitted, not restrict breathing, resist tearing, and be easy to clean.
A sports mouthguard is not the same device as a night guard worn for teeth grinding, and a night guard should not be treated as sports protection. If grinding is the issue you are researching, our separate explainer on a gum shield for bruxism covers that different use.
Mouthguards for Braces, Children, and Higher Risk Mouths
A properly fitted mouthguard may be especially important for people who wear braces or fixed bridge work. The American Dental Association explains that a blow could damage brackets or other fixed appliances, and that a guard provides a barrier between the braces and the cheek or lips. Do not wear a removable retainer during contact sports. Athletes with braces need a guard with room for brackets, wires, and tooth movement during treatment, so ask the treating orthodontist which style suits the appliance rather than forcing a standard guard over it. Our guide to orthodontics for teens explains how braces and aligners differ, which helps when planning sports protection during treatment.
Children and teens need guards checked more often, because their mouths are still growing and changing. The American Academy of Pediatric Dentistry also notes that some mouths are at higher risk: children with a pronounced overjet, where the upper front teeth sit well forward, and children whose lips do not cover the front teeth fully, face a higher frequency of dental trauma. Those athletes gain the most from a well fitting guard worn every time.
Caring for a Mouthguard and Knowing When to Replace It
Rinse the guard before and after each use, or brush it with a toothbrush and toothpaste. The American Dental Association advises cleaning it regularly in cool, soapy water, storing it in a sturdy vented container so it can dry, and never leaving it in the sun or in hot water, which can warp it. The American Academy of Pediatric Dentistry adds: do not chew on the guard, and replace it when it shows signs of wear and tear. Bring it to dental checkups so the dentist can check its fit.
Replace a guard immediately if it is torn, cracked, bitten through, loose, or no longer covers the teeth properly. A guard that must be clenched in place will be out of position at the moment of impact, and it makes breathing and speaking harder.
Prevention Beyond the Mouthguard
Helmets and face masks reduce the frequency and severity of dental and facial injuries in the sports that use them, and they work alongside a guard rather than replacing it. Follow the rules of the sport, because many dental injuries come from player to player contact, sticks, elbows, and falls onto hard surfaces rather than from the ball itself.
Coaches and parents can prepare before the season starts. The American Academy of Pediatric Dentistry encourages coaches and administrators to consult a dentist with expertise in facial injuries before practices begin, for recommendations on the immediate management of injuries such as a knocked out tooth. A simple sideline plan helps: know the steps for a knocked out permanent tooth, keep clean gauze and a small container available so a tooth can be stored in milk, and know which dental clinic to phone. Our article on sports dental trauma and what contact sport does to teeth shows what is at stake in a well known case.
The sports involved are wider than many families expect. The American Dental Association notes that while contact sports such as boxing are higher risk, a dental injury can also happen in non contact activities such as gymnastics and skating. Football, hockey, lacrosse, basketball, martial arts, baseball, soccer, cycling, and skateboarding all appear in association guidance on mouthguard use. If a ball, an elbow, a stick, or the ground can reach the face, a guard belongs in the kit.
When to Seek Urgent Care
Get emergency medical care now
Call emergency services or go to an emergency department for any of the following after a blow to the face or head: loss of consciousness, confusion, repeated vomiting, a worsening headache, blurred or double vision, difficulty breathing or swallowing, quickly spreading swelling, heavy bleeding that does not stop with steady pressure, a suspected broken or dislocated jaw, an inability to open or close the mouth, or a bite that suddenly will not meet. Dental treatment waits until medical safety is established.
Get urgent dental care the same day, immediately for a knocked out tooth
Contact a dentist immediately, and say what has happened, for a knocked out permanent tooth, a tooth pushed out of place or driven into the gum, a very loose tooth, uncontrolled bleeding from the mouth, severe tooth pain, a large break with the inner tooth visible, or swelling of the gum, face, or jaw. If your own dentist is closed, use the practice emergency instructions or an urgent dental service. NHS guidance treats a knocked out or displaced tooth as a dental emergency. Speed matters most for the knocked out tooth, because the sooner it is replanted, the more likely it is to reattach.
Book a prompt dental appointment
A small painless chip, a crack that only twinges with cold, a minor cut that stopped bleeding quickly, and a mouthguard damaged in play all still deserve a prompt appointment. A small chip can hide a crack or nerve damage, and a tooth that took a heavy blow should be recorded and monitored even when it looks normal. If pain, swelling, discoloration, or a small bump on the gum appears days or weeks later, contact the dentist again rather than waiting for a routine visit.
This article gives general information only. For personal advice about an injury, talk with your own dentist or doctor, who can examine the tooth and take an X ray.
Frequently Asked Questions
Should a knocked out tooth be put back in by a coach or parent?
Yes, for a permanent tooth, if the person is cooperative and it can be done gently without force. Hold the tooth only by the crown, ease it back in, and bite gently on clean gauze. If there is any doubt, if the person is a young child, or if there is a head injury, do not force it. Keep the tooth in milk and get urgent dental care. Never reinsert a baby tooth.
How long do I have to save a knocked out permanent tooth?
As little time as possible. The sooner it is replanted, the more likely it is to reattach, and dental guidance treats the first hour as the critical window, with immediate replanting best of all. Do not give up on a tooth because an hour has passed, though. Keep it in milk and let the dentist assess it.
Does a mouthguard prevent concussion?
A mouthguard is designed to protect the teeth, gums, lips, cheeks, and jaw. It should not be relied on as concussion protection, and it does not replace a helmet, safe technique, or the rules of the game. Anyone with concussion symptoms after a blow to the head, such as headache, confusion, dizziness, or vomiting, needs medical assessment even if they were wearing a guard.
What if I cannot find the knocked out tooth?
Still seek urgent dental care. The dentist will check whether a fragment remains in the socket, whether the tooth was pushed into the gum rather than lost, and whether a fragment is embedded in any cut. Options for the gap can be discussed once healing is underway.
Can a chipped tooth wait until next week?
A small, painless chip can usually wait until the dental practice is open, which is the position NHS guidance takes, but it should not be left indefinitely. Book a prompt appointment, keep any fragment in milk, and call sooner if pain starts, sensitivity lingers, the gum swells, or the tooth changes color, because those changes can mean the inner tooth is injured.
My child knocked out a baby tooth. Is that an emergency?
It needs a prompt dental check, but the tooth itself is not put back. Never reinsert a baby tooth, because doing so can damage the permanent tooth developing underneath. Control bleeding with gentle pressure, keep the child comfortable, and contact a dentist the same day so the mouth and developing teeth can be checked.
Should a mouthguard be worn in practice as well as in games?
Yes. Injuries happen in practice as well as in competition, and surveillance data reviewed by the American Academy of Pediatric Dentistry found large numbers of head and face injuries during practice. A guard only protects when worn, so wear it for every session where contact or a fall is possible.
Sources & references
- American Dental Association, MouthHealthy, Dental Emergencies. Keeping a knocked out permanent tooth moist at all times, placing it back in the socket without touching the root or storing it between the cheek and gums or in milk, getting to a dentist right away, warm water rinsing and cold compresses for a cracked tooth, gentle cleaning and a cold compress for a bitten lip or tongue, floss for objects stuck in the mouth, and wearing a mouthguard for sports and recreational activities.
- American Dental Association, MouthHealthy, Mouthguards. Mouthguards cushioning a blow to the face and minimizing the risk of broken teeth and injuries to the lips, tongue, face, and jaw, typical coverage of the upper teeth, risk in non contact activities such as gymnastics and skating, the three types (custom made, boil and bite, and stock) and their fit trade offs, protection for braces, and care, vented storage, and replacement guidance including more frequent replacement for growing children and teens.
- American Academy of Pediatric Dentistry, Policy on Prevention of Sports Related Orofacial Injuries, Reference Manual of Pediatric Dentistry, latest revision 2023, cited from the 2025 manual. Risk of facial injury in all sporting activities, significant reduction from mandatory protective equipment, helmets, face masks, and mouthguards reducing frequency and severity, crown fractures as the most common injury to permanent teeth, higher risk with increased overjet and inadequate lip coverage, the protective functions of a mouthguard, and the recommendation that coaches consult a dentist before the season on immediate management of injuries such as avulsed teeth.
- American Academy of Pediatric Dentistry with the Academy for Sports Dentistry and partner associations, Choosing the Mouth Guard That Is Right for Your Sport and Recreational Activities. Joint recommendation that children and adults in organized sports and recreational activities wear comfortable, well fitted mouthguards that do not restrict breathing, resist tearing, and are easy to clean, the three types with their advantages and disadvantages, and care advice including cool soapy water washing and replacement when worn.
- NHS Inform (NHS Scotland), Broken or Knocked Out Tooth. A knocked out or displaced tooth as a dental emergency, the crown handling and reinsertion sequence for an adult tooth, never reinserting a baby tooth because of the risk to the adult tooth underneath, storing a tooth or fragment in milk, splinting to the teeth on either side for about two weeks, a simple chip as non urgent but needing an appointment, and mouthguard protection for sports with custom made guards offering the most comfort and retention.
- International Association of Dental Traumatology, Prevention and Emergency Care (public guidance). A primary tooth should not be replaced once knocked out, holding a permanent tooth by the crown (the white part) and not the root, rinsing shortly with water if dirty, replanting immediately if possible, biting on a handkerchief to hold the tooth, storing in a cup of milk or saline or inside the cheek when replanting is not possible, seeking specialized dental treatment immediately, and storing a broken fragment in milk or water rather than dry.
