Skip to main content
Dr. Kalibat Joins MFE!Dr. Guanche Joins MFE!Lake Nona Office: Now OpenDr. Berrios Joins MFE!Dr. Chavarriaga Joins MFE!
Dental Trauma

Tooth Injury from Sports: What to Do

Mid-Florida Endodontics 8 min read Medically reviewed by Dr. Hamza Mir, DMD, MS Updated September 29, 2026

Direct answer

For a knocked-out permanent tooth, hold it by the crown, not the root, rinse gently if dirty, try reinserting it, and reach an endodontist within 30 minutes. The longer it stays dry, especially past 60 minutes, the lower its chance of healing normally. For loose, shifted, or cracked teeth, keep it still and get same-day care.

Dental injuries in sports are more common than most athletes and parents realize. Sports-related dental trauma accounts for a meaningful share of all dental injuries, and unlike many other injuries, the window for the most successful treatment is measured in minutes, not days.1 The American Association of Endodontists advises reaching a dentist or endodontist within 30 minutes4, and in a long-term study of 400 replanted teeth, the risk of the root fusing to the bone rose steadily with dry time, reaching 86% for fully formed teeth left dry more than 60 minutes, though some still healed.5

Knowing exactly what to do in the first moments after a dental sports injury can be the difference between saving a tooth and losing it permanently.

Knocked-Out Permanent Tooth. Act Quickly

1
Find the tooth immediately. Pick it up by the crown (the white part you chew with), never touch the root. The periodontal ligament (the thin layer of fibers connecting the tooth root to the jawbone, which acts as a shock absorber and contains pressure-sensitive nerve fibers) fibers on the root are critical for reattachment and are easily damaged.1
2
Rinse gently if dirty, with saline, milk, or clean water for a few seconds. Do not scrub, wipe, or use soap. Do not let the root dry out.2
3
Reinsert into the socket if possible. Gently push the tooth back into position and have the patient bite on a clean cloth to hold it. This is the best storage medium. Do not force it.2
4
If reinsertion isn’t possible, store the tooth in milk (best available option), the patient’s own saliva (hold in cheek), or saline. Do not store in water or let it dry. Time spent dry outside the socket is the most critical factor in outcome.1
5
Get to an endodontist or dentist immediately. Call ahead so they can prepare. The sooner the tooth is back in place, the better the prognosis; immediate replantation gives the supporting ligament cells the best chance to survive and reattach.1

Types of Sports Dental Injuries and What to Do

Emergency. Act Immediately

Avulsion (Completely Knocked-Out Tooth)

The entire tooth including root is displaced from the socket. Only occurs with permanent teeth, primary (baby) teeth are NOT replanted as this can damage developing adult teeth. Follow the emergency protocol above. Root canal treatment is almost always required after replantation.2

Tooth Injury from Sports: What to Do - Sports bag tooth rescue kit
Immediate actionReinsert in socket or store in milk. Call endodontist immediately. Every minute counts.
Emergency. Same Day

Intrusion (Tooth Pushed Into the Bone)

A tooth pushed upward into the socket by impact, appears shorter than neighbors. One of the most serious dental injuries. Requires urgent specialist evaluation. Depending on severity and patient age, treatment may involve allowing spontaneous re-eruption, orthodontic repositioning, or surgical repositioning, followed by root canal treatment.2

Immediate actionDo not attempt to reposition. Seek same-day endodontic evaluation. 3D CBCT (cone-beam CT, a low-dose 3D X-ray that lets us see the tooth and bone from every angle) imaging required to assess root and bone damage.
Same-Day Evaluation

Luxation (Tooth Loosened or Displaced)

The tooth is still in the socket but has been loosened, tilted, or moved laterally. The periodontal ligament has been partially torn and the pulp (the soft living tissue inside the tooth, containing nerves and blood vessels) may be compromised. Treatment involves repositioning and splinting (bonding to adjacent teeth for stability). Root canal treatment may or may not be needed depending on pulp response over time.2

Immediate actionDo not wiggle or attempt to reposition. Avoid biting on the tooth. Seek same-day evaluation. Take medications as recommended by your provider for pain.
Same-Day Evaluation

Tooth Injury from Sports: What to Do - Abscess tooth root lesion clean

Crown Fracture with Pulp Exposure

A broken tooth where the pink pulp tissue is visible at the fracture site. Urgent evaluation is needed, the exposed pulp is vulnerable to infection. In appropriate cases, pulp capping may preserve pulp vitality (whether the living tissue inside the tooth is still healthy and functioning). Root canal treatment is often required. A permanent crown will be needed once pulp status is confirmed stable.2

Immediate actionDo not touch the exposed pulp. Keep the area as clean as possible. Seek same-day evaluation. Save any broken tooth fragments and bring to the appointment.
Prompt Evaluation (Soon After Injury)

Uncomplicated Crown Fracture (No Pulp Exposure)

A chip or fracture of enamel (the hard outer shell of the tooth, the hardest substance in the human body) and dentin (the layer of tooth beneath the hard enamel, softer and more sensitive, containing microscopic channels that connect to the nerve) without visible pulp exposure. Less urgent but still requires evaluation, the fracture may be deeper than it appears, and exposed dentin is sensitive and vulnerable to bacterial infiltration. Treatment typically involves bonding or a crown; root canal treatment may be needed if the pulp becomes inflamed over time.2

Immediate actionSave any tooth fragments. Seek evaluation promptly. Monitor for developing sensitivity or pain.
Monitor and Evaluate

Concussion (No Movement, Tender to Touch)

The tooth has been jarred by impact but not displaced. It may be sore to bite or touch but is firm in the socket. No immediate intervention typically needed, but the tooth should be monitored for pulp changes over the following weeks to months, some concussed teeth develop pulp necrosis (death of the living tissue inside the tooth) gradually even without initial displacement.2

Immediate actionSoft diet. Avoid biting hard foods on affected tooth. Follow up with dentist within a week and again a few weeks later for pulp vitality assessment.

Preventing Sports Dental Injuries

Custom MouthguardA professionally made, custom-fitted mouthguard provides significantly better protection than over-the-counter boil-and-bite versions. It cushions impact and distributes force away from individual teeth. A systematic review of contact-sport athletes found that mouthguard wearers had a much lower rate of dental and bony injuries than non-wearers.3 Ask your general dentist about a custom mouthguard if you or your child plays contact sports.
Helmets and Face ShieldsFor high-impact sports, a helmet with a face shield or cage prevents the most severe facial and dental trauma. Many youth sports require these, adults should use them voluntarily in applicable sports.
Know Your RiskBasketball, soccer, baseball, and martial arts are among the higher-risk sports for dental trauma, not just contact sports like football and hockey. Any sport involving balls, sticks, or collisions carries dental injury risk.
Have a PlanCoaches, trainers, and parents should know the basics of dental first aid, particularly the knocked-out tooth protocol. A “tooth rescue kit” containing save-a-tooth solution can be kept in sports bags for fast access at the field.
Clinical Evidence
Replantation timing is the strongest predictor of avulsed tooth (a tooth that has been completely knocked out of its socket) survival. In a study of 400 avulsed and replanted permanent incisors published in Endodontics & Dental Traumatology, the length of the dry extra-alveolar storage period and immediate replantation were among the factors most strongly related to healing of the periodontal ligament, and the authors recommended immediate replantation in every case.1 The current International Association of Dental Traumatology guidelines build on this evidence, advising rapid replantation when possible and storage in milk, saliva, or saline rather than water when it is not.2 These findings are why fast, calm first aid at the field matters so much: the supporting ligament cells stay viable only while the root is kept moist and out of the socket for as short a time as possible.1

If symptoms escalate, emergency root canal treatment is available at most MFE locations.

Tooth Injury from Sports: What to Do - Antibiotics tooth infection medication bottle

Related reading: when dental trauma requires root canal treatment | what happens if you crack a tooth | how endodontists diagnose tooth pain after an injury

Dental trauma moves fast. Your nearest MFE location offers same-day emergency evaluations for tooth injuries. Call ahead so they are ready for you. Find a location near you.
Reviewed by the Endodontic Specialists at Mid-Florida Endodontics
American Association of Endodontists members serving Florida since 2006.

Works Cited

Sources are peer-reviewed clinical research and consensus guidelines on traumatic dental injuries.
  1. Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM. Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing. Endod Dent Traumatol. 1995;11(2):76-89. doi:10.1111/j.1600-9657.1995.tb00464.x Prospective Study
  2. DiAngelis AJ, Andreasen JO, Ebeleseder KA, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012;28(1):2-12. doi:10.1111/j.1600-9657.2011.01103.x
  3. Fernandes LM, Neto JCL, Lima TFR, et al. The use of mouthguards and prevalence of dento-alveolar trauma among athletes: a systematic review and meta-analysis. Dent Traumatol. 2019;35(1):54-72. doi:10.1111/edt.12441 Systematic Review
  4. American Association of Endodontists. Knocked-Out Teeth. Accessed September 28, 2026. aae.org
  5. Lauridsen E, Andreasen JO, Bouaziz O, Andersson L. Risk of ankylosis of 400 avulsed and replanted human teeth in relation to length of dry storage: a re-evaluation of a long-term clinical study. Dent Traumatol. 2020;36(2):108-116. doi:10.1111/edt.12520 Prospective Study

Frequently asked questions

Can a knocked-out tooth be saved if it's been out for an hour?

It depends on how the tooth was stored during that hour. A tooth kept moist in milk throughout has much better prospects than one kept dry in a paper towel. The periodontal ligament cells on the root surface begin dying within minutes of drying out, but survive much longer in appropriate storage media. Even with compromised cells, replantation may still be attempted, though long-term outcomes are less predictable. Get to an endodontist as fast as possible regardless.

My child knocked out a baby tooth during sports. Should I replant it?

No. Baby teeth (primary teeth) should not be replanted after avulsion. Reinserting a primary tooth into the socket risks damaging the developing permanent tooth bud beneath. Seek evaluation to assess any other injuries and to plan for eventual space maintenance if needed.

A tooth was knocked loose but not out. Does it need a root canal?

Not necessarily immediately. Luxated (loosened) teeth are splinted and monitored. The pulp may recover on its own in some cases, particularly in younger patients, or it may gradually become necrotic (dead: referring to tissue that has lost its blood supply and died, most commonly the pulp inside an infected tooth) over weeks to months, at which point root canal treatment is initiated. Regular follow-up with your endodontic specialist is essential after any dental luxation (when a tooth is displaced or pushed out of its normal position by an impact, but not fully knocked out) injury.

How does Mid-Florida Endodontics handle dental trauma emergencies?

We accommodate same-day emergency appointments for dental trauma at multiple locations across Florida. Call us immediately after a dental injury: describe what happened and we will prepare for your arrival. For knocked-out teeth, start the replantation protocol described above while calling us simultaneously.

Keep reading.

How Dentists Treat Fractured Teeth How do dentists treat fractured teeth? Treatment depends on fracture type and depth, from bonding to root cana… What Happens If You Crack a Tooth? What happens if you crack a tooth? The outcome depends on crack depth and location. Learn the progression, tre… When Dental Trauma Requires a Root Canal Does dental trauma always require a root canal? Not immediately, but many traumatized teeth develop pulp necro…

Care close to home

Think your tooth is cracked or injured?

Early evaluation makes all the difference for traumatic dental injuries. See an endodontic specialist fast.

Get an Evaluation Meet Our Doctors
Get an Evaluation Meet Our Doctors