Something has gone wrong.

The clock matters more here than anywhere else in dentistry.

1. Pick the tooth up by the crown — the chewing part. Do not touch the root.
2. If it is dirty, rinse it briefly in milk or saline. Do not scrub it, and do not use tap water for long.
3. If you can, push it straight back into the socket the right way round and bite gently on a clean cloth to hold it.
4. If you cannot, keep it in milk, or in saliva by holding it inside the cheek. Never in water, never dry, never in tissue.
5. Get to a dentist immediately. Reimplantation is time-critical.

A baby tooth is the exception — do not put a knocked-out baby tooth back in, as it can damage the adult tooth forming above it. Still get the child seen.

How urgent this is depends on whether the nerve is exposed.

1. Keep any fragment — in milk if it is a large piece.
2. Rinse gently with warm water.
3. If a sharp edge is cutting your tongue or cheek, orthodontic wax or sugar-free gum will cover it temporarily.
4. Avoid chewing on that side.
5. Call the practice and describe it. Sensitivity to air or cold usually means the inner layers are exposed and it should be seen sooner.

Pain that wakes you, or that lingers long after something hot or cold, tends to mean the nerve is involved.

1. Take over-the-counter pain relief as directed on the packet, and only if it is safe for you.
2. Do not hold aspirin against the gum. It burns the tissue and does not help the tooth.
3. Cold compress on the outside of the cheek, twenty minutes on, twenty off.
4. Sleep propped up — lying flat raises the pressure and the pain with it.
5. Call as early in the day as you can. Painkillers manage a toothache; they do not treat it.

Usually uncomfortable rather than urgent, but the tooth underneath is now unprotected.

1. Keep the crown if you still have it — it can often be re-cemented.
2. Clean the tooth gently and keep it clean.
3. Pharmacy temporary filling material can cover the gap for a few days.
4. Never use household glue.
5. Avoid chewing on that side and get it looked at before the tooth chips further.

Some ooze for a few hours is expected. Steady bleeding is not.

1. Roll clean gauze into a firm pad, place it over the socket and bite down hard for twenty minutes without checking it. Checking restarts the clock.
2. A damp black tea bag works in place of gauze — the tannins help.
3. Stay upright. No rinsing, no spitting, no straws, no smoking.
4. If it is still bleeding heavily after an hour of firm pressure, call the practice. Outside hours, go to an emergency department.

Common, and usually fixable at home.

1. Floss gently — take the floss out sideways rather than snapping it back up.
2. Rinse with warm salt water.
3. Do not use a pin, a knife, or anything metal. Gum damage is worse than the popcorn husk.
4. If it will not shift, or the gum is sore afterwards, book in.

Uncomfortable, rarely an emergency.

1. Orthodontic wax over the end of the wire will stop the ulceration.
2. A protruding wire can be gently tucked down with the eraser end of a pencil.
3. Do not cut a wire yourself unless it is choking you.
4. Contact whoever placed the appliance.