Knocked-Out Tooth Treatment
in Honolulu, HI
 A knocked-out tooth is a dental emergency, and knocked-out tooth treatment in Honolulu, HI works best within the first hour after the tooth comes out.
If a permanent tooth has been knocked out, call Pacific Maxillofacial Center at 808-585-8455 right away, pick the tooth up by the crown and not the root, and keep it moist. Our board-certified oral and maxillofacial surgeons treat dental trauma, and the faster we see you, the better the chance of saving the tooth.
A knocked-out, or avulsed, tooth can often be re-implanted when it is handled correctly and you reach us quickly. Our surgeons treat injuries like this as part of our oral surgery care, including the cases where a tooth cannot be saved and needs replacement.
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What to Do in the First 30 Minutes
Move fast. A knocked-out permanent tooth has its best chance when you act in the first few minutes, and you can do these steps on the way to us.
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Pick the tooth up by the crown – Hold it only by the white crown, never the root. Touching the root can damage the cells the tooth needs to reattach.
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Rinse it gently only if it is dirty – Use milk or saline for a few seconds. Do not scrub it, do not use tap water, and do not let it dry out or wrap it in tissue.
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Try to place it back in the socket – If you can, gently slide the tooth back into the socket the right way around and bite softly on a clean cloth to hold it. A tooth put back quickly has the best odds.
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If you cannot reinsert it, keep it moist – Store it in a cup of milk, or hold it inside your cheek if you will not swallow it. Saliva works if milk is not handy. Never store it in plain water.
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Call us and come straight in – Call Pacific Maxillofacial Center at 808-585-8455 on the way, and bring the tooth with you either way, even if some time has already passed. The first hour matters most, and if you cannot reach us, go to the nearest emergency room. |
Why Time Matters With a Knocked-Out Tooth
 A knocked-out tooth, or dental avulsion, means the whole tooth including the root has come out of the socket. The delicate ligament cells on the root start to die within roughly 30 to 60 minutes out of the mouth, which is why the first hour matters so much. A tooth re-implanted inside that window has a far better chance of reattaching than one that has been dry or out for hours.
Keeping the tooth in milk or saliva slows that cell loss and buys time. Even if hours have gone by, bring the tooth with you, because we can still check whether it or the socket can be treated. Acting quickly also protects the bone and gum around the empty socket, which matters whether we save the tooth or replace it.
Your Tooth Trauma Surgeon in Honolulu
Dr. Todd K. Haruki and Dr. Neil Oishi both hold DDS and MD degrees and are Diplomates of the American Board of Oral and Maxillofacial Surgery. A knocked-out tooth often comes with injury to the surrounding bone, gum, or lip, which is the type of facial injury an oral and maxillofacial surgeon is trained to handle, not just the tooth itself.
Dr. Oishi serves as an on-call facial trauma surgeon at Queen's Medical Center, where treating knocked-out teeth and other facial injuries is part of his regular work. That hospital trauma experience is exactly what you want behind an avulsion case.
Dr. Haruki founded Pacific Maxillofacial Center in 1999 and is a Fellow of the American Dental Society of Anesthesiology. If your injury needs more than a quick re-implantation, the in-office sedation his anesthesia training supports keeps a stressful visit comfortable. We offer the full range of sedation options without referring out.
What Happens at Our Office
When you arrive, we move quickly, and the exact treatment depends on the tooth, the socket, and how much time has passed.
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Rapid exam and CBCT scan – We check the tooth, the socket, and the surrounding bone, and take a cone beam CT scan to find any hidden fracture of the root or jaw. More on our imaging technology.
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Re-implantation and splinting – If the tooth is viable, we reposition it in the socket and splint it to the neighboring teeth for a couple of weeks while the ligament reattaches.
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Root canal follow-up – Most re-implanted adult teeth need a root canal soon after, because the nerve rarely survives the injury. We coordinate that with an endodontist as the tooth stabilizes.
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If the tooth cannot be saved – When the root is fractured or the tooth has been out too long, a clean tooth extraction is the safer path, under local anesthesia or sedation. In many cases we can place a same-day implant or graft the socket to keep it ready for one later.
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Follow-up and monitoring – We see you back to confirm the tooth or implant is settling and to watch for root resorption, a slow breakdown of the root that can follow re-implantation, over the months ahead. |
Why Choose Our Team for Tooth Trauma
 A knocked-out tooth is a time-sensitive injury, and where you go in the first hour affects what can be saved. We take trauma calls and work to see you fast at our Honolulu and Waipi'o offices.
A few specifics from our practice. Dr. Oishi's on-call trauma work at Queen's Medical Center means avulsion and facial injuries are familiar territory for our team, not a rare event. Both surgeons are dual-degree DDS/MD oral and maxillofacial surgeons, so we manage the bone and soft-tissue damage that often comes with a knocked-out tooth, not only the tooth. We CBCT-scan trauma cases to catch root and jaw fractures that don't show on the surface, and for severe injuries we also handle maxillofacial trauma reconstruction.
We coordinate with your regular dentist and, when a re-implanted tooth needs it, with an endodontist for the root canal, so your follow-up is organized rather than left for you to chase down.
Knocked-Out Tooth Cost and Insurance
Cost matters, and we want to be straight with you. Emergency trauma care is hard to quote in advance, because it depends on what the injury needs: re-implantation and splinting alone, a root canal, or removal and replacement if the tooth cannot be saved. We give you a clear estimate once we have examined the tooth and reviewed the CBCT scan.
Because a knocked-out tooth is an injury, part of the care may fall under medical coverage rather than dental, especially when other facial trauma is involved. Our team checks both your dental and any applicable medical benefits and explains what is covered. Our financial and insurance options cover accepted payment methods, and we can set up payment plans for the balance. Call our office to go over your coverage.
Get Emergency Care Now
A knocked-out tooth can't wait. Call us at 808-585-8455 right now and head our way with the tooth kept moist. Our Honolulu office is at 1060 Young St #312, Honolulu, HI 96814. Our Waipi'o office is at 94-1221 Ka Uka Blvd #B-204 in Waipahu, HI 96797. If it is after hours or you cannot reach us, go to the nearest emergency room. For non-urgent follow-up, you can request an appointment online or contact us.
Frequently Asked Questions
What should I do if my tooth gets knocked out?
The single biggest factors are speed and keeping the tooth moist, so call us and head in within the hour. The most common mistakes that ruin a tooth's chances are scrubbing it, rinsing it under tap water, letting it dry, or storing it in water. Handle it by the crown, keep it in milk, and if you are comfortable doing so, gently place it back in the socket on the way.
Can a knocked-out tooth be saved?
Often, yes. A tooth that goes back into the socket quickly and was kept moist has a good chance of reattaching. What lowers the odds is time spent dry, a cracked root, or heavy damage to the socket. Even when the original tooth cannot be saved, coming in fast still protects the bone for a replacement, so the visit is worth it either way.
How should I store the tooth on the way to the office?
Milk is the best easy option, because it keeps the root cells alive far better than water. Holding the tooth inside your cheek also works for an adult who will not swallow it, and saliva is a reasonable backup. Plain water is the one thing to avoid, since it actually damages the cells on the root.
Does putting the tooth back in hurt?
Re-implanting the tooth is usually quick, and we numb the area first, so it is more pressure than pain. For more involved injuries we can use sedation. Most of the soreness comes afterward and is manageable with over-the-counter pain medication and ice for a day or two.
What if my tooth cannot be saved?
We remove what is left cleanly and move to replacement. In many cases we can place a same-day implant, or place a bone graft in the socket to keep it ready for an implant once it heals. You are not left with a permanent gap, and we go over the options with you before doing anything.
Is a knocked-out baby tooth treated the same way?
No. A knocked-out baby tooth is usually not put back, because re-implanting it can damage the developing permanent tooth underneath. It is still worth a prompt visit so we can check the socket and the area for other injury, but the approach is different from an adult tooth.
Should I go to the ER or the dentist for a knocked-out tooth?
For the tooth itself, an oral surgeon or dentist is the better choice, since re-implantation is time-sensitive and specialized. Go to the emergency room first if there is heavy bleeding, a possible head injury, or you simply cannot reach a dental office quickly.
What is root resorption after a re-implanted tooth?
Root resorption is when the body slowly breaks down the root of a re-implanted tooth, sometimes months or years later. It does not always happen, but it is the main long-term risk after an avulsion, which is why we monitor the tooth at follow-up visits rather than treating re-implantation as the end of care. |
