Having a tooth pulled when it’s not loose isn’t much fun, but sometimes it is a necessity for your child. It is important, however, for parents to understand when tooth extractions are a good idea, and how you can help prepare your child for the experience at the pediatric dentist.

When Dentists Recommend Tooth Extractions

Children are supposed to lose their first set of teeth (primary teeth, sometimes called “baby teeth”), which usually happens around elementary school age, and a tooth won’t loosen and come out naturally until the permanent tooth below pushes through the gums. However, some children have issues that might require a dentist to pull teeth before the permanent tooth is ready to erupt. The most common reasons are:

• Extreme decay that cannot be fixed with a filling or root canal
• Overcrowding that might cause problems in jaw development
• A fractured or broken tooth that is too damaged to repair
• To prepare for braces

Most pediatric dentists will only recommend a tooth extraction as a last resort when other treatment options won’t work. Being too quick to extract a tooth can cause problems with a child’s speech, chewing, and development, so talk to the dentist about other choices whenever possible. In addition, if your dentist must remove baby teeth as the result of trauma or decay, make sure they place a space maintainer that will allow permanent teeth to properly erupt when they are ready. Otherwise existing baby teeth can shift out of place and cause problems when permanent teeth are ready to grow in as your child gets older.

Preparing a Child for Tooth Extractions

There are two different options for an extraction:

• A simple extraction, where the tooth is visible above the gum line, which can be performed at a pediatric dentist’s office using a local anesthetic
• A more complex extraction that requires nitrous oxide or IV sedation

Depending on your pediatric dentist’s capabilities, you may need to work with an oral surgeon in the latter case.

For all types of extractions, it’s a good idea to do what you can to prepare your child for the procedure. The problem for most parents is that they aren’t sure how to do that in a way that won’t scare their child. In many cases it’s better to take your child to a pediatric dentist, or talk to the staff at your dentist’s office, to find out how you can talk about it effectively so there are no surprises but also so you can avoid causing the child too much anxiety ahead of the visit.

Proper Post-Op Care

The final step in tooth extraction is post-operative care. Your child may be in some pain, and the dentist can prescribe pain medication or recommend an over-the-counter option. It’s important to keep gauze on the surgical area until the bleeding stops, and have them rest with their head elevated and avoid unnecessary activity until the blood clots and a scar forms. Feed them soft foods high in nutrients (not just ice cream) for a few days following the procedure, and make sure they’re drinking plenty of water.

If you think your child’s teeth might need to be extracted, schedule an appointment with Walker Pediatric Dentistry to find out what options are available.